'My feet - visible, but ignored ... ' A qualitative study of foot care for people with rheumatoid arthritis

Objective: To explore patients' experiences of foot problems associated with rheumatoid arthritis, from onset of symptoms to being provided with foot health interventions. Design: A qualitative design was used with an interpretive phenomenological approach to the data collection and analysis. Setting: University of Salford, School of Health Science. Subjects: Sixteen female and six male adults with rheumatoid arthritis-related foot problems and experience of receiving foot health interventions. Method: Data were collected through digital recordings of three focus groups which were conducted by an experienced researcher. An observer made field notes. Transcribed data were analysed using a thematic framework. Data were verified with randomly selected participants and agreement achieved with the participants, researcher and observer. Results: The results were organized into five themes: the significance of foot symptoms in relation to diagnosis of rheumatoid arthritis; knowledge of and explanation about foot symptoms; accessing foot health interventions; the effectiveness of foot health interventions; and improvements to foot health interventions. Despite foot problems being of concern to the participants, they were often ignored by practitioners from before diagnosis through to foot management. Conclusions: This study has highlighted a polarity between what these participants need in relation to their foot symptoms and the management of them. That foot problems are often ignored is of concern at multiple levels. These range from the implications of ignoring foot symptoms that may aid diagnosis of rheumatoid arthritis, to ignoring the need for effective foot health interventions.