Rheumatoid arthritis patients' experiences of wearing therapeutic footwear - A qualitative investigation

Background: Specialist 'therapeutic' footwear is recommended for patients with diseases such asrheumatoid arthritis (RA) as a beneficial intervention for reducing foot pain, improving foot health,and increasing general mobility. However, many patients choose not to wear this footwear.Recommendations from previous studies have been implemented but have had little impact inimproving this situation. The aim of this study was to explore RA patients' experiences of thisfootwear to ascertain the factors which influence their choice to wear it or not.Method: Ten females and three males with RA and experience of wearing specialist footwear wererecruited from four National Health Service orthotic services. Semi-structured interviews werecarried out in the participants own homes. A hermeneutic phenomenological analysis of thetranscripts was carried out to identify themes.Results: The analysis revealed two main themes from both the female and male groups. Thesewere the participants' feelings about their footwear and their experiences of the practitioner/sinvolved in providing the footwear. In addition, further themes were revealed from the femaleparticipants. These were feelings about their feet, behaviour associated with the footwear, andtheir feelings about what would have improved their experience.Conclusion: Unlike any other intervention specialist therapeutic footwear replaces somethingthat is normally worn and is part of an individual's body image. It has much more of a negativeimpact on the female patients' emotions and activities than previously acknowledged and thisinfluences their behaviour with it. The patients' consultations with the referring and dispensingpractitioners are pivotal moments within the patient/practitioner relationship that have thepotential to influence whether patients choose to wear the footwear or not