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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| Format: | Article |
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MDPI AG
2023-04-01
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| Series: | Sensors |
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| Online Access: | https://www.mdpi.com/1424-8220/23/9/4423 |
| _version_ | 1827742600383168512 |
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| author | Anas Ababneh Kathleen Finlayson Helen Edwards David G. Armstrong Bijan Najafi Jaap J. van Netten Peter A. Lazzarini |
| author_facet | Anas Ababneh Kathleen Finlayson Helen Edwards David G. Armstrong Bijan Najafi Jaap J. van Netten Peter A. Lazzarini |
| author_sort | Anas Ababneh |
| collection | DOAJ |
| 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), <i>p</i> < 0.01). There was fair agreement (r = 0.46; <i>p</i> < 0.01) and large 95% limits of agreement with significant proportional bias (β = 0.46, <i>p</i> < 0.01) for validity, and minimal agreement for test–retest reliability (K = 0.36; <i>p</i> < 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. |
| first_indexed | 2024-03-11T04:07:24Z |
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| institution | Directory Open Access Journal |
| issn | 1424-8220 |
| language | English |
| last_indexed | 2024-03-11T04:07:24Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Sensors |
| spelling | doaj.art-e2f212f262894e93ad71e51888da80e32023-11-17T23:44:12ZengMDPI AGSensors1424-82202023-04-01239442310.3390/s23094423The Validity and Reliability of Self-Reported Adherence to Using Offloading Treatment in People with Diabetes-Related Foot UlcersAnas Ababneh0Kathleen Finlayson1Helen Edwards2David G. Armstrong3Bijan Najafi4Jaap J. van Netten5Peter A. Lazzarini6Faculty of Nursing, Applied Science Private University, Amman 11931, JordanSchool of Nursing, Queensland University of Technology, Brisbane, QLD 4059, AustraliaSchool of Nursing, Queensland University of Technology, Brisbane, QLD 4059, AustraliaKeck School of Medicine, University of Southern California, Los Angeles, CA 90089, USAInterdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USADepartment of Rehabilitation Medicine, 1105 AZ Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1012 WX Amsterdam, The NetherlandsCentre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD 4059, AustraliaAdherence 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), <i>p</i> < 0.01). There was fair agreement (r = 0.46; <i>p</i> < 0.01) and large 95% limits of agreement with significant proportional bias (β = 0.46, <i>p</i> < 0.01) for validity, and minimal agreement for test–retest reliability (K = 0.36; <i>p</i> < 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.https://www.mdpi.com/1424-8220/23/9/4423adherencediabetic footfoot ulceroffloadingself-report |
| spellingShingle | Anas Ababneh Kathleen Finlayson Helen Edwards David G. Armstrong Bijan Najafi Jaap J. van Netten Peter A. Lazzarini The Validity and Reliability of Self-Reported Adherence to Using Offloading Treatment in People with Diabetes-Related Foot Ulcers Sensors adherence diabetic foot foot ulcer offloading self-report |
| 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 | adherence diabetic foot foot ulcer offloading self-report |
| url | https://www.mdpi.com/1424-8220/23/9/4423 |
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