An evaluation of knowledge on different aspects of foot health in patients with rheumatoid arthritis

Abstract

Background: Foot problems are common in rheumatoid arthritis (RA), with physical pathologies manifesting in the feet and adversely impacting quality of life. An increasing amount of evidence supports effective management of foot problems in patients living with RA, with foot health education being acknowledged as a fundamental component in achieving good foot health. Aim: To evaluate knowledge amongst patients with RA on foot health, self-care practices, and the role of the podiatrist in foot care. Research Design and Method: A single-centre, non-experimental prospective study design was conducted on 52 Maltese patients living with RA attending the specialised rheumatology clinic within the podiatry clinic at Birkirkara Health Centre. Participants aged 18 or over with RA score of 6 or higher according to the 2010 American College of Rheumatology/European League Against Rheumatism Classification Criteria for RA were recruited in the study. The “Education for podiatric health in patients with rheumatoid arthritis No questionnaire” was utilised to evaluate knowledge on foot health in RA patients. Results: Participants in this study were knowledgeable on certain aspects related to foot health, however, areas of knowledge deficit were: proper toenail trimming, knowledge related to foot deformities, falls, and difficulty in ambulation due to RA. With regards to the role of the podiatrist in foot health, most participants were aware that podiatrist perform toenail trimming, and remove hyperkeratotic lesions, however certain participants were unfamiliar with other roles of the podiatrist. As regards to patients’ measures when experiencing foot pain responses ranged from conservative treatments at home, to reaching out to health professionals. A sub-analysis of the study showed a correlation between aspects of self-care and gender, between knowledge on the repercussion of RA on feet and level of education, and between aspects of self-care and level of education. Age, marital status, duration of RA, and attendance to a foot health educational programme showed no correlation. Conclusion: The knowledge deficits identified in this study indicate the necessity of foot health educational sessions to be implemented for the RA population. Further research in different settings such as in rheumatology clinics which do not operate within the podiatry centre could be essential in evaluating knowledge on foot health amongst patients with RA.