The Sutherland Hospital, Sydney, NSW, Australia, Wound Management Innovation Cooperative Research Centre, Queensland University of Technology, Kelvin Grove, QLD Australia.
Faculty of Health, Deans Office, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia.
J Clin Nurs. 2018 Mar;27(5-6):e931-e939. doi: 10.1111/jocn.13994. Epub 2018 Jan 15.
To gain insight into the experience of recurrent venous leg ulcers from the individual's perspective and provide knowledge on potential risks of recurrence not previously investigated.
Venous leg ulcers are a consequence of chronic venous disease and frequently recur. They are costly and can impact on physical and psychological health. Despite research suggesting the risk can be reduced through compression and lifestyle changes, recurrence rates are often high. This study provides an insight into individual's perceptions of the cause of their ulcers and how they try to avoid them.
A qualitative design guided by the Chronic Illness Trajectory Model and Social Cognitive Theory.
A purposive sample of three males and four females were recruited from a community nursing clinic. Participants were ulcer free, had experienced at least two previous venous leg ulcers and could speak and comprehend English. An interpretive descriptive approach was taken using semi-structured interviews and thematic analysis.
Three themes each containing three categories emerged: The Increasing Influence of the Recurring Wound on Mind and Body, Reflection on Past Experiences and Optimism in the Face of Adversity. Most participants reported traumatic injury and lower leg surgery triggered ulcer recurrence. Failure to replace compression stockings was also deemed a cause. Compression was reported essential, but some participants were unaware of the level they were wearing and how often it should be replaced. Other preventive activities included avoiding injury and securing immediate assistance if wounding occurred.
Clinicians need to be aware that lower leg surgery may trigger recurrent venous ulceration and that individuals require ongoing emotional, physical and financial support throughout the trajectory of venous disease. The continued use of old compression stockings should be avoided and recurrence prevented by adoption of evidence-based practice rather than reflection on past experiences.
This research raises the awareness of factors from the individual's perspective which can influence the recurrence of venous leg ulcers.
从个体角度深入了解复发性静脉下肢溃疡的经验，并提供以前未调查过的潜在复发风险的知识。
静脉下肢溃疡是慢性静脉疾病的后果，经常复发。它们成本高昂，会影响身体和心理健康。尽管研究表明通过压缩和生活方式改变可以降低风险，但复发率往往很高。本研究深入了解了个体对溃疡原因的看法以及他们如何试图避免溃疡。
在慢性疾病轨迹模型和社会认知理论的指导下进行定性设计。
从社区护理诊所招募了三名男性和四名女性的目的性样本。参与者溃疡痊愈，至少经历过两次先前的静脉下肢溃疡，并且能够说和理解英语。采用半结构化访谈和主题分析的解释性描述方法。
出现了三个主题，每个主题包含三个类别：反复发作的伤口对身心的影响越来越大、对过去经历的反思以及面对逆境的乐观主义。大多数参与者报告创伤性损伤和小腿手术引发了溃疡复发。未能更换压缩袜也被认为是一个原因。报告称压缩是必要的，但一些参与者不知道他们穿着的压缩等级以及应该多久更换一次。其他预防活动包括避免受伤和在受伤时立即寻求帮助。
临床医生需要意识到小腿手术可能会引发复发性静脉溃疡，并且个体在整个静脉疾病轨迹中需要持续的情感、身体和经济支持。应避免继续使用旧的压缩袜，并通过采用基于证据的实践而不是反思过去的经验来预防复发。
这项研究提高了人们对个体角度可能影响静脉下肢溃疡复发的因素的认识。
