Background Foot and ankle problems are common but often neglected in Rheumatology patients. We developed a self-administered, rapid screening questionnaire with unique feature of diagrams for patients to indicate their problems visually. There are ten questions which include domains of symptoms, function, disability, work, footwear and surgery. We further simplified the language (SMOG reading age <11), and added a patient global assessment 100mm VAS to allow patients to express symptom severity.
Objectives Our objective was to assess the usability of the modified Swindon Foot and Ankle Questionnaire (SFAQ) in different rheumatology units where foot screening questionnaires are not routinely used.
Methods 234 patients from 3 rheumatology centres (Swindon n=86, Truro n=87, Basingstoke n=61) were invited to complete the SFAQ prior to outpatient consultation. We recorded their rheumatological diagnosis, SFAQ score (0 to 10), VAS score (0 to 100) and recorded if they had used the foot diagrams.
Results All 234 patients completed the SFAQ, the vast majority unaided. Diagnoses included Rheumatoid Arthritis (40%), Psoriatic Arthritis (14%), Ankylosing Spondylitis, Osteoarthritis, Fibromyalgia, Sjogren's and SLE.
SFAQ 10 point questionnaire score: mean 2.9, median 3.0 (range 0-10); 62 patients (26%) scored 0.
VAS: 192 (82%) patients completed the 100mm VAS: mean 28, median 20, (range 0-100). There was a strong correlation between the SFAQ score and VAS foot score (r=0.67) 15 patients did not use the VAS. 27 patients wrote words above the VAS instead of a marking a line.
Pictures: 146 (62%) patients indicated their symptoms on the foot diagram;
10 patients used neither diagram nor VAS and their mean SFAQ score was 0.9 (n=10).
Work: 19 (8.5%) answered 'yes' to the question “in the last week have your feet or ankles stopped you going to work?” Their mean VAS score was 67 and mean SFAQ score was 7.1.
Conclusions The modified SFAQ is a rapid, patient administered questionnaire, simple enough to be completed unaided prior to consultations in different rheumatology centres. The questions, foot diagrams and VAS were all widely used and gave patients the opportunity to communicate their symptoms in a variety of ways. There was a strong correlation between SFAQ score and VAS score.
8.5% patients with high scores reported their foot and ankle symptoms had stopped them working. Clinicians may use this as a rapid tool to prompt early diagnosis and treatment of foot and ankle problems in Rheumatology patients, highlighted as a commonly neglected aspect of patient care.
Disclosure of Interest None declared
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