What influences a patients decision to use custom-made orthopaedic shoes?

Abstract

Background: Despite potential benefits, some patients decide not to use their custom-made orthopaedic shoes (OS). Factors are known in the domains usability, communication and service, and opinion of others that influence a patients decision to use OS. However, the interplay between these factors has never been investigated. The aim of this study was to explore the interplay between factors concerning OS, and the influences thereof on a patients decision to use OS. Methods: A mixed-methods design was used, combining qualitative and quantitative data by means of sequential data analysis and triangulation. Priority was given to the qualitative part. Qualitative data was gathered with a semistructured interview covering the three domains. Data was analysed using the framework approach. Quantitative data concerned the interplay between factors and determining a rank-order for the importance of factors of usability. Results: A patients decision to use OS was influenced by various factors indicated as being important and by acceptance of their OS. Factors of usability were more important than factors of communication; the opinion of others was of limited importance. An improvement of walking was indicated as the most important factor of usability. The importance of other factors (cosmetic appearance and ease of use) was determined by reaching a compromise between these factors and an improvement of walking. Conclusions: A patients decision to use OS is influenced by various factors indicated as being important and by acceptance of their OS. An improvement of walking is the most important factor of usability, the importance of other factors (cosmetic appearance and ease of use) is determined by reaching compromises between these factors and an improvement of walking. Communication is essential to gain insight in a patients acceptance and in the compromises they are willing to reach. This makes communication the key for clinicians to influence a patients decision to use OS. © 2012 van Netten et al.; licensee BioMed Central Ltd.