title: Podiatrists' perspectives on their role in promoting self-care in high-risk patients with diabetes.
abstract: Abstract Self-foot care is key in preventing morbidity in high-risk diabetic patients. Motivational interviewing (MI) is an approach to encouraging behavioral change by patients that can be utilized in medical settings. Our goal was to explore how podiatrists promote self-care in such patients and if they use MI techniques. A 19 question online survey of US-based practicing podiatrists. Most answers were on a 5 point scale. MI index was the sum of answers to 5 relevant questions. Of 843 podiatrists, 86% considered foot self-care to be very important for high-risk diabetic patients and 90% felt it was their role to discuss self-foot care with them; 49% felt that they had training and were successful in promoting behavioral change, but the majority were definitely (38%) or possibly (46%) interested in learning more. Only 24% scored >15 / 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 the podiatrist's age, gender, geographic location, % time in surgery, or years in practice. Reported barriers to counseling were lack of reimbursed time and poor patient engagement. Most podiatrists 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 minority demonstrate MI skills; fortunately the majority 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.
authors: a Penn State College of Medicine, Penn State Hershey Institute for Diabetes and Obesity.
authors: Robert
authors: R
authors: Gabbay
authors: Jennifer
authors: J
authors: Tinloy
authors: Shailja
authors: S
authors: Kaul
authors: Jan
authors: J
authors: Ulbrecht
authors: Eric
authors: E
authors: Schaefer