title: Perceived usability and use of custom-made footwear in diabetic patients at high risk for foot ulceration.
abstract: OBJECTIVE
  To assess the perceived usability and use of custom- made footwear in diabetic patients who are at high-risk for foot ulceration, and to elucidate the determinants of usability and use.
  
  
  METHODS
  Survey.
  
  
  METHODS
  A total of 153 patients with diabetes, peripheral neuropathy, prior plantar foot ulceration and newly prescribed custom-made footwear, recruited from 10 Dutch multidisciplinary foot clinics.
  
  
  METHODS
  The Questionnaire of Usability Evaluation was used to assess the patients' perception of weight, appearance, comfort, durability, donning/doffing, stability, benefit and overall appreciation of their prescription footwear (all expressed as visual analogue scores). Data on priorities for usability and footwear use (in h/day) were obtained from patient reports. Multivariate logistic regression analysis was used to assess determinants of usability and use.
  
  
  RESULTS
  Median (interquartile range) score for overall appreciation was 8.3 (7.1-9.1). Scores ranged from 6.5 (4.5-8.6) for weight to 9.6 (6.3-9.9) for donning/doffing. Footwear comfort was listed most often (33.3%) as the highest priority. Footwear use was <60% of daytime (where daytime was defined as 16 h out of bed) in 58% of patients. The only significant determinant of footwear use was the perceived benefit of the footwear (p = 0.045).
  
  
  CONCLUSIONS
  Perceived usability of footwear was mostly positive, although individual scores and priorities varied considerably. Footwear use was low to moderate and dependent only on the perceived benefit of the footwear. Therefore, practitioners should focus on enhancing the patient's ap-preciation of the therapeutic benefit of custom-made footwear.
authors.affiliation: Rehabilitation, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Mark L J
authors.initials: ML
authors.lastname: Arts
authors.forename: Mirjam
authors.initials: M
authors.lastname: de Haart
authors.forename: Sicco A
authors.initials: SA
authors.lastname: Bus
authors.forename: Jan P J
authors.initials: JP
authors.lastname: Bakker
authors.forename: Hub G A
authors.initials: HG
authors.lastname: Hacking
authors.forename: Frans
authors.initials: F
authors.lastname: Nollet
mesh_terms: D000328:Adult; D000368:Aged; D017719:Diabetic Foot / Q000150:complications / Q000517:prevention & control* / Q000534:rehabilitation*; D003929:Diabetic Neuropathies / Q000150:complications; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010349:Patient Compliance / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011312:Pressure; D012775:Shoes; D011795:Surveys and Questionnaires