Table 1.
1 | The footwear you are wearing today was recommended by someone? □ YES □ NO From who? □ Endocrinologist □ Podiatrist □ Physiatrist □ Orthopedic technician □ Orthopedic □ Other: _____________________ |
2 | Do you think you are wearing suitable footwear? □ YES □ NO |
3 | How many hours a day do you wear this footwear? ________________ |
4 | Do you think foot ulcers can come from footwear? □ YES □ NO |
5 | Have you ever been told your feet are at risk of (re)ulceration? □ YES □ NO |
6 | Do you think they are? □ YES □ NO |
7 | Have you ever received any recommendation on choosing footwear? □ YES □ NO |
8 | Do you remember at least three? 1______________________ 2 _______________________ 3 ______________________ |
9 | Can you follow these recommendations? □ YES □ NO |
10 | Do you think they are excessive? □ YES □ NO |