Nurses' Foot Health and Work Well-being

An electronic Foot Health Promoting Program (FHPP) will be tested with nurses using quasi-experimental study design.

The participants will be assigned to experimental (N=130) and comparison (N=130) groups. The experimental group will receive an electronic intervention (Foot Health Promotion Program) for 8 weeks consisting of foot self-care guidance (skin and nail self-care), foot exercises, foot stretching and professional footwear guidance. Detailed components of the intervention will be produced on the bases of survey (part 1) results. The intervention (Figure 3) will be electronic via internet (Moodle platform) where a material package of foot health care will be delivered. Each participant will receive a user account to platform. The platform is divided into four main themes all related to foot health. Each theme consists of two topics of foot health. Each topic includes lectures (delivered via Adobe Presenter) and self-directed learning where participant will go through a list of links to websites (will be evaluated with certain criteria beforehand) and watch videos about foot self-care. In addition, the learning will be evaluated using four individual tasks related to foot self-care. By responding to task a participant will receive an example of the correct answer and using that he/she can evaluate own response and learn by that. Participants' use of different links (quantity) and their paths in the intervention platform will be calculated and analysed. The participants will be tested before the intervention (baseline) and one month (follow-up 1) and four (follow-up 2) months after the intervention. The primary outcome is foot health knowledge and secondary outcomes are foot health, musculoskeletal problems, work ability, health-related quality of life and work satisfaction. Hypothesis is: Increasing nurses' knowledge about foot health will improve their foot health and work ability. Ultimate goal is to develop tools for the occupational health care and improve the attention paid to feet as part of the work ability among nurses.

• Foot Health Promoting Program (Behavioral), also known as FHPP: An electronic intervention for 8 weeks consisting of foot self-care guidance targeted to nurses.

Primary outcomes

• Change from Baseline Foot self-care knowledge at 4 and 12 weeks [baseline, 4 weeks, 12 weeks]: Measured with Foot Self-Care Knowledge Questionnaire including 11 questions using a "true," "false," or "don't know" response options.

Secondary outcomes

• Change from Baseline Foot health at 4 and 12 weeks [baseline, 4 weeks, 12 weeks]: Self-reported foot health questionnaire (SFHQ) will be modified for this study. It will measure self-reported foot health consisting of five subscales: skin, nails, foot structure, foot pain and professional footwear.
• Change from Baseline Musculoskeletal Disorders at 4 and 12 weeks [baseline, 4 weeks, 12 weeks]: Nordic Questionnaire measures musculoskeletal disorders in neck, shoulders, upper back, elbows, low back, wrists/hands, hips/thighs, knees and ankles/feet.
• Change from Baseline Foot health Status at 4 and 12 weeks [baseline, 4 weeks, 12 weeks]: Foot Health Status Questionnaire measures foot health related to quality of life. There are 4 subscales: foot pain (4 questions), foot function (4 questions), footwear (3 questions), and general foot health (2 questions).
• Change from Baseline Work Ability Score at 4 and 12 weeks [baseline, 4 weeks, 12 weeks]: Work Ability Score, assesses workers self-assessed work ability (one item with 0-10 scale)

Sex: All, ages: 18 Years to 65 Years, accepts healthy volunteers

Inclusion Criteria:

* nurses (registered nurses, licensed practical nurses, public health nurses) working in the operating theatre

Exclusion Criteria:

* other health care professionals

• Results publication: Stolt M, Katajisto J, Peltonen J, Suhonen R, Leino-Kilpi H. Development and testing of a new electronic foot health promotion programme on nurses' foot self-care. BMC Nurs. 2020 Apr 19;19:29. doi: 10.1186/s12912-020-00423-z. eCollection 2020. PMID 32327936

• Minna Stolt, PhD, Principal investigator, University of Turku