Patients' experiences of lupus-related foot problems: a qualitative investigation

Lupus. 2017 Oct;26(11):1174-1181. doi: 10.1177/0961203317696590. Epub 2017 Mar 9.

Abstract

Background Systemic lupus erythematosus (SLE) can present with a variety of symptoms. Previous research has shown there is a high prevalence of lower limb and foot problems in patients with SLE associated with the musculoskeletal, vascular and neurological changes. Furthermore, there is a high prevalence of infections affecting the feet and a range of common skin and nail problems. However, it is not known how these foot problems impact upon people's lives. Therefore, we aimed to explore this using a qualitative approach. Method Following ethical approval, 12 participants were recruited who had a diagnosis of SLE, current and/or past experience of foot problems and were over 18 years in age. Following consent, interviews were carried out with an interpretivist phenomenological approach to both data collection and analysis. Results Seven themes provide insight into: foot problems and symptoms; the impact of these foot problems and symptoms on activities; disclosure and diagnosis of foot problems; treatment of foot problems and symptoms; perceived barriers to professional footcare; unanswered questions about feet and footcare; and identification of the need for professional footcare and footcare advice. Conclusion These participants tend to "self-treat" rather than disclose that they may need professional footcare. A lack of focus upon foot health within a medical consultation is attributed to the participant's belief that it is not within the doctor's role, even though it is noted to contribute to reduced daily activity. There is a need for feet to be included as a part of patient monitoring and for foot health management to be made accessible for people with SLE.

Keywords: Systemic lupus erythematosus; foot; interviews; podiatry; qualitative; experiences.

MeSH terms

  • Activities of Daily Living
  • Adult
  • Aged
  • Cost of Illness
  • Female
  • Foot Diseases / diagnosis
  • Foot Diseases / etiology*
  • Foot Diseases / therapy
  • Health Knowledge, Attitudes, Practice
  • Health Services Accessibility
  • Humans
  • Interviews as Topic
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / diagnosis
  • Lupus Erythematosus, Systemic / therapy
  • Middle Aged
  • Patient Acceptance of Health Care
  • Podiatry / methods
  • Qualitative Research
  • Risk Factors
  • Self Care