Article

OBJECTIVE: To assess the perceived usability and use of custom- made footwear in
diabetic patients who are at high-risk for foot ulceration, and to elucidate the
determinants of usability and use. DESIGN: Survey. SUBJECTS: A total of 153
patients with diabetes, peripheral neuropathy, prior plantar foot ulceration and
newly prescribed custom-made footwear, recruited from 10 Dutch multidisciplinary foot clinics.
METHODS: The Questionnaire of Usability Evaluation was used to
assess the patients' perception of weight, appearance, comfort, durability,
donning/doffing, stability, benefit and overall appreciation of their
prescription footwear (all expressed as visual analogue scores). Data on
priorities for usability and footwear use (in h/day) were obtained from patient
reports. Multivariate logistic regression analysis was used to assess
determinants of usability and use. RESULTS: Median (interquartile range) score
for overall appreciation was 8.3 (7.1-9.1). Scores ranged from 6.5 (4.5-8.6) for
weight to 9.6 (6.3-9.9) for donning/doffing. Footwear comfort was listed most
often (33.3%) as the highest priority. Footwear use was <60% of daytime (where
daytime was defined as 16 h out of bed) in 58% of patients. The only significant
determinant of footwear use was the perceived benefit of the footwear (p =
0.045). CONCLUSION: Perceived usability of footwear was mostly positive, although
individual scores and priorities varied considerably. Footwear use was low to
moderate and dependent only on the perceived benefit of the footwear. Therefore,
practitioners should focus on enhancing the patient's ap-preciation of the
therapeutic benefit of custom-made footwear.

Langue : ANGLAIS