A novel shoe comfortability evaluation method to reflect recognition in nursing of diabetic foot among diabetes patients in Southwest China

Effective footwear and offloading interventions were recommended in the official guidance for diabetic foot (DF) management, where unfortunately the detail of shoes' definition was still unclear; meanwhile, in China, 0.1 billion population has been diagnosed with diabetes mellitus, but what kind of shoes worn by Chinese diabetic patients was unknown. Therefore, the aim of this study was to establish a system to quantify the comfortability of shoes among DF patients, and based on this method conduct a random survey of shoe wearing situation in diabetes population in Sichuan province. 472 participants joined in this study and their shoes were defined as structure of shoes, upper materials, status of welt, heel height and thickness of sole. Each part of shoes was first quantified into scores; and then aggregated scores were calculated as the final assessment result for the shoes. Three levels reflecting the recognition of shoes from patients were classified into: discomfort; moderate comfort; comfort. Finally, a univariate analysis with least significant difference (LSD) was exerted in shoe wearing comfort for variables of age, gender, BMI, occupation, history of diabetes mellitus and Michigan score. Results show that numbers of elder and male patients wear comfort shoes were more than that of female and younger ones; meanwhile, those findings were recorded to be significant. Overall, comfortability quantification system was established and both gender and age factors determined the consciousness and knowledge in shoe wearing; thereby, our system was valid and shoes wearing education for female and younger diabetic patients are urgent.