what-when-how
In Depth Tutorials and Information
assessment of the patient's footwear - history of
usage and preferences
As identified in Chapter 4, footwear has evolved from being merely a
protection for the foot from the environment to being an important aspect
of body image and social status. These two factors have become inherent
in our footwear choices and therefore the habits associated with the
wearing of footwear are often well established. It is often an emotive
subject to discuss when it comes to assessing a patient's footwear. If,
through this assessment, the practitioner deems the footwear unsuitable
for the individual's foot health, patient-focused negotiating skills have to
be used, rather than just informing the patient that their footwear choice
is 'bad'. Supporting patients in changing their footwear wearing habits is
covered in Chapter 9. However, it is important that the approach to the
patient during assessment of their footwear be non-judgemental as this
is pivotal in building and maintaining a concordant relationship with the
patient. Patient preferences have to be respected as these may originate
from choice or necessity, for example the choice of footwear for specific
occupations.
It is important to ascertain if the footwear worn to the consultation is
what is usually worn. In fact, for new patients it is often useful to request
in the patient's appointment letter that they bring a selection of the foot-
wear worn most frequently.
The structure of a footwear assessment can be tailored to suit the
practitioner's style but there are certain aspects that must be covered.
Some of these may already have been covered in the patient's general
assessment but certainly all these aspects have relevance to not only
assessment of, but also management through, footwear.
Patient assessment checklist
These are fundamental issues which need to be covered before the deci-
sion is made with regard to footwear as an intervention. Designing your
own assessment form is recommended:
•
Past and current medical history, medication-associated problems or
complications.
•
Medication and allergies.
•
Social history.
•
Patient's activities of daily living.
•
Circulatory problems (including microvascular and macrovascular
disease, oedema).
