矫形鞋类的医学观点、信念及处方：一项针对荷兰骨科医生和康复从业者的调查

Medical opinions, beliefs and prescription of orthopaedic footwear: a survey of Dutch orthopaedists and rehabilitation practitioners.

作者信息

Boer H, Seydel E R

机构信息

Department of Psychology, University of Twente, Enschede, The Netherlands.

出版信息

Clin Rehabil. 1998 Jun;12(3):245-53. doi: 10.1191/026921598673747905.

DOI:10.1191/026921598673747905

PMID:9688041

Abstract

OBJECTIVES

To get insight into medical opinions about the use of orthopaedic footwear and the medical and social factors related to the prescription of orthopaedic footwear by orthopaedists and rehabilitation practitioners.

METHODS

In this study 85 orthopaedists and 96 rehabilitation practitioners filled out a questionnaire measuring perceived desirability of prescribing orthopaedic footwear in specific medical conditions, the perceived advantages of orthopaedic footwear, the perceived disadvantages of orthopaedic footwear, the attitude to orthopaedic footwear and satisfaction with the co-operation with the pedorthist. Clinicians were asked to estimate their referral rate of orthopaedic footwear.

RESULTS

Orthopaedists and rehabilitation practitioners agree that the prescription of orthopaedic footwear should be considered in the case of rheumatoid arthritis, amputation of the foot and diabetic foot and not be considered in the case of sprain and back pain. In the case of hallux valgi, dermatological problems and clavus (severe corn) a reticent prescription policy seems to be the optimal choice. In the other medical conditions studied no unequivocal prescription policy could be derived. Respondents who prescribed orthopaedic footwear more than the median (more than 50 prescriptions per year) were more often rehabilitation practitioner, perceived more advantages of prescription footwear, perceived less disadvantages of prescription footwear and were more satisfied about the co-operation with the pedorthist.

CONCLUSION

In some medical conditions orthopaedists and rehabilitation practitioners agree about the optimal use of orthopaedic footwear. In some other medical conditions orthopaedists and rehabilitation practitioners are divided about the use of orthopaedic footwear. Reported rate of prescription was not related to desirability of prescription, but was related to beliefs such as perceived advantages, perceived disadvantages and satisfaction with co-operation with the pedorthist, underlining the importance of cognitive factors in prescription style.

摘要

目的

深入了解医学专业人士对于矫形鞋使用的看法，以及骨科医生和康复治疗师开具矫形鞋处方所涉及的医学和社会因素。

方法

在本研究中，85名骨科医生和96名康复治疗师填写了一份问卷，该问卷用于衡量在特定医疗状况下开具矫形鞋处方的可接受程度、矫形鞋的 perceived 优点、矫形鞋的 perceived 缺点、对矫形鞋的态度以及对与足病矫形师合作的满意度。临床医生被要求估计他们开具矫形鞋处方的比例。

结果

骨科医生和康复治疗师一致认为，在类风湿性关节炎、足部截肢和糖尿病足的情况下应考虑开具矫形鞋处方，而在扭伤和背痛的情况下则不应考虑。对于拇外翻、皮肤病问题和鸡眼（重度鸡眼），谨慎的处方政策似乎是最佳选择。在其他研究的医疗状况中，无法得出明确的处方政策。开具矫形鞋处方超过中位数（每年超过50份处方）的受访者更常是康复治疗师，他们认为处方鞋的优点更多，缺点更少，并且对与足病矫形师的合作更满意。

结论

在某些医疗状况下，骨科医生和康复治疗师对于矫形鞋的最佳使用达成共识。在其他一些医疗状况下，骨科医生和康复治疗师在矫形鞋的使用上存在分歧。报告的处方比例与处方的可接受程度无关，但与诸如 perceived 优点、perceived 缺点以及对与足病矫形师合作的满意度等信念有关，这凸显了认知因素在处方方式中的重要性。