Importance of Footwear for Preventing Xerosis and Hyperkeratosis in Older People with Psychiatric Disorders Living in an Institution
Abstract
:1. Introduction
2. Materials and Methods
2.1. Ethical Considerations
2.2. Design and Sample
2.3. Procedure
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Components of a Footwear | Street Footwear | Home Footwear | Sports Shoes |
---|---|---|---|
Toe box | Closed, wide, adapted to the foot, room for the toes, not pointed [12,13]. | Closed, fairly stiff, adapted to deformities [12,13]. | Closed, round, wide, adapted to the foot, room for toes [12,14]. |
Heel height | Men 2–2.5 cm. Women 2–3 cm [12]. | Low and wide. Men and women 2 cm [12,13]. | No heel or added insoles [15]. |
Material of uppers | Quality, natural materials: leather, suede [12,14]. | Washable, synthetic, flexible, light, warm for winter and breathable for summer [12,13,14]. | Elastic (normally leather) and breathable [14,15]. |
Sole | Materials: natural or manmade rubber, polyurethane. Sole thickness: 8–10 mm. Non-slip features: tread for better grip on the floor [12,14]. | Flexible but stable. Cushioning. Materials: microcellular rubber or polyurethane, natural or manmade rubber. Non-slip features: tread to aid gripping [12,14]. | Light, cushioning, with non-slip features: tread for better grip on the ground [12,14,15]. |
Width and length | Appropriate volume for the foot and metatarsal-phalangeal zone. Length: 10–20 mm men’s footwear and 10–15 mm women’s footwear [5,12]. | Suitable for deformities and the volume of the foot. Length: 10–20 mm men’s footwear and 10–15 mm women’s footwear [12,14]. | Suitable for the volume of the foot [12,14]. |
Seams | No harmful seams [12,14,16]. | No harmful seams [12,14,16]. | No harmful seams [12,14,16]. |
Fastenings | High, with laces or Velcro [12,14]. | Velcro or elastic [12,14]. | Laces or Velcro, with tongue [2,12]. |
Quarter | Stiff heel counter, closed [12,14]. | Light heel counter without reinforcing, closed [12,14]. | Heel counter, closed [12,14]. |
Participant Demographics | ||||
---|---|---|---|---|
Analyzed Variables | Categories | CP | IP | p-Value |
Sex | Mens | 44.4% | 61.4% | 0.116 |
Women | 55.6% | 38.6% | ||
Age (years) | Mens | 64.75 ± 12.036 | 63.70 ± 9.953 | 0.561 |
Women | 60.06 ±13.911 | 72.35 ± 9.360 | 0.008 * | |
Total | 62.14 ±13.219 | 67.05 ± 10.519 | 0.141 | |
BMI | Severely underweight (<16) | 0.0% | 0.0% | 0.207 |
Moderately underweight (16–16.99) | 0.0% | 0.0% | ||
Acceptably underweight (17–18.49) | 0.0% | 0.0% | ||
Normal (healthy weight) (18.5–24.99) | 35.5% | 22.7% | ||
Overweight (25–29.99) | 46.8% | 50.0% | ||
Obese Class I (30–34.99) | 16.1% | 18.2% | ||
Obese Class II (35–40) | 1.6% | 9.1% | ||
Obese Class III (>40) | 0.0% | 0.0% | ||
Diabetes mellitus | Total | 11.1% | 20.5% | 0.270 |
Hypertension | Total | 28.6% | 13.6% | 0.099 |
Hypercholesterinemia | Total | 30.2% | 25.0% | 0.663 |
Type of foot (footprints) | Cavus foot | 28.1% | 40.0% | 0.418 |
Flat Foot | 6.3% | 4.0% | ||
Normal Foot | 43.8% | 24.0% | ||
Asymmetry in Feet | 21.9% | 32.0% | ||
Dx psychiatric disorder | None | 88.9% | 0.0% | 0.000 * |
PsyD | 0.0% | 25.0% | ||
PD | 0.0% | 29.5% | ||
DCA | 0.0% | 29.5% | ||
MD | 11.1% | 15.9% | ||
Barthel Index (BI) | Total dependency (<20) | 0.0% | 0.0% | 0.098 |
Severe dependency (21–60) | 0.0% | 0.0% | ||
Moderate dependency (61–90) | 1.6% | 4.5% | ||
Slight dependency (91–99) | 7.9% | 20.5% | ||
Fully Independent (100) | 90.5% | 75.0% |
Characteristics of Street Footwear | ||
---|---|---|
YES | Shoe upper: natural, quality materials | NO |
YES | Volume: appropriate for the foot | NO |
YES | Heel: appropriate height | NO |
YES | Sole: light with multidirectional tread, neither too flexible nor too stiff | NO |
YES | Seams: not harmful | NO |
YES | Quarter: closed, with heel counter | NO |
YES | Toe box: closed, not pointed | NO |
YES | In good state of repair | NO |
Characteristics of Home Footwear | ||
YES | Shoe upper: flexible materials | NO |
YES | Volume: appropriate for the foot | NO |
YES | Heel: appropriate height | NO |
YES | Sole: Microcellular rubber, natural or manmade rubber, non-slip | NO |
YES | Seams: not harmful | NO |
YES | Quarter: closed, with heel counter | NO |
YES | Toe box: closed, not pointed | NO |
YES | In good state of repair | NO |
Characteristics of Sports Shoes | ||
YES | Shoe upper: flexible, breathable materials | NO |
YES | Volume: appropriate for the foot | NO |
YES | Heel: none | NO |
YES | Sole: cushioning and non-slip | NO |
YES | Seams: not harmful | NO |
YES | Quarter: closed, with heel counter | NO |
YES | Shoe box: closed, not pointed, room for toes | NO |
YES | In good state of repair | NO |
Population/Sex | N | Street | N | Sports | N | Home | Chi-Square |
---|---|---|---|---|---|---|---|
CP | 57 | 90.5% | 5 | 7.9% | 1 | 1.6% | <0.001 * |
PI | 14 | 31.8% | 5 | 11.4% | 25 | 56.8% | |
N | Street | N | Sports | N | Home | Chi-Square | |
Men CP | 26 | 92.9% | 2 | 7.1% | 0 | 0% | <0.001 * |
Men PI | 13 | 48.1% | 4 | 14.8% | 10 | 37% | |
N | Street | N | Sports | N | Home | Chi-Square | |
Women CP | 31 | 88.5% | 3 | 8.6% | 1 | 2.9% | <0.001 * |
Women PI | 1 | 5.9% | 1 | 5.9% | 15 | 82.2% |
Type of Material | N | % CP | N | % PI | Chi-Square |
---|---|---|---|---|---|
Leather | 56 | 77.8% | 16 | 22.2% | <0.001 * |
Textile | 1 | 3.7% | 26 | 96.3% | |
Synthetic or other | 6 | 75% | 2 | 25% | |
PI | N | % Men | N | % Women | Chi-Square |
Leather | 15 | 93.8% | 1 | 6.3% | 0.004 * |
Textile | 11 | 42.3% | 15 | 57.7% | |
Synthetic or other | 1 | 50% | 1 | 50% | |
CP | N | % Men | N | % Women | Chi-Square |
Leather | 25 | 48.2% | 29 | 51.8% | 0.223 |
Textile | 0 | 0% | 1 | 100% | |
Synthetic or other | 1 | 16.7% | 5 | 83.3% |
Footwear State of Repair | Poor | % | Good | % | Fisher Exact Test |
---|---|---|---|---|---|
CP | 1 | 1.6% | 62 | 98.4% | 0.008 * |
PI | 7 | 15.9% | 37 | 84.1% | |
Men | Poor | % | Good | % | Fisher Exact Test |
CP | 0 | 0% | 28 | 100% | 0.004 * |
PI | 7 | 25.9% | 20 | 74.1% | |
Women | Poor | % | Good | % | Fisher Exact Test |
CP | 1 | 2.9% | 34 | 97.1% | 0.673 |
PI | 0 | 0% | 17 | 100% |
Footwear Type and Foot Pathologies | |||||
---|---|---|---|---|---|
N | % Toe deformity | N | % No Toe Deformity | Chi-Square | |
Street footwear | 54 | 76.1% | 17 | 23.9% | 0.426 |
Home footwear | 18 | 69.2% | 8 | 30.8% | |
Sports shoes | 9 | 90% | 1 | 10% | |
N | % Keropathies | N | % No keropathies | Chi-Square | |
Street footwear | 62 | 87.3% | 9 | 12.7% | 0.662 |
Home footwear | 21 | 80.3% | 5 | 19.2% | |
Sports shoes | 9 | 90% | 1 | 10% | |
N | % Dermatopathies | N | % No dermatopathies | Chi-Square | |
Street footwear | 35 | 49.3% | 36 | 50.7% | 0.107 |
Home footwear | 19 | 73.1% | 7 | 26.9% | |
Sports shoes | 5 | 50% | 5 | 50% | |
N | % Onychopathies | N | % No onychopathies | Chi-Square | |
Street footwear | 34 | 47.9% | 37 | 52.1% | 0.171 |
Home footwear | 18 | 69.2% | 8 | 30.8% | |
Sports shoes | 5 | 50% | 5 | 50% | |
N | % Xerosis | N | % No xerosis | Chi-Square | |
Street footwear | 13 | 18.3% | 58 | 81.7% | 0.000 * |
Home footwear | 17 | 65.4% | 9 | 34.6% | |
Sports shoes | 3 | 30% | 7 | 70% | |
N | % Dorsal Hk 4th toe | N | % No dorsal Hk 4th toe | Chi-Square | |
Street footwear | 0 | 0% | 71 | 100% | 0.008 * |
Home footwear | 3 | 11.5% | 23 | 88.5% | |
Sports shoes | 0 | 0% | 10 | 100% | |
Shoe Upper Material and Foot Pathologies | |||||
N | % Toe deformity | N | % No toe deformity | Chi-Square | |
Leather | 54 | 75% | 18 | 25% | 0.233 |
Textile | 19 | 70.4% | 8 | 29.6% | |
Synthetic or other | 8 | 100% | 0 | 0% | |
N | % Keropathies | N | % No keropathies | Chi-Square | |
Leather | 62 | 86.1% | 10 | 13.9% | 0.415 |
Textile | 22 | 81.5% | 5 | 18.5% | |
Synthetic or other | 8 | 100% | 0 | 0% | |
N | % Dermatopathies | N | % No dermatopathies | Chi square | |
Leather | 34 | 47.2 | 38 | 52.8 | 0.060 |
Textile | 19 | 70.4 | 8 | 29.6 | |
Synthetic or other | 6 | 75 | 2 | 25 | |
N | % Onychopathies | N | % No onychopathies | Chi-Square | |
Leather | 33 | 45.8% | 39 | 54.2% | 0.080 |
Textile | 19 | 70.4% | 8 | 29.6% | |
Synthetic or other | 5 | 62.5% | 3 | 37.5% | |
N | % Xerosis | N | % No Xerosis | Chi-Square | |
Leather | 13 | 18.1% | 59 | 81.9% | 0.000 * |
Textile | 17 | 63% | 10 | 37% | |
Synthetic or other | 3 | 37.5% | 5 | 62.5% | |
N | % Dorsal Hk 4th toe | N | % No dorsal Hk 4th toe | Chi-Square | |
Leather | 0 | 0% | 72 | 100% | 0.010 * |
Textile | 3 | 11.1% | 24 | 88.9% | |
Synthetic or other | 0 | 0% | 8 | 100% |
People with Intellectual Disability and Psychiatric Disorder | |||
---|---|---|---|
% Xerosis | % No xerosis | Fisher exact test | |
Leather footwear | 25.0% | 75.0% | 0.031 * |
Non-leather footwear | 60.7% | 39.3% | |
% Dorsal Hk 4th toe | % No dorsal Hk 4th toe | Fisher exact test | |
Leather footwear | 0.0% | 100% | 0.290 |
Non-leather footwear | 10.7% | 89.3% | |
% Xerosis | % No xerosis | Fisher exact test | |
Textile footwear | 61.5% | 38.5% | 0.036 * |
Non-textile footwear | 27.8% | 72.2% | |
% Dorsal Hk 4th toe | % No dorsal Hk 4th toe | Fisher exact test | |
Textile footwear | 11.5% | 88.5% | 0.258 |
Non-textile footwear | 0% | 100% | |
% Xerosis | % No xerosis | Fisher exact test | |
Synthetic footwear | 50.0% | 50.0% | 1.000 |
Non-synthetic footwear | 47.6% | 52.4% | |
% Dorsal Hk 4th toe | % No dorsal Hk 4th toe | Fisher exact test | |
Synthetic footwear | 0% | 100% | 1.000 |
Non-synthetic footwear | 7.1% | 92.9% |
People Populations Taking Psychotropic Medication | |||
---|---|---|---|
% Xerosis | % No xerosis | Fisher exact test | |
Leather footwear | 23.8% | 76.2% | 0.037 * |
Non-leather footwear | 57.7% | 42.3% | |
% Dorsal Hk 4th toe | % No dorsal Hk 4th toe | Fisher exact test | |
Leather footwear | 0% | 100% | 0.242 |
Non-leather footwear | 11.5% | 88.5% | |
% Xerosis | % No Xerosis | Fisher exact test | |
Textile footwear | 58.3% | 41.7% | 0.039 * |
Non-textile footwear | 26.1% | 73.9% | |
% Dorsal Hk 4th toe | % No dorsal Hk 4th toe | Fisher exact test | |
Textile footwear | 12.5% | 87.5% | 0.234 |
Non-textile footwear | 0.0% | 100% | |
% Xerosis | % No Xerosis | Fisher exact test | |
Synthetic footwear | 50.0% | 50.0% | 1.000 |
Non-synthetic footwear | 42.2% | 57.8% | |
% Dorsal Hk 4th toe | % No dorsal Hk 4th toe | Fisher exact test | |
Synthetic footwear | 0.0% | 100% | 1.000 |
Non-synthetic footwear | 6.7% | 93.3% |
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Pérez-Pico, A.M.; Marcos-Tejedor, F.; Iglesias-Sánchez, M.J.; Acevedo, R.M. Importance of Footwear for Preventing Xerosis and Hyperkeratosis in Older People with Psychiatric Disorders Living in an Institution. Int. J. Environ. Res. Public Health 2018, 15, 584. https://doi.org/10.3390/ijerph15040584
Pérez-Pico AM, Marcos-Tejedor F, Iglesias-Sánchez MJ, Acevedo RM. Importance of Footwear for Preventing Xerosis and Hyperkeratosis in Older People with Psychiatric Disorders Living in an Institution. International Journal of Environmental Research and Public Health. 2018; 15(4):584. https://doi.org/10.3390/ijerph15040584
Chicago/Turabian StylePérez-Pico, Ana María, Félix Marcos-Tejedor, María José Iglesias-Sánchez, and Raquel Mayordomo Acevedo. 2018. "Importance of Footwear for Preventing Xerosis and Hyperkeratosis in Older People with Psychiatric Disorders Living in an Institution" International Journal of Environmental Research and Public Health 15, no. 4: 584. https://doi.org/10.3390/ijerph15040584