Current Pedorthics | September-October 2018 | Vol.50, Issue 5 | Page 38

‘A good fit?’ ‘neo-liberalized’ healthcare system [36] , future research in this area will continue to be important. Research suggests that Podiatry patients can struggle with self-care [8] , yet in a climate of cuts and cost-saving measures, it is likely that the onus will increasingly rest on patients to manage their own conditions. Therefore, research exploring the motivations behind patient experiences and barriers to change they encounter is timely and welcomed. The consequences of poor shoe choices can be significant, and increasing opportunities for genuine, individualized dialogue between practitioners and patients may help those patients to successfully make ‘healthier’ shoe choices that still align with their values and preferences. This, in turn, may lead to improved long-term foot health and ultimately reduce the burden placed on the NHS [37] . Conclusion To conclude, it is clear that adopting a more sociological perspective to healthcare research on shoes and footwear can add an important new dimension to our understanding of patient behavior within or outside the clinical encounter. Specifically, exploring patient values, motivations and preferences in relation to shoe choice can help to shed light on some of the barriers to change that patients may encounter when advised to adopt ‘healthier’ footwear. An understanding of the centrality of shoes to people’s sense of self and identity may help practitioners to recognize that changing footwear practices is not a simple, rational or neutral process. Rather, shoes may be intimately bound up with a patient’s sense of who they are — or who they want to be — meaning change may not come easily. The increasing use of more qualitative methods – particularly innovative methods such as shoe diaries and videos – offers further opportunities for practitioners to really explore patient values and priorities and their relationship with their feet and footwear. Moving forward, further use of in-depth methods that are embedded into patients’ everyday lives and explore their daily practices and habits will provide real scope to understand the ways in which practitioner advice is adopted, resisted or ignored (and of course why this is so) outside and beyond the clinical encounter. NOTES: Authors’ contributions Lisa Farndon, Email: [email protected] EN, VR, LF and WV drafted the manuscript. All four authors read and approved the final manuscript. Wesley Vernon, Email: [email protected] Contributor Information PUBLISHER’S NOTE Emily Nicholls, Email: [email protected] Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Victoria Robinson, Email: [email protected] 36 Pedorthic Footcare Association | www.pedorthics.org