Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Sep 24:11:54.
doi: 10.1186/s13047-018-0296-8. eCollection 2018.

Charcot neuroarthropathy patient education among podiatrists in Scotland: a modified Delphi approach

Benjamin Bullen  1 , Matthew Young  1 , Carla McArdle  2 , Mairghread Ellis  2
Affiliations

Charcot neuroarthropathy patient education among podiatrists in Scotland: a modified Delphi approach

Benjamin Bullen et al. J Foot Ankle Res. .

Abstract

Background: This evaluation sought to determine current Charcot neuroarthropathy (CN) diabetes patient education practices among Scottish National Health Service (NHS) and academic podiatrists and evaluate novel visual tools and develop expert consensus for future practice.

Methods: Questionnaires collected mixed qualitative and quantitative responses, analysed concurrently within a convergence coding matrix. Delphi methodology permitted member-checking and agreement of consensus over two rounds.

Results: Fourteen participants (16.28%) completed a Round One questionnaire, leading to the generation of four themes; Experience; Person-Centred Care and the Content and Context of CN patient education. Seven consensus statements were subsequently developed and six achieved over 80% agreement among 16 participants (18.60%) with a Round Two questionnaire. Respondents agreed CN patient education should be considered for all 'At-risk' individuals with diabetic peripheral neuropathy (DPN). Verbal metaphors, including the 'rocker-bottom' foot, soft or brittle bones, collapsing, walking on honeycomb and a shattering lightbulb were frequently employed. Visual tools, including visual metaphors and The Charcot Foot Thermometer, were positively evaluated and made available online.

Conclusions: Key findings included respondent's belief that CN education should be considered for all individuals with DPN and the frequent use of simile, analogy and metaphor in CN education. The concept of 'remission' proved controversial due to its potential for misinterpretation.

Keywords: Charcot neuroarthropathy; Consensus; Delphi methodology; Diabetic peripheral neuropathy; Metaphor; Patient education; Remission.

PubMed Disclaimer

Conflict of interest statement

This research was granted ethical approval by QMU’s Research Ethics Panel on 8th November 2016. Respondents were informed that submission of completed study materials constituted consent for participation in this research.Respondents were informed that submission of completed study materials constituted consent for publication of findings.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Round One Flowers and Bee Analytical Framework, representing Experience, Person-Centred Care and the Content and Context of CN patient education
See this image and copyright information in PMC

References

    1. American Orthopaedic Foot & Ankle Society. Charcot arthropathy. https://www.aofas.org/footcaremd/conditions/diabetic-foot/Pages/Charcot-.... Accessed 16 Sept 2018.
    1. Bailey CC, Root HF. Neuropathic foot lesions in diabetes mellitus. N Engl J Med. 1947;236(11):397–401. doi: 10.1056/NEJM194703132361103. - DOI - PubMed
    1. Sinha S, Munichoodappa CS, Kozak GP. Neuro-arthropathy (Charcot joints) in diabetes mellitus. Medicine. 1972;51(3):191–210. doi: 10.1097/00005792-197205000-00006. - DOI - PubMed
    1. Klenerman L. The Charcot joint in diabetes. Diabet Med. 1996;13(Suppl 1):52–54. doi: 10.1002/dme.1996.13.s1.52. - DOI - PubMed
    1. Fabrin J, Larsen K, Holstein PE. Long-term follow-up in diabetic Charcot feet with spontaneous onset. Diabetes Care. 2000;23(6):796–800. doi: 10.2337/diacare.23.6.796. - DOI - PubMed

MeSH terms