Foot health of nurses-A cross-sectional study

Association of Foot Health and Lower Extremity Function in Older People with Rheumatoid Arthritis: A Cross-Sectional Study

INTRODUCTION

Foot health and lower extremity function are important in older people with rheumatoid arthritis (RA), as they maintain and promote these individuals' independent living and functional health. RA is a long-term inflammatory health condition that alters foot structure and function. Relatively little is known about the association between foot health and lower extremity function in older people with RA. Therefore, the aim of the study was to analyse the levels of foot health and lower extremity function in older people with RA and to explore the associations between these factors.

METHODS

A cross-sectional survey design study was conducted. The data were collected online in April 2023 from a national association of patients with rheumatic conditions in Finland using two instruments: the Self-administered Foot Health Assessment Instrument (S-FHAI) and the Lower Extremity Function Scale (LEFS). The data were analysed using descriptive and inferential statistics.

RESULTS

Older people with RA (n = 270) reported many foot health problems, the most common of which were foot pain, dry skin, and oedema. Lower extremity function in older people with RA was at the mild-to-moderate functional limitation level and respondents reported major difficulties running or hopping, squatting, carrying out their usual hobbies, performing strenuous activities outside their homes or putting on shoes/socks. Poor levels of foot health were correlated with decreased lower extremity function.

CONCLUSION

Foot health is associated with lower extremity function in older people with RA. Therefore, it is essential that older people with RA be provided with systematic foot health assessments, care and rehabilitation to promote their lower extremity health and improve their functional health. Multiprofessional collaboration and seamless care chains at different levels of health care could benefit older people with RA looking to maintain their functional ability and - above all - promote their active ageing.

The Effect of Anthropometric Shoes on Lactic Acid Reduction in Nurses: A Mixed-Methods Study from Indonesia

Background

The mobilization characteristics of nurses' work, such as standing, walking, and transferring patients for a long time, can increase the risk of musculoskeletal disorders. Repetitive activities nurses perform can cause foot problems such as discomfort and insecurity, characterized by increased lactic acid levels. Anthropometric shoes are specifically designed to reduce complaints on nurses' feet.

Purpose

This study aimed to determine the effect of individual anthropometric shoes on lactic acid levels in nurses at the hospital.

Methods

This study used a mixed-method study design. This study involved 71 nurses in the quantitative study and 15 nurses in the qualitative study. Nurses in Emergency Room, Central Surgical Installation, Inpatient Room, Intensive Care Unit, and Outpatient Installation were randomly selected using a stratified random sampling technique. The instruments used were the Accutrend Lactacyd tool, demographic questionnaire and interview questionnaire. Bivariate data analysis was using Statistical Package for Social Sciences (SPSS) and qualitative data analysis using thematic analysis.

Results

This mixed-method study shows that anthropometric shoes can reduce nurses' lactic acid levels. In the quantitative study; there was a significant difference in lactic acid levels of nurses before and after using anthropometric shoes with the average results of measuring lactic acid levels, namely pre-test (22.48 mg/dL) and post-test (16.27 mg/dL), with a p-value (0.000). The qualitative study data revealed positive results related to increased nurse knowledge, positive views on the effect of shoes on nurse performance, and the impact of using anthropometric shoes in providing comfort and safety, such as decreased muscle fatigue and pain.

Conclusion

The findings of this study highlight the effect of individualized anthropometric shoes on lactic acid levels in nurses in Indonesian hospitals. It is essential to conduct further research and evaluate the results in a broader setting to ensure that anthropometric shoes can directly affect lactic acid levels.

Prevalence and Associated Factors of Ankle-Foot Pain Among Nurses Working in Surgical Units of Comprehensive Specialized Hospitals in Amhara Regional State, Northwest Ethiopia, 2022

Background

Ankle-foot pain is a serious public health concern among nurses and has a significant impact on the quality of the health care service delivery system. However, little is known about the prevalence and factors associated with ankle-foot pain among nurses working in surgical units in Ethiopia.

Purpose

The study aimed to assess the prevalence and associated factors of ankle-foot pain among nurses working in surgical units of comprehensive specialized hospitals in Amhara regional state, Northwest Ethiopia, 2022.

Participants and Methods

An institution-based cross-sectional study was conducted among 409 nurses working in surgical units of comprehensive specialized hospitals, from May 15 to June 7, 2022. A simple random sampling technique was employed. Data were collected by five BSc nurses using a structured self-administered questionnaire. The collected data were entered into Epi-data version 4.6 and exported to SPSS version 23 for analysis. The descriptive statistics and bivariable and multivariable logistic regression analyses were computed. Finally, variables were declared as statistically significant at P < 0.05 using the odds ratio and 95% CI.

Results

The prevalence of ankle-foot pain among nurses working in surgical units was 51.8% (95% CI = 46.9-57.5). More than 10 years of working experience [AOR = 3.48, 95% CI = 1.35-8.92], working 48 or more hours per week [AOR = 2.69, 95% CI = 1.27-6.00], prolonged standing [AOR = 5.72, 95% CI = 3.20-10.25], high physical job demand [AOR = 2.41, 95% CI = 1.53-3.80], and low job control [AOR = 2.34, 95% CI = 1.47-3.71] had statistically significant association with ankle-foot pain.

Conclusion

This study found that ankle-foot pain was common among nurses working in surgical units. Having more years of work experience, working more hours per week, prolonged standing, high physical job demand, and low job control were statistically associated with ankle-foot pain.

Foot and Ankle Disorders in Nurses Exposed to Prolonged Standing Environments: A Scoping Review

BACKGROUND

Prolonged standing environments constitute an occupational risk factor for nurses, particularly for developing foot and ankle disorders. The definitions and potential relationship to hours spent walking or standing are poorly understood. This scoping review aimed to synthesize the main disorders found on nurses' ankles and feet, their prevalence, the influence of hours spent walking or standing, and gender differences.

METHODS

This review followed a previously published protocol. Primary and secondary studies were retrieved from relevant databases from December 2020 to March 2021. Potential articles were collated to Mendeley, and two independent reviewers assessed the title and abstracts. Studies meeting inclusion criteria were included. Two researchers retrieved and reviewed the full text of these studies independently. A predetermined extraction tool was used to retrieve relevant data, summarized in a tabular and narrative format.

FINDINGS

The most common disorder was pain, followed by numbness, burning feet, bunions, structural deformities, and calluses. Prevalence differed among studies, depending on settings and specific local policies. Discussion: Various foot and ankle disorders and related variables have been found, with clear gaps that may be addressed in the future.

CONCLUSION/APPLICATIONS TO PRACTICE:

Few studies have focused on nurses' foot and ankle disorders. Mapping signs and symptoms may contribute to the future development of preventive interventions for nurses' workplaces.

Nurses’ experience with chronic foot pain and their job-the national science foundation foot health survey

Background

Chronic foot pain (CFP) impacts nurses' ability to provide care at the bedside. Treatment options for CFP were insufficient to address foot pain for nurses who stand or walk for prolonged periods while providing care to patients.

Aims

This study aimed to explore nurses' experience with CFP, current treatment options for foot pain, and the impact of foot pain on nurses' job performance.

Methods

This is secondary data from Individual interviews (n = 122) involving open-ended questions. Data were collected between April 2019-September 2020 while attending the National Science Foundation (NSF) I-Corps program comprising faculty and students among others in the United States. Multiple linear regression and multinomial/binary logistic regressions were conducted to assess what factors were associated with the pain and pain relief solutions.

Results

Nurses who worked at the bedside predominantly switched jobs and reported higher levels of foot pain than those who did not switch jobs (β = 0.19, p = .044). Longer working hours (β = 0.35, p < .001) were associated with higher levels of pain. Nurses who worked longer time were more likely to purchase new work shoes and socks (OR = 1.177, p = .025) to alleviate foot pain than changing shoes only.

Conclusions

Most nurses expressed interest in new products to relieve their CFP. Innovations are urgently needed to address CFP. Future longitudinal studies are required to further elucidate appropriate preventative strategies to prevent and treat CFP in nurses.

Baropodometric Assessment of the Podiatric Profile of Nursing Students in Clinical Settings: A Study Protocol

Introduction

Nursing students are exposed to increased risks of developing foot and ankle disorders due to prolonged standing and walking positions during clinical settings. This can lead to high dropout rates from nursing degree, thus contributing to a future shortage in nursing professionals. This protocol aims to develop a study to understand the influence of prolonged standing and walking positions on nursing students' foot health, and specifically to study the relationship between the podiatric profile (regional force and pressure exerted on the foot) and related signs and symptoms.

Methods and Analysis

A prospective observational cohort study will be conducted with 194 nursing students. Participants will be asked to walk through a baropodometric platform before and after a 5-month clinical training session. Assessment will focus on the change in podiatric profile, namely foot posture and foot function, at 5 months, and changes in foot health at 5 months. The study will start in January 2022 and it's expected to end by June 2022.

Discussion

The study aims to perform an innovative assessment of nursing students' podiatric profile, which will allow for a comprehensive description of foot/ankle changes and their relationship with prolonged standing and walking contexts.

Ethics and Dissemination

The study was approved by The Ethical Committee of the Health Sciences Research Unit: Nursing (UICISA: E), of the Nursing School of Coimbra (ESEnfC), with the approval code nr. P799_07_2021. The study was also recorded in ClinicalTrials.gov on the number NCT05197166. Findings will be used to publish articles in peer-review scientific journals and oral communications and posters at scientific meetings.

Foot Disorders in Nursing Standing Environments: A Scoping Review Protocol

Musculoskeletal disorders can be significantly disabling, particularly those related to work, when the underlying mechanisms and clinical variables are not well known and understood. Nurses usually remain in standing positions or walk for long periods, thus increasing the risk for the development of musculoskeletal disorders, particularly on the foot, such as plantar fasciitis or edema. This type of disorders is a major cause of sickness, absence from work, and also dropout ratios among nursing students, which contributes to the shortage of nursing professionals. This review will address foot disorders that arise from prolonged standing in nursing professionals and describe the main clinical parameters characterizing them, with exclusions for other health professions or disorders with other identified causes. English, French, Portuguese, and Spanish published studies from 1970 to the current year will be considered. The review will follow the JBI methodology, mainly though the PCC mnemonic, and the reporting guidelines for Scoping Reviews. The search will include main databases and relevant scientific repositories. Two independent reviewers will analyze the titles, abstracts, and full texts. A tool developed by the research team will aid in the data collection.

A Rasch analysis of the self-administered Foot Health Assessment Instrument (S-FHAI)

Background

Reliable and valid measurement is the foundation of evidence-based practice. The self-administered Foot Health Assessment Instrument (S-FHAI) was recently developed to measure patients’ evaluations of their own foot health. Evidence regarding the psychometric properties of the S-FHAI is limited. The aim of this study was to investigate those properties by using a Rasch analysis.

Methods

This methodological study analysed secondary data that was collected from nurses (n = 411) in 2015. The psychometric properties of the S-FHAI were evaluated using the Rasch model. Unidimensionality was analysed first, followed by item functioning, person misfit and differential item functioning (DIF).

Results

The S-FHAI demonstrated evidence of unidimensionality, with an acceptable item fit according to the Rasch model. Person fit and person separation were low, however, indicating restricted separation among different respondents. Item separation was high, demonstrating clear discrimination between the items. No DIF was detected in relation to gender, but significant DIF was demonstrated in relation to age for 6 of the 25 items.

Conclusions

The S-FHAI has potential for use in investigating self-reported foot health. The Rasch analysis revealed that the psychometric properties of the instrument were acceptable, although some issues should be addressed to improve the scale. In future, it may be beneficial to analyse the sensitivity of the items and to test the S-FHAI in more diverse patient populations.

Development and testing of a new electronic foot health promotion programme on nurses' foot self-care

Background

Nurses form the largest professional group in health care, and they spend most of their working day on their feet. From the perspective of work well-being, healthy feet are important to tolerate the physical demands of nursing work. However, little is known about how nurses’ foot self-care practices can be promoted with computerised interventions. The aim of this study was two-fold: to explore the preliminary effects of the electronic Foot Health Promotion Programme (FHPP) on foot self-care in nurses and to examine the usability of the programme.

Methods

A single group pretest-posttest design was used. The FHPP was targeted at nurses working in the operating theatre. The FHPP lasted for 4 weeks and focused on improving nurses’ knowledge and awareness of foot self-care through self-directed learning tasks. The primary outcome was knowledge of foot self-care. The secondary outcomes were foot health and work ability. Thirty-seven participants completed the study. The outcomes were assessed at baseline (April–June 2017) and 4 weeks (August–September 2017) after the intervention ended. The data were analysed statistically.

Results

Participants’ knowledge of foot self-care and foot health improved; however, the changes were not statistically significant. The FHPP was considered to be usable and has potential as a tool to increase knowledge of foot self-care among nurses.

Conclusions

The FHPP developed in this study is a newly developed potential tool to increase nurses’ knowledge of foot self-care. Application of the FHPP as part of occupational health care may enhance nursing personnel’s foot self-care and lower extremity health.

Trial registration

ClinicalTrials.gov NCT03116451, 17.4.2017.