Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Unit of Therapeutic Patient Education, WHO Collaborating Centre, Geneva University Hospitals, Geneva, Switzerland.
Front Endocrinol (Lausanne). 2024 Aug 7;15:1380525. doi: 10.3389/fendo.2024.1380525. eCollection 2024.
Adherence to therapeutic footwear is vital for effective diabetic foot ulcer prevention and treatment. Understanding the key adherence factors and potential barriers is important for footwear design and implementation. Our team is creating intelligent offloading footwear to prevent lower extremity amputations in people living with diabetes (PLwD). This exploratory study assessed the ability of the established Unified Theory of Acceptance and Use of Technology (UTAUT) model to predict behavioral intention to use or recommend this intelligent offloading footwear by PLwD, caregivers of PLwD, or medical professionals treating PLwD.
Online and paper questionnaires were implemented to assess the impact of the UTAUT model factors (performance expectancy, effort expectancy, social influence, facilitating conditions) and psychosocial factors (attitude, anxiety, self-efficacy) on the overall behavioral intention to use the footwear. Furthermore, factors influencing potential acceptance and rejection of the footwear were explored.
Patients (4.0/5) and medical professionals (4.1/5) showed a behavioral intention to "agree" to use or recommend the footwear when it becomes available. Structural equation modeling showed that the UTAUT constructed model may not be the best indicator for behavioral intention here based on a lack of statistical significance. However, the logistic regression modeling showed that the social influence for PLwD (p=0.004) and the attitude toward the footwear for medical professionals (p=0.001) may be the most important when designing and implementing the footwear, though several other factors (performance expectancy, effort expectancy, facilitating conditions, and self-efficacy) were also important for one or both of these populations. Additionally, cost and clinician support were shown to be important factors influencing potential acceptance of the footwear.
The study found promising intention to use the intelligent footwear in the future. This highlights the need to continue future development and implementation of the footwear to incorporate these results, thus improving the likelihood of high adherence of the footwear.
治疗性鞋具的依从性对于有效预防和治疗糖尿病足溃疡至关重要。了解关键的依从因素和潜在障碍对于鞋具设计和实施非常重要。我们的团队正在开发智能减压鞋，以预防糖尿病患者（PLwD）下肢截肢。这项探索性研究评估了既定的接受和使用技术的统一理论（UTAUT）模型预测 PLwD、PLwD 的照顾者或治疗 PLwD 的医疗专业人员使用或推荐这种智能减压鞋的行为意图的能力。
实施在线和纸质问卷，以评估 UTAUT 模型因素（绩效预期、努力预期、社会影响、促进条件）和心理社会因素（态度、焦虑、自我效能）对使用鞋具的总体行为意图的影响。此外，还探讨了影响鞋具潜在接受和拒绝的因素。
患者（4.0/5）和医疗专业人员（4.1/5）在鞋具可用时表现出“同意”使用或推荐鞋具的行为意图。结构方程模型显示，基于缺乏统计学意义，UTAUT 构建模型可能不是这里行为意图的最佳指标。然而，逻辑回归模型显示，社会影响对 PLwD（p=0.004）和对医疗专业人员的鞋具态度（p=0.001）可能是设计和实施鞋具时最重要的因素，尽管其他几个因素（绩效预期、努力预期、促进条件和自我效能）对这两个群体中的一个或两个群体也很重要。此外，成本和临床医生的支持被证明是影响鞋具接受度的重要因素。
该研究发现未来使用智能鞋具的意图很有前景。这突出表明需要继续进行鞋具的未来开发和实施，以纳入这些结果，从而提高鞋具高依从性的可能性。
