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Motivational Interviewing by Podiatric Physicians

A Method for Improving Patient Self-care of the Diabetic Foot

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  • 1 Penn State Institute for Diabetes and Obesity, Division of Endocrinology, Diabetes, and Metabolism, Penn State College of Medicine, Hershey, PA.
  • | 2 Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA.
  • | 3 Baltimore Podiatry Group, Baltimore, MD.
  • | 4 Department of Surgery, University of Arizona College of Medicine, Tucson, AZ.
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Foot ulceration and lower-extremity amputation are devastating end-stage complications of diabetes. Despite agreement that diabetic foot self-care is a key factor in prevention of ulcers and amputation, there has only been limited success in influencing these behaviors among patients with diabetes. While most efforts have focused on increasing patient knowledge, knowledge and behavior are poorly correlated. Knowledge is necessary but rarely sufficient for behavior change. A key determinant to adherence to self-care behavior is clinician counseling style. Podiatrists are the ideal providers to engage in a brief behavioral intervention with a patient. Motivational interviewing is a well-accepted, evidence-based teachable approach that enhances self-efficacy and increases intrinsic motivation for change and adherence to treatment. This article summarizes some key strategies that can be employed by podiatrists to improve foot self-care. (J Am Podiatr Med Assoc 101(1): 78–84, 2011)

Corresponding author: Robert A. Gabbay, MD, PhD, Penn State Institute for Diabetes and Obesity, Penn State College of Medicine, 500 University Dr, H044, Room C-6630, Hershey, PA 17033. (E-mail: rgabbay@hmc.psu.edu)