ABSTRACT BACKGROUND: Foot problems are believed to reduce quality of life and are increasingly present. Even among young adults of university age, untreated foot problems can lead to postural and mobility problems. Accordingly, our aim here was to determine the relationship between foot health and quality of life and general health among male and female university students. DESIGN AND SETTING: Observational cross-sectional quantitative study conducted at the Podiatric Medicine and Surgery Clinic of the University of Coruña, Ferrol, Spain. METHODS: A sample of 112 participants of median age 22 years came to a health center, where self-reported data were registered, including professional activity, and scores obtained through the Foot Health Status Questionnaire (FHSQ) were compared. RESULTS: In Section One of the FHSQ, the university students recorded lower scores of 66.66 in the footwear domain and 60 in the general foot health domain and higher scores of 84.37 in the foot pain domain and 93.75 in the foot function domain. In Section Two, they obtained lower scores of 60 in the overall health domain and 62.50 in the vigor domain and higher scores of 100 in the physical activity and 87.50 in the social capacity domain. Differences between males and females were evaluated using the Wilcoxon rank-sum test, which showing statistical significance (P < 0.05) regarding the dimensions of footwear and general foot health. CONCLUSIONS: These university students’ quality of life relating to foot health was poor. This appears to be associated with the university period, regardless of gender.

Resumo Introdução: o uso de sapatos com tamanhos inadequados é comum em pessoas idosas e acredita-se resultar em efeito negativo sobre a qualidade de vida relacionada à saúde do pé. O objetivo é descrever e comparar o impacto de uma amostra de participantes usando calçados de tamanho adequado e indivíduos com calçados de tamanho inadequado, e as pontuações relacionadas com a saúde do pé e geral. Método: de uma amostra de 64 participantes, com idade média de 75,3±7,9, de um centro ambulatorial, dados de autorrelato foram registrados e medidas do tamanho dos pés e dos calçados foram determinadas. Os escores foram comparados pelo Foot Health Status Questionnaire, na versão em espanhol, entre os grupos que usavam sapatos de tamanhos corretos e incorretos. Resultados: o grupo que utilizava sapatos inadequados mostrou pior qualidade de vida relacionada à saúde geral e no pé. Diferenças entre os grupos foram avaliadas utilizando o teste t para amostras independentes, sendo estatisticamente significativas (p<0,05) para dimensão da dor, função, calçados, saúde geral, do pé e função social. Conclusão: o uso de calçado inadequado tem um impacto negativo significativo sobre a qualidade de vida relacionada à saúde do pé. O grau de impacto negativo parece estar associado com idade, sexo e índice de massa corpórea (IMC).

Summary Introduction: The use of an improper shoe size is common in older people and is believed to have a detrimental effect on the quality of life related to foot health. The objective is to describe and compare, in a sample of participants, the impact of shoes that fit properly or improperly, as well as analyze the scores related to foot health and health overall. Method: A sample of 64 participants, with a mean age of 75.3±7.9 years, attended an outpatient center where self-report data was recorded, the measurements of the size of the feet and footwear were determined and the scores compared between the group that wears the correct size of shoes and another group of individuals who do not wear the correct size of shoes, using the Spanish version of the Foot Health Status Questionnaire. Results: The group wearing an improper shoe size showed poorer quality of life regarding overall health and specifically foot health. Differences between groups were evaluated using a t-test for independent samples resulting statistically significant (p<0.05) for the dimension of pain, function, footwear, overall foot health, and social function. Conclusion: Inadequate shoe size has a significant negative impact on quality of life related to foot health. The degree of negative impact seems to be associated with age, sex, and body mass index (BMI).

Objetivo: Conocer si la altura del arco del pie tiene impacto en la calidad de vida relacionada con la salud en la etapa escolar. Métodos: Ciento trece escolares acudieron a un centro ambulatorio donde se registraron datos autoinformados, se clasificaron los pies en función de los valores del índice del arco en tres grupos (aumentado, disminuido y normal) y se compararon las puntuaciones obtenidas según el Foot Health Status Questionnaire (FHSQ) versión española. Resultados: Los grupos con arco del pie aumentado, disminuido y normal muestran puntuaciones más bajas en la primera sección en las dimensiones salud del pie y calzado y puntuaciones altas en dolor y función del pie. En la segunda sección obtuvieron menos puntuación en la dimensión salud general y puntuaciones altas en función física, función social y vitalidad. Conclusiones: La comparación de las puntuaciones obtenidas muestra que la altura del arco tiene un impacto negativo en la calidad de vida. Dado que la evidencia actual sobre la etiología y el tratamiento de las enfermedades y deformidades es limitada, estos resultados ponen de manifiesto la necesidad de implementar programas para promover la salud de los pies y seguir investigando en esta condición común e incapacitante.

Objective: To determine whether arch height has an effect on the health-related quality of life of schoolchildren. Methods: One hundred and thirteen schoolchildren attended an out-patient centre where self-reported data were recorded, their feet were classified into one of three groups according to their arch index (high, normal or low) and the scores obtained from the Foot Health Status Questionnaire (FHSQ - Spanish version) were compared. Results: The groups with high, low and normal arch recorded lower scores in Section One for the general foot health and footwear domains and higher scores in foot pain and foot function. In Section Two they obtained lower scores in general health and higher scores in physical activity, social capacity and vigor. Conclusions: Comparison of the scores obtained reveals that arch height has a negative impact on quality of life. Given the limited extent of available evidence in respect of the aetiology and treatment of foot diseases and deformities, these findings reveal the need to implement programmes to promote foot health and carry out further research into this commonly occurring disabling condition.

BACKGROUND: There is wide-spread consensus that a part of the use of hospital resources is inadequate in the sense that the patients receive services that do not provide them with any significant benefits, or that could be more beneficial, or less costly, with a lower care standard. The main aim of this work is to determine the percentage of inadequate admissions and stays in hospital for the four most frequent Diagnosis-Related Groups (DRGs) in a maternity-children's hospital through the retrospective application of the paediatric version of the Adequacy Evaluation Protocol (AEP). METHOD: It was a retrospective study in which 353 out of the 361 medical records that made up the covered population were analysed. Chi-square and linear trend were the statistical analysis methods used. A variance analysis and the Scheffé multiple comparison test were applied to the average values obtained. RESULTS: The admissions were judged to be adequate in 284 (80.5%) of the cases and inadequate in 69 (19.5%). Of the stays in hospital, 76% were deemed to be appropriate and 24% inappropriate. In DRG 030 (stupor and trauma-related coma, coma<1 hour, age 0-17), a direct relation can be found between the length of the stay in hospital and the inappropriate use of hospitalisation. CONCLUSIONS: The results of this study show that a substantial proportion of the use of the hospital is inappropriate and that, particularly in DRG 030, this use is probably handled in an overly conservative way.

FUNDAMENTO: Existe un amplio consenso en que una parte de la utilización de los recursos hospitalarios es inadecuada, en el sentido de que los pacientes reciben servicios que no les proporcionan beneficios significativos, o bien, que podrían ser más beneficiosos, o menos costosos, en un nivel asistencial inferior. El objetivo principal de este trabajo es determinar, mediante la aplicación retrospectiva de la versión pediátrica del Protocolo de Evaluación de la Adecuación (AEP), el porcentaje de ingresos y estancias inadecuadas de los 4 Grupos Relacionados con el Diagnóstico (GDR) más frecuentes en un hospital materno-infantil. MÉTODO: Se trata de un estudio retrospectivo en el que se analizan 353 historias clínicas (HC) de las 361 que constituyen la población de estudio. Como análisis estadístico se utiliza Chi cuadrado y análisis de tendencia lineal. Sobre las medias obtenidas se aplicó un análisis de la varianza y la prueba de comparación múltiple de Scheffé. RESULTADOS: Las admisiones fueron juzgadas como adecuadas en 284 (80,5%) de los casos e inadecuadas en 69 (19,5%). El 76% de las estancias revisadas fueron juzgadas como apropiadas y el 24% como inapropiadas. En el GDR 030 (estupor y coma de origen traumático, coma<1 hora, edad 0-17) se aprecia una relación directa entre duración de la estancia y uso inapropiado de la hospitalización. CONCLUSIONES: De los resultados de este estudio se desprende que una sustancial proporción de la utilización en el hospital es inapropiada y que, particularmente en el GDR 030, es probable se esté efectuando un manejo especialmente conservador.

BACKGROUND: There is wide-spread consensus that a part of the use of hospital resources is inadequate in the sense that the patients receive services that do not provide them with any significant benefits, or that could be more beneficial, or less costly, with a lower care standard. The main aim of this work is to determine the percentage of inadequate admissions and stays in hospital for the four most frequent Diagnosis-Related Groups (DRGs) in a maternity-children's hospital through the retrospective application of the paediatric version of the Adequacy Evaluation Protocol (AEP). METHOD: It was a retrospective study in which 353 out of the 361 medical records that made up the covered population were analysed. Chi-square and linear trend were the statistical analysis methods used. A variance analysis and the Scheffé multiple comparison test were applied to the average values obtained. RESULTS: The admissions were judged to be adequate in 284 (80.5%) of the cases and inadequate in 69 (19.5%). Of the stays in hospital, 76% were deemed to be appropriate and 24% inappropriate. In DRG 030 (stupor and trauma-related coma, coma<1 hour, age 0-17), a direct relation can be found between the length of the stay in hospital and the inappropriate use of hospitalisation. CONCLUSIONS: The results of this study show that a substantial proportion of the use of the hospital is inappropriate and that, particularly in DRG 030, this use is probably handled in an overly conservative way.

FUNDAMENTO: Existe un amplio consenso en que una parte de la utilización de los recursos hospitalarios es inadecuada, en el sentido de que los pacientes reciben servicios que no les proporcionan beneficios significativos, o bien, que podrían ser más beneficiosos, o menos costosos, en un nivel asistencial inferior. El objetivo principal de este trabajo es determinar, mediante la aplicación retrospectiva de la versión pediátrica del Protocolo de Evaluación de la Adecuación (AEP), el porcentaje de ingresos y estancias inadecuadas de los 4 Grupos Relacionados con el Diagnóstico (GDR) más frecuentes en un hospital materno-infantil. MÉTODO: Se trata de un estudio retrospectivo en el que se analizan 353 historias clínicas (HC) de las 361 que constituyen la población de estudio. Como análisis estadístico se utiliza Chi cuadrado y análisis de tendencia lineal. Sobre las medias obtenidas se aplicó un análisis de la varianza y la prueba de comparación múltiple de Scheffé. RESULTADOS: Las admisiones fueron juzgadas como adecuadas en 284 (80,5%) de los casos e inadecuadas en 69 (19,5%). El 76% de las estancias revisadas fueron juzgadas como apropiadas y el 24% como inapropiadas. En el GDR 030 (estupor y coma de origen traumático, coma<1 hora, edad 0-17) se aprecia una relación directa entre duración de la estancia y uso inapropiado de la hospitalización. CONCLUSIONES: De los resultados de este estudio se desprende que una sustancial proporción de la utilización en el hospital es inapropiada y que, particularmente en el GDR 030, es probable se esté efectuando un manejo especialmente conservador.