Shoes are such an emotive issue, especially where we professionals are concerned. So many foot problems are caused by ill-fitting footwear and this can sometimes lead to frustration when our patients don’t take on board advice regarding healthy footwear.

So how do we support people to adopt a different approach?

I would argue at the core of everything we do we need to take a step back and literally put ourselves in our patients’ shoes.

My early training was rooted in a fact-based scientific approach and it was only later on in my career did I grow to realise the importance of listening, truly listening to the reasons behind why people make the choices that they do.

For many of us our shoes may not actually ‘fit’ our feet but ‘fit’ the social occasion – be it work, a party or an evening out and an excellent paper recently published by Nicholls et al in the Journal of Foot and Ankle Research highlights the importance of our approach and our communication style when we are guiding our patients in their footwear selection.

Yes shoes can lead to corns, calluses, blisters, heel pain and even ulcers in those with more vulnerable feet, such as those with diabetes; however we cannot force people into into ‘behaving’ as we think they should just because we’ve ‘told’ them.

My own PhD research looked at how we can support people with diabetes to undertake foot self-care. However what my interviews revealed was the immense demands people with diabetes face everyday and the tightrope they walk as they attempt to live well with diabetes and integrate the risks and demands of chronic illness into their normal routines.

It is the nature of this all-consuming ‘work’ required to successfully maintain blood glucose levels at the same time as trying to live a life without their illness dominating their day-to-day existence that may explain why other self-care behaviours such as a regular foot care regime are deemed to be less important in the absence of additional support and guidance from health care professionals.

What is clear is that if we are going to be effective in supporting people to modify their behaviour we need to invite people to tell their stories and understand their decision making.

Imparting knowledge and facts does not translate into action, so just telling someone they need to wear different shoes is unlikely to have any impact.

To effectively support our patients we need to understand the framework, support, education and resources they need to become fully involved in their care and work together to achieve the outcomes that are important to them. So next time you are ‘giving’ advice maybe start instead with the question “What’s important to you?”

Connecting • Listening • Sharing

#FeelYourFeet #Person-Centred Care #Storytelling #PersonalisedCare






Add a Comment