School of Health and Human Sciences, Southern Cross University, Bilinga, Queensland, Australia.
School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia.
PLoS One. 2019 Feb 21;14(2):e0211140. doi: 10.1371/journal.pone.0211140. eCollection 2019.
Few studies have investigated if people at risk of foot ulceration actually wear the footwear recommended by best practice guidelines to prevent foot ulceration. This study aimed to investigate the prevalence of, and factors associated with, wearing inadequate outdoor footwear in those with diabetes or peripheral neuropathy in an inpatient population.
This was a secondary analysis of a multi-site cross-sectional study investigating foot conditions in a large representative inpatient population admitted into hospital for any medical reason on one day. A range of explanatory variables were collected from all participants including sociodemographic, medical and foot condition factors. The outcome variable for this study was the self-reported outdoor footwear type worn most by participants outside the house in the year prior to hospitalisation. The self-reported footwear type was then categorised into adequate and inadequate according to footwear features recommended in guidelines for populations at risk of foot ulceration. Logistic regression identified factors independently associated with inadequate footwear in all inpatient participants, and diabetes and neuropathy subgroups.
Overall, 47% of a total of 726 inpatients wore inadequate outdoor footwear; 49% of the 171 in the diabetes subgroup and 43% of 159 in the neuropathy subgroup. Wearing inadequate outdoor footwear was independently associated (Odds Ratio (95% Confidence Interval)) with being female in the diabetes (2.7 (1.4-5.2)) and neuropathy subgroups (3.7 (1.8-7.9)) and being female (5.1 (3.7-7.1)), having critical peripheral arterial disease (2.5 (1.1-5.9)) and an amputation (0.3 (0.1-0.7)) in all inpatients (all, p<0.05).
Almost half of all inpatients at risk of foot ulceration reported wearing outdoor footwear most of the time that did not meet recommendations for prevention. We found women were much more likely to wear inadequate footwear. More work needs to be done to increase the uptake of footwear recommendations in these populations to prevent foot ulceration.
很少有研究调查过患有足部溃疡风险的人是否真正穿着最佳实践指南推荐的预防足部溃疡的鞋子。本研究旨在调查住院人群中糖尿病或周围神经病变患者穿着不合适户外鞋的流行率和相关因素。
这是一项多地点横断面研究的二次分析，该研究调查了某一天因任何医疗原因住院的大型代表性住院人群的足部状况。从所有参与者中收集了一系列解释变量，包括社会人口统计学、医学和足部状况因素。本研究的因变量是参与者在住院前一年在户外家中最常穿的自我报告的户外鞋类型。根据指南中针对足部溃疡风险人群的鞋类特征，将自我报告的鞋类类型分为合适和不合适。逻辑回归确定了所有住院患者以及糖尿病和神经病变亚组中与不合适鞋类相关的独立因素。
总体而言，726 名住院患者中有 47%穿着不合适的户外鞋；171 名糖尿病患者中有 49%，159 名神经病变患者中有 43%。在糖尿病（2.7（1.4-5.2）和神经病变（3.7（1.8-7.9））亚组以及所有住院患者中（均为 p<0.05），女性、严重外周动脉疾病（2.5（1.1-5.9））和截肢（0.3（0.1-0.7））与穿着不合适的户外鞋独立相关。
几乎一半的患有足部溃疡风险的住院患者报告称，他们经常穿着不符合预防建议的户外鞋。我们发现女性更有可能穿着不合适的鞋子。需要做更多的工作来提高这些人群对鞋类建议的接受度，以预防足部溃疡。
