advertising
-
1
Singh N, Armstrong DG, Lipsky BA: Preventing foot ulcers in patients with diabetes. JAMA 293: 217, 2005.
-
2
Boulton AJ, Kirsner RS, Vileikyte L: Clinical practice: neuropathic diabetic foot ulcers. N Engl J Med 351: 48, 2004.
-
3
Perrin BM, Swerissen H, Payne C: The association between foot-care self efficacy beliefs and actual foot-care behaviour in people with peripheral neuropathy: a cross-sectional study. J Foot Ankle Res 2: 3, 2009.
-
4
Vileikyte L, Gonzalez JS, Leventhal H, et al: Patient Interpretation of Neuropathy (PIN) questionnaire: an instrument for assessment of cognitive and emotional factors associated with foot self-care. Diabetes Care 29: 2617, 2006.
-
5
Basu S, Hadley J, Tan RM, et al: Is there enough information about foot care among patients with diabetes? Int J Low Extrem Wounds 3: 64, 2004.
-
6
Pollock RD, Unwin NC, Connolly V: Knowledge and practice of foot care in people with diabetes. Diabetes Res Clin Pract 64: 117, 2004.
-
7
Ward A, Metz L, Oddone EZ, et al: Foot education improves knowledge and satisfaction among patients at high risk for diabetic foot ulcer. Diabetes Educ 25: 560, 1999.
-
8
Vileikyte L: “Psychological and Behavioral Issues in Diabetic Foot Ulceration,” in The Foot in Diabetes, p 132, edited by AJ Boulton, PR Cavanagh, G Rayman, John Wiley & Sons, Chichester, England, 2006.
-
9
Mason J, O'Keeffe C, McIntosh A, et al: A systematic review of foot ulcer in patients with type 2 diabetes mellitus. Diabet Med 16: 801, 1999.
-
10
Valk GD, Kriegsman DM, Assendelft WJ: Patient education for preventing diabetic foot ulceration: a systematic review. Endocrinol Metab Clin North Am 31: 633, 2002.
-
11
Kruger S, Guthrie D: Foot care: knowledge retention and self-care practices. Diabetes Educ 18: 487, 1992.
-
12
Knight KM, Dornan T, Bundy C: The diabetes educator: trying hard, but must concentrate more on behaviour. Diabet Med 23: 485, 2006.
-
13
Price PE: Education, psychology and “compliance.” Diabetes Metab Res Rev 24: S101, 2008.
-
14
Ronnemaa T, Hamalainen H, Toikka T, et al: Evaluation of the impact of podiatrist care in the primary prevention of foot problems in diabetic subjects. Diabetes Care 20: 1833, 1997.
-
15
Sloan FA, Feinglos MN, Grossman DS: Receipt of care and reduction of lower extremity amputations in a nationally representative sample of U.S. elderly. Health Serv Res 45: 1740, 2010.
-
16
Malone JM, Snyder M, Anderson G, et al: Prevention of amputation by diabetic education. Am J Surg 158: 520, 1989.
-
17
Barth R, Campbell LV, Allen S, et al: Intensive education improves knowledge, compliance, and foot problems in type 2 diabetes. Diabet Med 8: 111, 1991.
-
18
Rollnick MP, Butler C: Health Behavior Change: A Guide for Practitioners, Churchill Livingstone, London, 2000.
-
19
Miller RS: Motivational Interviewing: Preparing People for Change, Guilford Press, New York, 2002.
-
20
Britt E, Hudson SM, Blampied NM: Motivational interviewing in health settings: a review. Patient Educ Couns 53: 147, 2004.
-
21
Hettema J, Steele J, Miller WR: Motivational interviewing. Annu Rev Clin Psychol 1: 91, 2005.
-
22
Rollnick MW, Butler CC: Motivational Interviewing in Health Care: Helping Patients Change Behavior, Guilford Press, New York, 2008.
-
23
Ruback S, Sandbaek A, Lauritzen T, et al: Motivational interviewing: a systematic review and meta-analysis. Br J Gen Pract 55: 305, 2005.
-
24
Emmons KM, Rollnick S: Motivational interviewing in health care settings: opportunities and limitations. Am J Prev Med 20: 68, 2001.
-
25
Channon SJ, Huws-Thomas MV, Rollnick S, et al: A multicenter randomized controlled trial of motivational interviewing in teenagers with diabetes. Diabetes Care 30: 1390, 2007.
-
26
West DS, DiLillo V, Bursac Z, et al: Motivational interviewing improves weight loss in women with type 2 diabetes. Diabetes Care 30: 1081, 2007.
-
27
Lundahl B, Burke BL: The effectiveness and applicability of motivational interviewing: a practice-friendly review of four meta-analyses. J Clin Psychol 65: 1232, 2009.
-
28
Gabbay RA, Kaul S, Ulbrecht J, et al: Motivational interviewing by podiatric physicians: a method for improving patient self-care of the diabetic foot. JAPMA 101: 78, 2011.
-
29
Al Fisher Associates: 2007 podiatric practice survey: statistical results. JAPMA 97: 496, 2007.
-
30
Graham AS, Hammond A, Williams AE: Foot health education for people with rheumatoid arthritis: the practitioner's perspective. J Foot Ankle Res 5: 2, 2012.
-
31
Dunn C, Deroo L, Rivara FP: The use of brief interventions adapted from motivational interviewing across behavioral domains: a systematic review. Addiction 96: 1725, 2001.
-
32
Vasilaki EI, Hosier SG, Cox WM: The efficacy of motivational interviewing as a brief intervention for excessive drinking: a meta-analytic review. Alcohol 41: 328, 2006.
-
33
Hettema JE, Hendricks PS: Motivational interviewing for smoking cessation: a meta-analytic review. J Consult Clin Psychol 78: 868, 2010.
-
34
Bojadzievski T, Gabbay RA: Patient-centered medical home and diabetes. Diabetes Care 34: 1047, 2011.
-
35
American College of Physicians: The Patient-Centered Medical Home Neighbor: The Interface of the Patient-Centered Medical Home with Specialty/Subspecialty Practices, American College of Physicians, Philadelphia, 2010.
Podiatric Physicians' Perspectives on Their Role in Promoting Self-Care in High-Risk Patients with Diabetes
Search for other papers by Jennifer Tinloy in
Current site
Google Scholar
PubMed
Search for other papers by Shailja Kaul in
Current site
Google Scholar
PubMed
Search for other papers by Jan Ulbrecht in
Current site
Google Scholar
PubMed
Search for other papers by Eric Schaefer in
Current site
Google Scholar
PubMed
Search for other papers by Robert A. Gabbay in
Current site
Google Scholar
PubMed
Background
Foot self-care is key in preventing morbidity in high-risk diabetic patients. Motivational interviewing (MI) is an approach to encourage behavior change by patients that can be used in medical settings. The goal was to explore how podiatric physicians promote self-care in such patients and whether they use MI techniques.
Methods
We conducted a 19-question online survey of US-based practicing podiatric physicians. Most answers were on a 5-point scale. The MI index was the sum of answers to five relevant questions.
Results
Of 843 podiatric physicians, 86% considered foot self-care to be very important for high-risk diabetic patients, and 90% felt that it was their role to discuss foot self-care with them; 49% felt that they had training and were successful in promoting behavior change, but most were definitely (38%) or possibly (46%) interested in learning more. Only 24% of respondents scored at least 15 of 20 on the MI index. Higher MI scores were associated with more face time and more time discussing foot self-care but were not related to podiatric physicians' age, sex, geographic location, percentage of time in surgery, or years in practice. Reported barriers to counseling were lack of reimbursed time and poor patient engagement.
Conclusions
Most podiatric physicians view self-care behavior among high-risk diabetic patients and their role in promoting it as very important; most feel already proficient, but only a few demonstrate MI skills; most are willing to learn more. Success in behavioral counseling, such as MI, is likely to require more time and may be encouraged by a move from fee-for-service to outcome-based reimbursement.
advertising
