Phillips T, Stanton B, Provan A, Lew R
Department of Dermatology, Boston University School of Medicine, Massachusetts.
J Am Acad Dermatol. 1994 Jul;31(1):49-53. doi: 10.1016/s0190-9622(94)70134-2.
Leg ulcers affect probably 2.5 million persons in the United States, and their prevalence is likely to rise as the population ages. They cause considerable disability, and the cost of treating these chronic wounds is enormous.
The purpose of this study was to assess the financial, social, and psychologic implications of leg ulcers.
Data were collected by standardized personal interviews with 73 patients with chronic leg ulcers. The interview covered several domains that were selected to determine the impact of a leg ulcer on overall quality of life.
A significant number of patients had moderate to severe symptoms, principally pain, related to the leg ulcer. Eighty-one percent believed that their mobility was adversely affected by the ulcer; the dominant predictor of impaired mobility was swelling of the leg (p < 0.001). For younger, working patients, leg ulceration was correlated with time lost from work (p < 0.001), job loss (p < 0.01), and adverse effects on finances (p < 0.02). Fifty-eight percent of patients found caring for the ulcer burdensome. There was a strong correlation between time spent on ulcer care and feelings of anger and resentment. Sixty-eight percent of patients reported that the ulcer had a negative emotional impact on their lives, including feelings of fear, social isolation, anger, depression, and negative self-image.
Leg ulcers pose a substantial threat to a variety of dimensions of a patient's quality of life.
在美国，腿部溃疡可能影响250万人，并且随着人口老龄化，其患病率可能会上升。它们会导致相当大的残疾，治疗这些慢性伤口的成本巨大。
本研究的目的是评估腿部溃疡在经济、社会和心理方面的影响。
通过对73例慢性腿部溃疡患者进行标准化的个人访谈收集数据。访谈涵盖了几个领域，这些领域被选定用于确定腿部溃疡对总体生活质量的影响。
相当多的患者有中度至重度症状，主要是与腿部溃疡相关的疼痛。81%的患者认为他们的活动能力受到溃疡的不利影响；活动能力受损的主要预测因素是腿部肿胀（p<0.001）。对于较年轻的在职患者，腿部溃疡与工作时间损失（p<0.001）、失业（p<0.01）以及对财务的不利影响（p<0.02）相关。58%的患者发现护理溃疡很麻烦。在溃疡护理上花费的时间与愤怒和怨恨情绪之间存在很强的相关性。68%的患者报告说，溃疡对他们的生活产生了负面情绪影响，包括恐惧、社交孤立、愤怒、抑郁和负面自我形象。
腿部溃疡对患者生活质量的多个方面构成重大威胁。
