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The Validity and Reliability of Self-Reported Adherence to Using Offloading Treatment in People with Diabetes-Related Foot Ulcers

Adherence to using offloading treatment is crucial to healing diabetes-related foot ulcers (DFUs). Offloading adherence is recommended to be measured using objective monitors. However, self-reported adherence is commonly used and has unknown validity and reliability. This study aimed to assess the v...

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Autores principales: Ababneh, Anas, Finlayson, Kathleen, Edwards, Helen, Armstrong, David G., Najafi, Bijan, van Netten, Jaap J., Lazzarini, Peter A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10181495/
https://www.ncbi.nlm.nih.gov/pubmed/37177627
http://dx.doi.org/10.3390/s23094423
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author Ababneh, Anas
Finlayson, Kathleen
Edwards, Helen
Armstrong, David G.
Najafi, Bijan
van Netten, Jaap J.
Lazzarini, Peter A.
author_facet Ababneh, Anas
Finlayson, Kathleen
Edwards, Helen
Armstrong, David G.
Najafi, Bijan
van Netten, Jaap J.
Lazzarini, Peter A.
author_sort Ababneh, Anas
collection PubMed
description Adherence to using offloading treatment is crucial to healing diabetes-related foot ulcers (DFUs). Offloading adherence is recommended to be measured using objective monitors. However, self-reported adherence is commonly used and has unknown validity and reliability. This study aimed to assess the validity and reliability of self-reported adherence to using removable cast walker (RCW) offloading treatment among people with DFUs. Fifty-three participants with DFUs using RCWs were included. Each participant self-reported their percentage adherence to using their RCW of total daily steps. Participants also had adherence objectively measured using dual activity monitors. After one week, a subset of 19 participants again self-reported their percentage adherence to investigate test–retest reliability. Validity was tested using Pearson’s r and Bland–Altman tests, and reliability using Cohen’s kappa. Median (IQR) self-reported adherence was greater than objectively measured adherence (90% (60–100) vs. 35% (19–47), p < 0.01). There was fair agreement (r = 0.46; p < 0.01) and large 95% limits of agreement with significant proportional bias (β = 0.46, p < 0.01) for validity, and minimal agreement for test–retest reliability (K = 0.36; p < 0.01). The validity and reliability of self-reported offloading adherence in people with DFU are fair at best. People with DFU significantly overestimate their offloading adherence. Clinicians and researchers should instead use objective adherence measures.
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spelling pubmed-101814952023-05-13 The Validity and Reliability of Self-Reported Adherence to Using Offloading Treatment in People with Diabetes-Related Foot Ulcers Ababneh, Anas Finlayson, Kathleen Edwards, Helen Armstrong, David G. Najafi, Bijan van Netten, Jaap J. Lazzarini, Peter A. Sensors (Basel) Article Adherence to using offloading treatment is crucial to healing diabetes-related foot ulcers (DFUs). Offloading adherence is recommended to be measured using objective monitors. However, self-reported adherence is commonly used and has unknown validity and reliability. This study aimed to assess the validity and reliability of self-reported adherence to using removable cast walker (RCW) offloading treatment among people with DFUs. Fifty-three participants with DFUs using RCWs were included. Each participant self-reported their percentage adherence to using their RCW of total daily steps. Participants also had adherence objectively measured using dual activity monitors. After one week, a subset of 19 participants again self-reported their percentage adherence to investigate test–retest reliability. Validity was tested using Pearson’s r and Bland–Altman tests, and reliability using Cohen’s kappa. Median (IQR) self-reported adherence was greater than objectively measured adherence (90% (60–100) vs. 35% (19–47), p < 0.01). There was fair agreement (r = 0.46; p < 0.01) and large 95% limits of agreement with significant proportional bias (β = 0.46, p < 0.01) for validity, and minimal agreement for test–retest reliability (K = 0.36; p < 0.01). The validity and reliability of self-reported offloading adherence in people with DFU are fair at best. People with DFU significantly overestimate their offloading adherence. Clinicians and researchers should instead use objective adherence measures. MDPI 2023-04-30 /pmc/articles/PMC10181495/ /pubmed/37177627 http://dx.doi.org/10.3390/s23094423 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ababneh, Anas
Finlayson, Kathleen
Edwards, Helen
Armstrong, David G.
Najafi, Bijan
van Netten, Jaap J.
Lazzarini, Peter A.
The Validity and Reliability of Self-Reported Adherence to Using Offloading Treatment in People with Diabetes-Related Foot Ulcers
title The Validity and Reliability of Self-Reported Adherence to Using Offloading Treatment in People with Diabetes-Related Foot Ulcers
title_full The Validity and Reliability of Self-Reported Adherence to Using Offloading Treatment in People with Diabetes-Related Foot Ulcers
title_fullStr The Validity and Reliability of Self-Reported Adherence to Using Offloading Treatment in People with Diabetes-Related Foot Ulcers
title_full_unstemmed The Validity and Reliability of Self-Reported Adherence to Using Offloading Treatment in People with Diabetes-Related Foot Ulcers
title_short The Validity and Reliability of Self-Reported Adherence to Using Offloading Treatment in People with Diabetes-Related Foot Ulcers
title_sort validity and reliability of self-reported adherence to using offloading treatment in people with diabetes-related foot ulcers
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10181495/
https://www.ncbi.nlm.nih.gov/pubmed/37177627
http://dx.doi.org/10.3390/s23094423
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