A systematic review on the impact of leg ulceration on patients' quality of life

Oliver R Herber, Wilfried Schnepp, Monika A Rieger, Oliver R Herber, Wilfried Schnepp, Monika A Rieger

Abstract

Background: A systematic review was conducted to analyse journal articles that describe or measure the impact of leg ulceration on patients' quality of life (QoL) in order to improve the content of an educational programme that aims to enhance self-care agency in leg ulcer patients.

Method: Original articles published in English and German between 1990 and 2006 were included if the findings were analysed at the level of patients. Articles were excluded if (1) they investigated the impact of specific treatments or settings on QoL or (2) focused mainly on arterial ulcers or diabetic foot ulcers.

Results: Twenty-four original research articles met the inclusion criteria; 11 studies used a quantitative, 11 studies a qualitative, and 2 used a mixed method approach. The findings were collapsed into 5 core domains. Quantitative studies commonly investigated the parameters of pain, sleep, social isolation, and physical mobility. Patients had significantly more pain, more restrictions regarding social functioning, less vitality, and limitations with respect to emotional roles compared to the respective controls. Other problem areas identified were restrictions in work capacity, recreation, social interaction, psychological well-being, as well as problems caused by treatment regimes. Inconclusive results were obtained regarding pain intensity, physical restrictions, and gender effects.

Limitations: Numerous original studies neither undertook a differentiation of participants by ulcer aetiology nor did they analyse the results according to gender differences.

Conclusion: As leg ulceration has an impact on QoL, national guidelines on the treatment of leg ulceration need to more specifically address these far-ranging effects identified in this review.

References

    1. Persoon A, Heinen MM, Vleuten CJM, Rooij MJ, Kerkhof PCM, Achterberg T. Leg ulcers: a review of their impact on daily life. Journal of Clinical Nursing. 2004;13:341–354. doi: 10.1046/j.1365-2702.2003.00859.x.
    1. Wilson AB. Quality of life and leg ulceration from the patient's perspective. Br J Nurs. 2004;13:17–20.
    1. Gilbertson SAD. Strategies for searching electronic databases. Music Therapy Today. 2003;IV
    1. Fallowfield L. The quality of life: The Missing Dimension in Health Care. London, UK; 1990.
    1. Phillips T, Stanton B, Provan A, Lew R. A study of the impact of leg ulcers on quality of life: financial, social, and psychologic implications. Journal of the American Academy of Dermatology. 1994;31:49–53.
    1. Hamer C, Cullum N, Roe BH. Patients' perceptions of chronic leg ulcers. Journal of Wound Care. 1994;3:99–101.
    1. Cullum NRB. Leg ulcers: Nursing Management – A Research-based Guide. Scutari Press. 1995. pp. 125–134.
    1. Charles H. The impact of leg ulcers on patients' quality of life. Professional Nurse. 1995;10:571–574.
    1. Walshe C. Living with a venous leg ulcer: a descriptive study of patients' experiences. Journal of Advanced Nursing. 1995;22:1092–1100.
    1. Hofman D, Ryan TJ, Arnold F, Cherry GW, Lindholm C, Bjellerup M, Glynn C. Pain in venous leg ulcers. Journal of Wound Care. 1997;6:222–224.
    1. Douglas V. Living with a chronic leg ulcer: an insight into patients' experiences and feelings. Journal of Wound Care. 2001;10:355–360.
    1. Lindholm C, Bjellerup M, Christensen M, Zederfeld B. Quality of life in chronic leg ulcer patients. Acta Dermatology Venereal. 1993;73:440–444.
    1. Price PHK. Measuring health-related quality of life in patients with chronic leg ulcers. WOUNDS. 1996;6:91–94.
    1. Franks PJM, Moffatt CJ. Who suffers most from leg ulceration? Journal of Wound Care. 1998;7:383–385.
    1. Flett R, Harcourt B, Alpass F. Psychosocial aspects of chronic lower leg ulceration in the elderly. Western Journal of Nursing Research. 1994;16:183–192. doi: 10.1177/019394599401600205.
    1. Hyde CWB, Horsfall J, Winder G. Older women's experience of living with chronic leg ulceration. International Journal of Nursing Practice. 1999;5:189–198. doi: 10.1046/j.1440-172x.1999.00170.x.
    1. Chase SK, Whittemore R, Crosby N, Freney D, Howes P, Phillips TJ. Living with chronic venous ulcers: a descriptive study of knowledge and functional health status. Journal of Community Health Nursing. 2000;17:1–13. doi: 10.1207/S15327655JCHN1701_01.
    1. Klyscz T, Jünger M, Schanz S, Janz M, Rassner G, Kohnen R. Lebensqualität bei chronisch venöser Insuffizienz (CVI) Hautarzt. 1998;49:372–381. doi: 10.1007/s001050050758.
    1. Goncalves ML, de Gouveia Santos VL, de Mattos Pimenta CA, Suzuki E, Komegae KM. Pain in chronic leg ulcers. Journal of Wound, Ostomy, Continence Nursing. 2004;31:275–283.
    1. Hyland ME, Lay A, Thomson B. Quality of life of leg ulcer patients: questionnaire and preliminary findings. Journal of Wound Care. 1994;3:294–298.
    1. Klyscz T, Schanz S, Janz M, Kohnen R, Rassner G, Jünger M. Lebensqualität und Krankheitsbewältigung bei Patienten mit chronisch venöser Insuffizienz. Phlebologie. 1996;25:239–244.
    1. Krasner D. Painful venous ulcers: themes and stories about living with the pain and suffering. J Wound Ostomy Continence Nurs. 1998;25:158–168.
    1. Chase S, Melloni M, Savage A. A forever healing: the lived experience of venous ulcer disease. Journal of Vascular Nursing. 1997;10:73–78. doi: 10.1016/S1062-0303(97)90004-2.
    1. Hareendran A, Bradbury A, Budd J, Geroulakos G, Hobbs R, Kenkre J, Symonds T. Measuring the impact of venous leg ulcers on quality of life. Journal of Wound Care. 2005;14:53–57.
    1. Bland M. Coping with leg ulcers. Kai Tiaki: Nursing New Zealand. 1996;2:13–14.
    1. Ebbeskog BE, S L. Elderly persons' experiences of living with venous leg ulcer: living in a dialectal relationship between freedom and imprisonment. Scandinavian Journal of Caring Science. 2001;15:235–243. doi: 10.1046/j.1471-6712.2001.00018.x.
    1. Krasner D. Painful venous ulcers: themes and stories about their impact on quality of life. Ostomy Wound Manage. 1998;44:38–46.
    1. Hopkins A. Disrupted lives: investigating coping strategies for non-healing leg ulcers. British Journal of Nursing. 2004;13:556–563.
    1. Brown A. Chronic leg ulcers, part 2: do they affect a patient's social life? Br J Nurs. 2005;14:986–989.
    1. Pope CMN. Reaching the parts other methods cannot reach: An introduction to qualitative methods in health and health services research. British Medical Journal. 1995;311:42–45.
    1. Brown A. Chronic leg ulcers, part 1: do they affect a patient's social life? British Journal of Nursing. 2005;14:894–898.
    1. Anand SC, Dean C, Nettleton R, Praburaj DV. Health-related quality of life tools for venous-ulcerated patients. Br J Nurs. 2003;12:48–59.
    1. Jull A. Letter to the editor. International Journal of Nursing Practice. 2000;6:115. doi: 10.1046/j.1440-172x.2000.00231.x.

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel