title: Room for improvement: patient, parent, and practitioners' perceptions of foot problems and foot care in juvenile idiopathic arthritis.
abstract: OBJECTIVE
  To explore the perceived impact of disease-related foot problems and foot care in juvenile idiopathic arthritis (JIA) from the perspectives of patients, parents, pediatric rheumatologists, and health professionals.
  
  
  METHODS
  A qualitative study using an interpretative phenomenological approach.
  
  
  METHODS
  Outpatients department, public health service children's hospital.
  
  
  METHODS
  Patients (N=15; 4 adult patients, 2 parents of children with JIA, 3 pediatric rheumatologists, and 6 health professionals) from 2 National Health Service rheumatology centers (1 pediatric and 1 adult).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Qualitative outcomes were participants' perceptions elicited using semistructured interviews (telephone or face-to-face) and focus groups using an interpretative phenomenological approach. A data-driven inductive approach to coding and theme development was adopted for transcript analysis.
  
  
  RESULTS
  Participants volunteered to take part in a total of 7 interviews and 2 focus groups. The analysis revealed 6 key themes related to the impact of foot problems and perceptions of foot care from respective groups. These were the following: (1) pain, (2) mobility impairment, (3) reduced ability to perform activities of daily living, (4) footwear difficulties, (5) poor referral pathways/delayed access to care, and (6) lack of evidence in support of conservative foot care.
  
  
  CONCLUSIONS
  Several areas for development of foot care services were identified including a need for improved referral pathways, shorter waiting times for initial consultations, greater attention to patient compliance, and a need for better evidence in support of customized foot orthoses. Several key foot health-related outcomes were identified, which may be of importance for measuring therapeutic response to foot-related interventions.
authors: Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, UK. gordon.hendry@uws.edu.au
authors: Gordon J
authors: GJ
authors: Hendry
authors: Debbie E
authors: DE
authors: Turner
authors: Paula K
authors: PK
authors: Lorgelly
authors: James
authors: J
authors: Woodburn
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D001171:Arthritis, Juvenile / Q000150:complications*; D005260:Female; D005534:Foot Diseases / Q000209:etiology*; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D051346:Mobility Limitation; D010146:Pain; D010290:Parents / Q000523:psychology*; D010361:Patients / Q000523:psychology*; D010465:Perception; D010820:Physicians / Q000523:psychology*; D036301:Qualitative Research; D055815:Young Adult