Abstract
BackgroundThis evaluation sought to determine current Charcot neuroarthropathy (CN) diabetes patient education practices among Scottish National Health Service (NHS) and academic podiatrists and evaluate novel visual tools and develop expert consensus for future practice.MethodsQuestionnaires collected mixed qualitative and quantitative responses, analysed concurrently within a convergence coding matrix. Delphi methodology permitted member-checking and agreement of consensus over two rounds.ResultsFourteen participants (16.28%) completed a Round One questionnaire, leading to the generation of four themes; Experience; Person-Centred Care and the Content and Context of CN patient education. Seven consensus statements were subsequently developed and six achieved over 80% agreement among 16 participants (18.60%) with a Round Two questionnaire. Respondents agreed CN patient education should be considered for all ‘At-risk’ individuals with diabetic peripheral neuropathy (DPN). Verbal metaphors, including the ‘rocker-bottom’ foot, soft or brittle bones, collapsing, walking on honeycomb and a shattering lightbulb were frequently employed. Visual tools, including visual metaphors and The Charcot Foot Thermometer, were positively evaluated and made available online.ConclusionsKey findings included respondent’s belief that CN education should be considered for all individuals with DPN and the frequent use of simile, analogy and metaphor in CN education. The concept of ‘remission’ proved controversial due to its potential for misinterpretation.
Highlights
This evaluation sought to determine current Charcot neuroarthropathy (CN) diabetes patient education practices among Scottish National Health Service (NHS) and academic podiatrists and evaluate novel visual tools and develop expert consensus for future practice
Reported among 0.1–0.4% of the diabetes population [2,3,4,5], CN prevalence may increase to 10% among individuals with diabetic peripheral neuropathy (DPN) [6]
Further categorisation lead to the development of a floral arrangement and identification of three themes: Person-Centred Care and the Content and Context of CN patient education (Additional file 1: Appendix 3)
Summary
This evaluation sought to determine current Charcot neuroarthropathy (CN) diabetes patient education practices among Scottish National Health Service (NHS) and academic podiatrists and evaluate novel visual tools and develop expert consensus for future practice. Podiatrists may enlist metaphors, such as the ‘rocker-bottom’ foot, to improve patient appreciation of CN deformity and novel visual tools have been developed to support preventative education [13]. The authors are unaware of previous research investigating podiatrist’s CN patient education practices or the use of metaphor or visual tools to support education. Given an absence of Level One clinical evidence [14] or guidance concerning ‘At-risk’ education, an evaluation was designed to determine current CN patient education practices among NHS and academic podiatrists in Scotland, evaluate novel visual tools and develop expert consensus to inform future practice
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