An evaluation of podiatric intervention with regards to foot self-care practices amongst the independent elderly living in the community

Abstract

Aim: The aim of this study was to identify any significant differences in foot health status and self-care practices after regular visits to the Podiatry Clinic in the elderly population who live independently. Methods: A multi-centre, non-experimental prospective study was conducted on 109 individuals aged 65 years and above and who made use of Podiatry Clinics within the local Health Centres at Primary Health sector. Patients were recruited by means of an intermediary from different health centres during their routinely scheduled appointment. Two questionnaires were used to screen for foot-related self-care practices and foot-related quality of life namely the Nottingham Assessment for Functional Footcare Revised (NAFF) and Foot Health Status Questionnaire (FHSQ) respectively. Participants were interviewed 4 times over a period of one year at 4-month intervals and asked to answer again the previously mentioned questionnaires. Changes in responses were recorded for analysis. For statistical analysis, data was categorized by gender, age and educational level groups Results: The normality of the data was tested using the Shapiro-Wilk test and non-parametric tests were utilized. The Kruskal-Wallis Test exhibited a significant improvement in mean NAFF scores and a significant decrease in FHSQ scores from T0 to T3. Additionally, the Spearman correlation found that no relationship between mean NAFF and total FHSQ scores. Mean NAFF scores demonstrated that the 85< age group was the only age group to have a non-significant improvement. Both gender groups exhibited significant improvements. Those with post-secondary education are the only educational level group to not have improved significantly. Mean FHSQ scores did not differ significantly between age, gender and educational level groups. Out of the domains of the FHSQ, the only significant difference noted was in Physical Activity domains in all age gender and educational level groups (except for primary and secondary level of education). A significant difference was noted in the Vigor domain in the 75-85 age group. Conclusion: The findings of this study suggest that in the independent living older adult population, visits to the podiatry clinic have been shown to improve foot-related self-care practices over a period of 1 year. This was observed by the higher frequency of positive footcare behaviours by the NAFF. On the other hand, the results show that foot-related quality of life did not improve in the sample population. Physical activity was the major aspect that the sample population regressed in. The findings of this study imply that improvement in the domains of the FHSQ are not dependent only on visits to the podiatrists and ability to self-care. There could be other intrinsic and extrinsic factors other than podiatric interventions that could influence the quality of life. It is important that podiatrists remain the first point of care when it comes to foot health however adopting a multidisciplinary approach is imperative so as to care for patients holistically.