Foot care for patients with rheumatoid arthritis by nurses using a multidisciplinary team approach

Abstract

  Infection secondary to immunological disorders caused by rheumatoid therapeutic agents is a clinically important problem because ingrown nails and callosity due to rheumatoid arthritis-induced foot deformation are painful and at risk of wound formation. Foot swelling, pain, and deformation caused by rheumatoid arthritis affect patients’ daily life and decrease their self-care ability. Therefore, we recognized the importance of foot care by nurses and started a foot care protocol in our Rheumatic Center. This foot care protocol involves foot observation, foot bathing, nail clipping, treatment of callosity, and explanations of how to perform foot care at home and how to select shoes. While listening to patients’ stories about changes in their physical condition, thoughts regarding their disease, and adjustments of their medical treatment methods, we attempt to relate to the patients’ general experience of living with their medical condition and its treatment. Callosity occurs secondary to foot deformity, and surgical techniques may be adapted to the particular deformity according to the doctor’s recommendation. Nurses are closely involved in the patients’ decision-making process. We consider that although nurses have an important role in foot care for patients with rheumatoid arthritis, the care that nurses can perform is limited. Therefore, a team approach involving cooperation with other professionals such as rheumatologists, orthopedic surgeons, dermatologists, prosthetists, and orthotists is important. We believe that it is necessary to create an environment in which such care can be delivered to many patients.