Factors associated with wearing inadequate outdoor footwear in populations at risk of foot ulceration: A cross-sectional study

• Published in: PloS one 2019-02, Vol.14 (2), p.e0211140-e0211140
• Main Authors: Barwick, Alex L, Hurn, Sheree E, van Netten, Jaap J, Reed, Lloyd F, Lazzarini, Peter A
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Amputation; Analysis; At risk populations; Best practice; Biology and Life Sciences; Chronic illnesses; Confidence intervals; Cross-Sectional Studies; Diabetes; Diabetes mellitus; Diabetic foot; Diabetic Foot - etiology; Diabetic Foot - prevention & control; Disease prevention; Earth Sciences; Ethics; Family medical history; Feet; Female; Foot diseases; Foot ulcer; Foot Ulcer - etiology; Foot Ulcer - prevention & control; Footwear; Guidelines; Health aspects; Hospital patients; Hospitals; Humans; Inpatients; Leg ulcers; Logistic Models; Male; Medicine and Health Sciences; Middle Aged; People and Places; Peripheral Nervous System Diseases - complications; Peripheral neuropathy; Peripheral vascular diseases; Population; Populations; Practice guidelines (Medicine); Prevention; Queensland; Regression analysis; Risk; Risk Factors; Secondary analysis; Self Report; Shoes - adverse effects; Shoes - standards; Social Sciences; Statistical analysis; Studies; Subgroups; Trauma; Wear; Wound healing
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0211140

Few studies have investigated if people at risk of foot ulceration actually wear the footwear recommended by best practice guidelines to prevent foot ulceration. This study aimed to investigate the prevalence of, and factors associated with, wearing inadequate outdoor footwear in those with diabetes or peripheral neuropathy in an inpatient population. This was a secondary analysis of a multi-site cross-sectional study investigating foot conditions in a large representative inpatient population admitted into hospital for any medical reason on one day. A range of explanatory variables were collected from all participants including sociodemographic, medical and foot condition factors. The outcome variable for this study was the self-reported outdoor footwear type worn most by participants outside the house in the year prior to hospitalisation. The self-reported footwear type was then categorised into adequate and inadequate according to footwear features recommended in guidelines for populations at risk of foot ulceration. Logistic regression identified factors independently associated with inadequate footwear in all inpatient participants, and diabetes and neuropathy subgroups. Overall, 47% of a total of 726 inpatients wore inadequate outdoor footwear; 49% of the 171 in the diabetes subgroup and 43% of 159 in the neuropathy subgroup. Wearing inadequate outdoor footwear was independently associated (Odds Ratio (95% Confidence Interval)) with being female in the diabetes (2.7 (1.4-5.2)) and neuropathy subgroups (3.7 (1.8-7.9)) and being female (5.1 (3.7-7.1)), having critical peripheral arterial disease (2.5 (1.1-5.9)) and an amputation (0.3 (0.1-0.7)) in all inpatients (all, p