An Explorative Study on the Efficacy and Feasibility of the Use of Motivational Interviewing to Improve Footwear Adherence in Persons with Diabetes at High Risk for Foot Ulceration
The authors aimed to explore the effect of motivational interviewing on footwear adherence and to assess the feasibility of applying motivational interviewing in persons with diabetes who are at high risk for foot ulceration, and who have low adherence to wearing prescribed custom-made footwear.
This study was designed as an explorative trial in which participants were randomly allocated to one of two study arms in a balanced manner.
First, a 7-day baseline measurement of footwear adherence was conducted in each patient.
Those who wore their prescribed footwear for less than 80% of the steps taken either inside or outside their homes were classified as having low adherence.
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These patients were randomly assigned to either standard education (control group) or standard education plus two sessions of motivational interviewing (intervention group).
Each patient in the study received standard education, which consisted of written and verbal information given by the rehabilitation medicine specialist at footwear delivery on the proper use of footwear and the importance of wearing this footwear to prevent complications.
Motivational interviewing was given in addition to standard education in the intervention group and consisted of two 45-min sessions, 1 week apart.
It focused mainly on enhancing the patient’s knowledge and motivation for change.
Footwear adherence was assessed at baseline and 1 week and 3 months after the intervention.
Daily step activity was measured simultaneously and synchronously with footwear use using a step activity monitor strapped around the ankle.
Nonsignificant but clinically meaningful short-term positive effects of motivational interviewing on adherence to wearing prescribed custom-made footwear at home, where walking activity is higher than away from home, were found in the intervention group.
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References:
- Keukenkamp, R., Merkx, M. J., Busch-Westbroek, T. E., Bus, S. A. (2018) An Explorative Study on the Efficacy and Feasibility of the Use of Motivational Interviewing to Improve Footwear Adherence in Persons with Diabetes at High Risk for Foot Ulceration. Journal of the American Podiatric Medical Association: March/April 2018, Vol. 108, No. 2, pp. 90-99
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