Women’s experiences of wearing therapeutic footwear in three European countries

Williams, AE; Nester, CJ; Ravey, M; Kottink, A; Morey-Klapsing, G

Abstract

Background: Therapeutic footwear is recommended for those people with severe foot problems associated with
rheumatoid arthritis (RA). However, it is known that many do not wear them. Although previous European studies
have recommended service and footwear design improvements, it is not known if services have improved or if this
footwear meets the personal needs of people with RA. As an earlier study found that this footwear has more
impact on women than males, this study explores women’s experiences of the process of being provided with it
and wearing it. No previous work has compared women’s experiences of this footwear in different countries,
therefore this study aimed to explore the potential differences between the UK, the Netherlands and Spain.
Method: Women with RA and experience of wearing therapeutic footwear were purposively recruited. Ten women
with RA were interviewed in each of the three countries. An interpretive phenomenological approach (IPA) was
adopted during data collection and analysis. Conversational style interviews were used to collect the data.
Results: Six themes were identified: feet being visibly different because of RA; the referring practitioners’ approach
to the patient; the dispensing practitioners’ approach to the patient; the footwear being visible as different to
others; footwear influencing social participation; and the women’s wishes for improved footwear services. Despite
their nationality, these women revealed that therapeutic footwear invokes emotions of sadness, shame and anger
and that it is often the final and symbolic marker of the effects of RA on self perception and their changed lives.
This results in severe restriction of important activities, particularly those involving social participation. However,
where a patient focussed approach was used, particularly by the practitioners in Spain and the Netherlands, the
acceptance of this footwear was much more evident and there was less wastage as a result of the footwear being
prescribed and then not worn. In the UK, the women were more likely to passively accept the footwear with the
only choice being to reject it once it had been provided. All the women were vocal about what would improve
their experiences and this centred on the consultation with both the referring practitioner and the practitioner that
provides the footwear.
Conclusion: This unique study, carried out in three countries has revealed emotive and personal accounts of what
it is like to have an item of clothing replaced with an ‘intervention’. The participant’s experience of their
consultations with practitioners has revealed the tension between the practitioners’ requirements and the women’s
‘social’ needs. Practitioners need greater understanding of the social and emotional consequences of using
therapeutic footwear as an intervention.

Citation

Williams, A., Nester, C., Ravey, M., Kottink, A., & Morey-Klapsing, G. Women’s experiences of wearing therapeutic footwear in three European countries. Journal of Foot and Ankle Research, 3(23), https://doi.org/10.1186/1757-1146-3-23

• Journal Article Type: Article
• Deposit Date: Oct 22, 2010
• Publicly Available Date: Apr 5, 2016
• Journal: Journal of Foot and Ankle Research
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 3
• Issue: 23
• DOI: https://doi.org/10.1186/1757-1146-3-23
• Publisher URL: http://dx.doi.org/10.1186/1757-1146-3-23