Bobbink Paul, Gschwind Géraldine, Larkin Philip, Probst Sebastian
Geneva School of Health Sciences, HES-SO, University of Applied Sciences and Arts, Western Switzerland, Geneva, Switzerland.
Faculty of Biology and Medicine, University Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland.
Qual Health Res. 2025 Jul;35(8):901-915. doi: 10.1177/10497323241285692. Epub 2024 Oct 28.
Venous leg ulcers (VLUs) provoke multiple symptoms and impact individuals and society as a whole. Their treatment and prevention strategies require individual's involvement in self-management strategies. Insufficient knowledge with regard to prevention, management, and treatment has been identified as a critical factor related to VLUs and their recurrence. Therapeutic patient education (TPE) proposed as part of a management strategy for this population provides unclear benefits regarding wounds healing or prevention of recurrence. The aim of the study was to develop a theory explaining how individuals with a VLU experience an individualized nurse-led TPE program regarding self-management strategies. The constructivist approach of Charmaz to the grounded theory method was used to develop the theory. A total of 26 individuals contributed to the co-construction of the theory through face-to-face or telephone semi-structured interviews. Data analysis and data collection occurs simultaneously with a comparative process to reveal the conceptual categories, apply theoretical sampling, and define theoretical saturation. The theory of "Conscientiously Engaging in Self-Management" was co-constructed with the participants encapsulating four categories: "Being influenced by my own story," "Being personally informed," "Making conscientious decisions to engage in self-adapted management strategies," and "Integrating a conscientious way of living." This theory highlights individuals' voices and stories toward their journey of VLU self-management taking contextual factors into consideration. This new theory offers new knowledge about implementation of self-management strategies for individuals living with a VLU and will inform clinical practice and contribute to the development of targeted interventions.
下肢静脉溃疡（VLUs）会引发多种症状，对个人乃至整个社会都有影响。其治疗和预防策略需要患者参与自我管理策略。已发现对预防、管理和治疗的知识不足是与下肢静脉溃疡及其复发相关的关键因素。作为该人群管理策略一部分提出的治疗性患者教育（TPE）在伤口愈合或预防复发方面的益处尚不明确。本研究的目的是构建一种理论，解释患有下肢静脉溃疡的个体如何体验关于自我管理策略的个体化护士主导的TPE项目。采用Charmaz的建构主义扎根理论方法来构建该理论。共有26人通过面对面或电话半结构化访谈参与了该理论的共同构建。数据分析和数据收集同时进行，通过比较过程揭示概念类别、应用理论抽样并确定理论饱和度。与参与者共同构建了“自觉参与自我管理”理论，该理论包含四个类别：“受自身经历影响”、“获得个人信息”、“做出自觉决策以采用自我适应的管理策略”以及“融入自觉的生活方式”。该理论突出了个体在下肢静脉溃疡自我管理过程中的声音和经历，并考虑了背景因素。这一新理论为患有下肢静脉溃疡的个体实施自我管理策略提供了新知识，将为临床实践提供参考，并有助于制定有针对性的干预措施。
