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Bazancir-Apaydin Z, Sakizli Erdal E, Keser I, Erer D. The profile beyond leg pain: In basis of central sensitization, kinesiophobia, and body awareness in patients with chronic venous disease. Phlebology 2024:2683555241286385. [PMID: 39314072 DOI: 10.1177/02683555241286385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2024]
Abstract
Objective: Leg pain has long been underestimated despite being one of the most important symptoms of chronic venous disease (CVD). Studies investigating leg pain and psychosocial profile in CVD are limited. The study aimed to investigate leg pain, central sensitization, kinesiophobia, and body awareness in patients with CVD. Methods: The ninety-eight patients (80 female, 18 male) diagnosed with CVD were included in the study. The severity of leg pain was evaluated with the Visual Analog Scale (VAS). The patients were assessed with the Central Sensitization Inventory (CSI-A and B) for central sensitization-related symptoms and -positivity, the Body Awareness Questionnaire (BAQ) for body awareness, and the Tampa Kinesiophobia Scale (TKS) for kinesiophobia. The cut-off score was admitted as 41 for TKS. Results: The leg pain (mean (SD) = 4.3 ± 2) and body awareness (mean (SD) = 82.4 ± 22) were moderate levels in patients with CVD. Nearly half of the patients (n = 46, 46.9%) had both central sensitization positivity and elevated kinesiophobia (n = 46, 47%). The CSI was correlated with the VAS (r = 0.32, p = .001), TKS (r = 0.40, p < .001), and BAQ (r = 0.20, p = .048). Significant correlations were determined between Body Mass Index and TKS (r = 0.48, p < .001) and BAQ (r = -0.31, p = .002). Also, the patients with a TKS score ≥41-points had higher CSI-A scores (p = .002) than those with a TKS score< 41. Conclusions: Leg pain, central sensitization, and kinesiophobia are commonly seen in patients with CVD, and central sensitization seems to have a negative effect on leg pain, kinesiophobia, and body awareness. The profile beyond pain should be evaluated in detail, and various rehabilitation strategies need to be developed to manage central sensitization, interoception, kinesiophobia, and weight control in patients with CVD.
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Affiliation(s)
- Zilan Bazancir-Apaydin
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ankara Medipol University, Ankara, Türkiye
| | - Elif Sakizli Erdal
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Kırıkkale University, Kırıkkale, Türkiye
| | - Ilke Keser
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Türkiye
| | - Dilek Erer
- Department of Cardiovascular Surgery, Dilek Erer Special Official Clinic, Ankara, Türkiye
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Obesity and Wound Healing: Focus on Mesenchymal Stem Cells. Life (Basel) 2023; 13:life13030717. [PMID: 36983872 PMCID: PMC10059997 DOI: 10.3390/life13030717] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 02/20/2023] [Accepted: 03/03/2023] [Indexed: 03/09/2023] Open
Abstract
Chronic wounds represent nowadays a major challenge for both clinicians and researchers in the regenerative setting. Obesity represents one of the major comorbidities in patients affected by chronic ulcers and therefore diverse studies aimed at assessing possible links between these two morbid conditions are currently ongoing. In particular, adipose tissue has recently been described as having metabolic and endocrine functions rather than serving as a mere fat storage deposit. In this setting, adipose-derived stem cells, a peculiar subset of mesenchymal stromal/stem cells (MSCs) located in adipose tissue, have been demonstrated to possess regenerative and immunological functions with a key role in regulating both adipocyte function and skin regeneration. The aim of the present review is to give an overview of the most recent findings on wound healing, with a special focus on adipose tissue biology and obesity.
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Autologous whole blood clot and negative-pressure wound therapy in South Africa: A comparison of the cost and social considerations. S Afr Med J 2022; 112:800-805. [PMID: 36472331 DOI: 10.7196/samj.2022.v112i10.16527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Advanced wound treatment modalities enhance healing of hard-to-heal wounds, decrease the risk of amputations, and improve the quality of life of patients. Modalities have different rates of efficacy and incur different social and financial costs to the individual and the healthcare system. Two such modalities, the autologous whole blood clot (WBC) and negative-pressure wound therapy (NPWT), were compared in the South African (SA) context. The comparison was conducted on hard-to-heal wounds, with a specific focus on diabetic foot ulcers (DFUs). OBJECTIVES To compare the social considerations and financial costs of using autologous WBC v. NPWT in the treatment of DFUs in SA. METHODS Data were obtained based on current supply costs from SA suppliers for the two modalities, the standard of care for both modalities, the number of applications required for each, and social considerations provided by SA wound management clinicians. Wound healing rates were obtained from the published literature. This information was used to calculate costs of two scenarios (scenario 1: low exudate v. scenario 2: high exudate), which were compared over two treatment durations (4 and 12 weeks) for each treatment modality. Calculations included weekly cost of supplies, total cost saved by a patient with a DFU managed with either of the wound therapies, and the difference in total cost saved between the two modalities. Key social considerations were assessed qualitatively from discussions with SA clinicians experienced in both autologous WBC and NPWT, and from published research. RESULTS The cost of supplies per week was ZAR3 250 for autologous WBC and ZAR4 804 for NPWT in scenario 1, and ZAR3 332 and ZAR6 612 in scenario 2. With healing rates over 4 weeks' treatment duration of 19% for autologous WBC and 10% for NPWT, autologous WBC saved ZAR17 719.93, or 9% more than using NPWT, in scenario 1 and ZAR18 381.47, or 10% more, in scenario 2. At 12 weeks' treatment duration, healing rates for autologous WBC and NPWT were 75% and 43%, respectively. In scenario 1, results indicated a 43% cost difference between the two modalities. Autologous WBC had a total cost saving of ZAR61 874.40 compared with NPWT over a period of 12 weeks. In scenario 2, results indicated a 46% cost difference between the two modalities. Autologous WBC had a total cost saving of ZAR70 454.68 compared with NPWT over a period of 12 weeks. One of the identified social considerations is that NPWT needs a reliable supply of electricity to recharge the pump, while autologous WBC does not. CONCLUSION Both modalities are safe and effective in treating hard-to-heal wounds of the lower extremities. Autologous WBC consistently demonstrated better outcomes than NPWT in terms of both healing rate and cost-effectiveness, as well as having some advantages in terms of social considerations in SA.
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Liu S, Team V, Qiu Y, Weller CD. Investigating Quality of Life Instrument Measurement Properties for Adults with Active Venous Leg Ulcers: A Systematic Review. Wound Repair Regen 2022; 30:468-486. [PMID: 35639021 PMCID: PMC9545457 DOI: 10.1111/wrr.13034] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 04/07/2022] [Accepted: 05/24/2022] [Indexed: 11/30/2022]
Abstract
The primary objective of this systematic review was to identify which quality of life instruments have been applied in published studies of patients with active venous leg ulcers. Our secondary objective was to map the measurement properties of each identified quality of life instrument and to inform future recommendations for clinical practice and research. We searched CINAHL, Ovid Medline, Ovid Emcare and ProQuest to identify studies published from 1 January 2000 to 31 July 2021. Eleven studies that utilised quality of life instruments in adults with active venous leg ulcers met the inclusion criteria. Thirteen quality of life instruments were identified as some studies utilised both generic and condition‐specific quality of life instruments. Six out of nine (6/9) instruments were rated ‘very good’ of methodological quality on internal consistency; 1/7 studies rated ‘adequate’ on reliability; 2/4 rated ‘adequate’ on content validity; 3/6 studies rated ‘adequate’ on structural validity; 5/6 rated ‘adequate’ on hypotheses testing for construct and 2/6 studies rated ‘adequate’ on responsiveness. There is limited evidence of measurement properties of quality of life instruments for people with active venous leg ulcers. The Venous Leg Ulcer Quality of Life Questionnaire (VLU‐QoL) could be provisionally recommended for use although from our review it is clear further studies to assess VLU‐QoL measurement properties are needed to inform future recommendations for clinical practice and research.
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Affiliation(s)
- Shiwen Liu
- School of Nursing and Midwifery, Monash University, Level 5 Alfred Centre, 99 Commercial Road, Melbourne, VIC, Australia
| | - Victoria Team
- School of Nursing and Midwifery, Monash University, Level 5 Alfred Centre, 99 Commercial Road, Melbourne, VIC, Australia
| | - Yunjing Qiu
- School of Nursing and Midwifery, Monash University, Level 5 Alfred Centre, 99 Commercial Road, Melbourne, VIC, Australia
| | - Carolina D Weller
- School of Nursing and Midwifery, Monash University, Level 5 Alfred Centre, 99 Commercial Road, Melbourne, VIC, Australia
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Abstract
Diabetic foot ulcer (DFU) is a severe complication of diabetes mellitus (DM). Patients with DFU have increased mortality and morbidity as well as decreased quality of life (QoL). The present scoping review aims to study the social issues of diabetic foot. Following PRISMA guidelines, the review was conducted in two databases (Scopus and Pubmed) with the use of the following keywords: “social aspects and diabetic foot”, “social characteristics and diabetic foot”, “social issues and diabetic foot”, “demographic profiles and diabetic foot”, “social determinants and diabetic foot”, “social capital and diabetic foot”, “social characteristics and gender and diabetic foot”, “social profiles and diabetic foot”, “social relationships and diabetic foot” and “social risk and diabetic foot”, from July to August 2021. Predetermined exclusion and inclusion criteria were selected. Forty-five studies (quantitative and qualitative) were eligible for inclusion in this review. Gender problems, socioeconomic status, social capital, and medical problems were the most important negative variables for diabetic foot. All the included variables reveal that the social impact of diabetic foot is the most important factor for management and prevention, in terms of aggravation and more, of the diabetic foot.
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Gomes NN, Rosa LMMDS, Ferreira MDA, Silva RCD. Social representations of patients with vasculogenic ulcers about quality of life: an analysis of the social context. Rev Bras Enferm 2021; 75:e20210136. [PMID: 34705995 DOI: 10.1590/0034-7167-2021-0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 05/27/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to describe the social representations of patients with vasculogenic ulcers about quality of life and analyze such representations from the social context of patients' insertion in relation to the healthcare service. METHOD a qualitative research, based on social representations, developed in a Family Clinic in Rio de Janeiro with 30 patients with vasculogenic ulcers for over 90 days. Data were produced through interviews and submitted to lexicographical analysis using the Alceste software. RESULTS the weaknesses of care in the healthcare service to which patients were linked contributed to exacerbate the reconfiguration of daily life that the occurrence of ulcers implies, due to the presence of pain and physical restrictions, influencing the representation of quality of life. FINAL CONSIDERATIONS the representation was objectified as a counterpoint to the image of "being happy", and actions expressed proactivity in the search for a cure or passivity due to lack of clinical results.
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Cardoso IA, Salomé GM, Mendonça ARDA, Miranda FD, Alves JR. Elaboration and Validation of Flowchart for the Prevention and Treatment of Intestinal Peristomal Skin Complications. JOURNAL OF COLOPROCTOLOGY 2021. [DOI: 10.1055/s-0041-1735460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Abstract
Objective To build and validate a flowchart for the prevention and treatment of intestinal peristomal skin complications.
Method For the construction of the algorithms, a systematic review was carried out in health sciences databases comprising the last 10 years. The evaluation of the algorithms was carried out by 38 nurses. For the validation of the algorithms, the Delphi technique was used. The statistical analysis used was the content validity index and the Cronbach alpha coefficient. The questionnaire was sent by e-mail and in person after approval by the Ethics and Research Committee.
Results In the first evaluation of the algorithms, there was no agreement among the experts. However, after making the corrections suggested by the evaluators, the algorithms were resent, with a 100% consensus among the evaluators. The questions used to validate the algorithms contributed favourably to the internal consistency and content validation of the instrument, since the respective Cronbach alpha was 0.9062 and the global content validity index (g-CVI) was 0.91 in the first validation and 1.0 in the second validation.
Conclusion After an integrative literature review, the flowcharts were built and validated by a professional with experience in the area, showing 100% agreement among the experts in the second evaluation.
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Affiliation(s)
- Imaculada Aparecida Cardoso
- Programa de Mestrado Profissional em Ciências Aplicadas à Saúde, Universidade do Vale do Sapucaí, São Paulo, SP, Brazil
| | - Geraldo Magela Salomé
- Programa de Mestrado Profissional em Ciências Aplicadas à Saúde, Universidade do Vale do Sapucaí, São Paulo, SP, Brazil
| | | | - Flávio Dutra Miranda
- Programa de Mestrado Profissional em Ciências Aplicadas à Saúde, Universidade do Vale do Sapucaí, São Paulo, SP, Brazil
| | - José Ronaldo Alves
- Programa de Mestrado Profissional em Ciências Aplicadas à Saúde, Universidade do Vale do Sapucaí, São Paulo, SP, Brazil
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Petkovšek-Gregorin R. Razjede in njihovo celjenje pri pacientih po amputaciji. OBZORNIK ZDRAVSTVENE NEGE 2021. [DOI: 10.14528/snr.2021.55.2.2987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Uvod: Najpogostejši vzroki, ki vplivajo na celjenje razjed pri pacientih po amputaciji, so periferna arterijska bolezen, sladkorna bolezen in kronična venska insuficienca. Namen raziskave je bil prepoznati dejavnike, ki lahko vplivajo na celjenje razjede na amputacijskem krnu.Metode: Uporabljena je bila kvantitativna neeksperimentalna raziskovalna metodologija. Izvedena je bila retrospektivna raziskava s pregledom negovalne dokumentacije o spremljanju razjede. V raziskavo je bilo vključenih 134 pacientov po amputaciji spodnjega uda z razjedo, hospitaliziranih v letu 2017. Uporabljeni sta bili opisna statistika in logistična regresija.Rezultati: Razjedo, nastalo zaradi različnih vzrokov, je imelo 134 pacientov. Ženske imajo v primerjavi v moškimi več možnosti za prisotnost razjede ob odpustu (RO = 4,8, 95 % IZ: 1–22), prav tako pacienti, ki so imeli razjedo že ob sprejemu (RO = 7,7, 95 % IZ: 3–19,2), in tisti z več kot eno razjedo (RO = 4,7, 95 % IZ: 1–22,3). Pri pacientih, ki imajo razjedo na amputacijskem krnu, imajo večjo možnost, da se bo ta do konca rehabilitacije zacelila (RO = 0,2, 95 % IZ: 0,1–0,6 p = 0,004).Diskusija in zaključek: Ugotovitve nakazujejo, da je pri ženskah večja verjetnost, da razjeda ob odpustu ne bo zaceljena, kot pri pacientih, pri katerih je bila razjeda prisotna že ob sprejemu, in pri tistih, ki imajo več razjed. Treba bi bilo izvesti raziskavo, ki bi zajela večje število pacientov. Prav tako bi bilo treba natančneje določiti parametre spremljanja.
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Moreira CNDO, Marques CB, Salomé GM, Cunha DRD, Pinheiro FAM. Health locus of control, spirituality and hope for healing in individuals with intestinal stoma. JOURNAL OF COLOPROCTOLOGY 2021. [DOI: 10.1016/j.jcol.2016.04.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Abstract
Objective To assess the health locus of control, spirituality and hope of cure in patients with intestinal stoma.
Methods This study was conducted at the Polo of Ostomized People in the city of Pouso Alegre, Minas Gerais. Participants were 52 patients with intestinal stoma. Three questionnaires were applied for data collection: a questionnaire on demographic and stoma-related data; the Scale for Health Locus of Control; the Herth Hope Scale, and the Self-rating Scale for Spirituality.
Results Most ostomized subjects were women aged over 61 years, married and retired. As to the stoma, in the majority of cases these operations were definitive and were carried out due to a diagnosis of neoplasia. Most ostomized subjects had a 20- to 40-mm diameter colostomy, 27 showed dermatitis as a complication, and 39 (75%) used a two-part device. The mean total score for the Scale for Health Locus of Control, the Herth Hope Scale, and the Self-rating Scale for Spirituality were 62.42, 38.27, and 23.67, respectively. Regarding the dimensions of the Scale for Health Locus of Control, the dimension “completeness of health” = 22.48, dimension “externality-powerful others” = 22.48, and dimension “health externality” = 19.48.
Conclusion Ostomized patients participating in the study believe they can control their health and that caregivers and individuals involved in their rehabilitation can contribute to their improvement. The cure or improvement has a divine influence through religious practices or beliefs.
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Lima JAD, Muniz KDC, Salomé GM, Ferreira LM. Association of sociodemographic and clinical factors with self-image, self-esteem and locus of health control in patients with an intestinal stoma. JOURNAL OF COLOPROCTOLOGY 2021. [DOI: 10.1016/j.jcol.2017.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Abstract
Objective To evaluate the sociodemographic and clinical factors related to patients with an intestinal stoma and to correlate them with locus of health control, self-esteem and self-image.
Method 44 patients with an intestinal stoma participated in the study. The following instruments were used: Scale for Locus of Health Control, Rosenberg Self-Esteem Scale/UNIFESP-EPM and Body Investment Scale.
Results With regard to Locus Health Control variables, sociodemographic variables with alterations were: unemployed (28.13); retirees (27.79); age up to 50 years (28.44); and singles (27.89). Regarding Body Investment Scale, the sociodemographic variables with alterations were: age up to 50 years (21.79); single (19.15) or married (17.53); retired (18.79) or unemployed (19.83); and can read and write (20.13). Regarding Rosenberg-EPM Self-esteem Scale, all sociodemographic variables were altered.
Conclusions Ostomized patients presented alterations in the following variables: unemployed, retired, aged up to 50 years and unmarried. There were also alterations in individuals whose cause of the stoma was neoplasia, a temporary stoma, stoma time <4 years, and ostomized non-participants of an association or support group, and who also did not practice physical activities. We conclude from these findings that ostomized individuals who participated in the study and who were included in these variables showed negative feelings about their body and believed that only they could control their health and that the people involved in their care and rehabilitation did not could contribute to their improvement.
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Affiliation(s)
- Joelma Alves de Lima
- Universidade do Vale do Sapucaí (UNIVAS), Programa Institucional de Bolsas de Iniciação Científica (PIBIC), Pouso Alegre, MG, Brazil
| | - Karina de Cássia Muniz
- Universidade do Vale do Sapucaí (UNIVAS), Programa Institucional de Bolsas de Iniciação Científica (PIBIC), Pouso Alegre, MG, Brazil
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Health locus of control, body image and self-esteem in individuals with intestinal stoma. JOURNAL OF COLOPROCTOLOGY 2021. [DOI: 10.1016/j.jcol.2017.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
Objective To evaluate the health locus of control, self-esteem, and body image in patients with an intestinal stoma.
Method A descriptive, cross-sectional, analytical study conducted at the pole of the ostomates of the city of Pouso Alegre. The study was approved by Research Ethics Committee of Universidade do Vale do Sapucaí. Opinion: 620,459. Patients: 44 patients with an intestinal stoma. Four instruments were used: a questionnaire with demographic and stomatologic data, the Health Locus of Control Scale, the Rosenberg Self-Esteem Scale/UNIFESP-EPM, and the Body Investment Scale. Statistics: Chi-square, Pearson, Mann–Whitney and Kruskal–Wallis tests. p < 0.05 was determined.
Results The majority of patients were over 70 years, 16 (36.4%) were female, 30 (68.2%) were married, 31 (70.5%) were retirees, 31 (70.5%) had an income of 1–3 minimum wages, 32 (72.7%) did not practice physical activity, 18 (40.9%) had an incomplete elementary education, and 35 (79.5%) participated in a support or association group. 33 (75%) participants received the stoma because of a neoplasia; and 33 (75%) had a definitive stoma. In 36 (81.8%) participants, the type of stoma used was a colostomy, and 22 (50%) measured 20–40 mm in diameter; 32 (72.7%) participants used a two-piece device. With regard to complications, there were 29 (65.9%) cases of dermatitis. The mean total score for the Health Locus of Control Scale was 62.84; for the Rosenberg Self-Esteem Scale, 27.66; and for the Body Investment Scale, 39.48. The mean scores for the dimensions internal, powerful others, and chance of the Health Locus of Control Scale were 22.68, 20.68, and 19.50, respectively. With respect to the Body Investment Scale, for the dimensions body image, body care, and body touch, the mean scores were 11.64, 11.00, and 13.09, respectively.
Conclusion In this study, the participants showed changes in self-esteem and body image and also showed negative feelings about their body. Ostomized individuals believe that they themselves control their state of health and do not believe that other persons or entities (physician, nurse, friends, family, god, etc.) can assist them in their improvement or cure and, in addition, believe that their health is controlled by chance, without personal or other people's interference.
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Gomes NN, Rosa LMMDS, Ferreira MDA, Silva RCD. Representations and practices of patients with vasculogenic ulcers on quality of life. Rev Gaucha Enferm 2021. [DOI: 10.1590/1983-1447.2021.20200098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: To identify the social representations and practices of patients with vasculogenic ulcer about their quality of life. Method: Qualitative research that applied the Social Representations theory. Participants were 30 patients with vasculogenic ulcers registered at a health unit in Rio de Janeiro. Data was collected through semi-structured interviews, and lexical analysis was applied. Results: The social representations about the quality of life of the patients were built from the affections arising from the changes in their lives. Thus, losses arising from the reconfiguration of daily life led to a negative symbolic construction about themselves and their lives, which resulted, on the one hand, in proactive self-care behaviors and, on the other, in less self-care. Conclusion: Care for health promotion and social support is required to re-signification of life with ulcer and the adoption of new coping practices.
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Gethin G, Vellinga A, Tawfick W, O'Loughlin A, McIntosh C, Mac Gilchrist C, Murphy L, Ejiugwo M, O'Regan M, Cameron A, Ivory JD. The profile of patients with venous leg ulcers: A systematic review and global perspective. J Tissue Viability 2020; 30:78-88. [PMID: 32839066 DOI: 10.1016/j.jtv.2020.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/05/2020] [Accepted: 08/05/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND A holistic profile that includes demographic, medical history and wound characteristics of individuals with venous leg ulceration is lacking. Lack of such a profile negatively impacts the ability to develop interventions to improve patient outcomes. OBJECTIVES To describe the profile of the patient population with venous leg ulceration from published observational (non-interventional) studies and to identify gaps in the knowledge base for future research in this area. METHODS A systematic review of observational studies that included more than 50 patients, from any world region, of any age and in any care setting. RESULTS twenty studies, involving 3395 patients, from all world regions met our criteria. Demographic characteristics were well reported and showed a female to male ratio of 1.2:1, average age of 47-65 years, high levels of co-morbidities including hypertension (53-71%) and diabetes (16-20%), and only one study reporting ethnicity. When reported, approximately 4-30% had high levels of depression. The average wound size was 18.6-43.39 cm2; mean wound duration was 13.8-65.5 months, mean number of recurrences was four. No study reported on demographic factors plus medical history plus wound characteristics together. CONCLUSION a comprehensive, holistic profile of the population with VLU is lacking. There is a critical need for more comprehensive profiling to enable the development of targeted interventions to improve outcomes.
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Affiliation(s)
- G Gethin
- National University of Ireland, Galway, Ireland; Alliance for Research & Innovation in Wounds (ARIW), Ireland.
| | - A Vellinga
- National University of Ireland, Galway, Ireland; Alliance for Research & Innovation in Wounds (ARIW), Ireland
| | - W Tawfick
- National University of Ireland, Galway, Ireland; Alliance for Research & Innovation in Wounds (ARIW), Ireland
| | - A O'Loughlin
- National University of Ireland, Galway, Ireland; Alliance for Research & Innovation in Wounds (ARIW), Ireland
| | - C McIntosh
- National University of Ireland, Galway, Ireland; Alliance for Research & Innovation in Wounds (ARIW), Ireland
| | - C Mac Gilchrist
- National University of Ireland, Galway, Ireland; Alliance for Research & Innovation in Wounds (ARIW), Ireland
| | - L Murphy
- National University of Ireland, Galway, Ireland; Alliance for Research & Innovation in Wounds (ARIW), Ireland
| | - M Ejiugwo
- National University of Ireland, Galway, Ireland; Alliance for Research & Innovation in Wounds (ARIW), Ireland
| | - M O'Regan
- National University of Ireland, Galway, Ireland; Alliance for Research & Innovation in Wounds (ARIW), Ireland
| | - A Cameron
- National University of Ireland, Galway, Ireland; Alliance for Research & Innovation in Wounds (ARIW), Ireland
| | - J D Ivory
- National University of Ireland, Galway, Ireland; Alliance for Research & Innovation in Wounds (ARIW), Ireland
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Subrata SA. Implementation of spiritual care in patients with diabetic foot ulcers: a literature review. ACTA ACUST UNITED AC 2020; 29:S24-S32. [PMID: 32790549 DOI: 10.12968/bjon.2020.29.15.s24] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Lower extremity amputation is a complication of diabetic foot ulcers that can cause spiritual crisis. Integrating spiritual care into nursing practice is important to overcome this. However, studies articulating the role of nurses in spiritual care when caring for patients with diabetic foot ulcers is limited. This article aims to describe the importance of providing spiritual care for this group of patients. The interpretation of spiritual care with respect to the relationship between the patient and the family, and the role of the nurse are discussed. The findings offer a theoretical perspective on spiritual care that can be used to develop spiritual interventions, as well as prevent spiritual crises in patients with diabetic foot ulcers.
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Affiliation(s)
- Sumarno Adi Subrata
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand, Nursing Lecturer at the Department of Nursing and Wound Research Centre, Faculty of Health Sciences, Universitas Muhammadiyah Magelang, Indonesia
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Rodriguez JEC, Gamboa SG. Psychosocial factors of patients with venous leg ulcers and their association with healing. ESTIMA 2020. [DOI: 10.30886/estima.v18.845_in] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objectives: To identify psychosocial factors present in patients with venous leg ulcers and the association that these factors have in the healing of venous leg ulcers. Methods: An integrative review of the quantitative studies in MEDLINE, Scielo and Cochrane Library databases, between 2008 and 2019, using the keywords, psychosocial factors, venous ulcer, wound healing, anxiety and depression in English, Spanish and Portuguese. Results: sixteen studies were included. The psychosocial factors present in patients with venous ulcers were depression, anxiety, feelings of helplessness, subjective well-being, self-esteem, loneliness and spirituality. Stress, a negative perception of venous ulcer, living alone and severe experience of symptoms such as pain and depression have statistically significant associations with longer periods of healing. Conclusions: Depression is one of the most frequently measured factors and present in this population. The available evidence on the association of psychosocial factors with the healing of venous ulcers is low.
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Rodriguez JEC, Gamboa SG. Factores psicosociales en los pacientes con úlceras venosas y su asociación con la cicatrización. ESTIMA 2020. [DOI: 10.30886/estima.v18.845_esp] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objetivo: Identificar los factores psicosociales presentes en pacientes con úlceras venosas y la evidencia disponible sobre la asociación que estos factores tienen con la curación de este tipo de heridas. Métodos: Revisión integradora de la literatura de estudios cuantitativos en las bases de datos MEDLINE, Scielo y Cochrane Library entre los años 2008 y 2019, utilizando las palabras clave, factores psicosociales, úlcera venosa, cicatrización de heridas ansiedad y depresión en idioma inglés, español y portugués. Resultados: Dieciséis estudios fueron incluidos. Los factores psicosociales presentes en los pacientes con úlceras venosas fueron depresión, ansiedad, sentimientos de impotencia, bienestar subjetivo, autoestima, soledad y espiritualidad. El estrés, una percepción negativa de la úlcera venosa, vivir solo y la experiencia severa de síntomas como dolor y depresión tienen asociaciones estadísticamente significativas con periodos más prolongados de curación. Conclusión: La depresión es uno de los factores psicológicos medido y presente con mayor frecuencia en esta población. La evidencia disponible frente a la asociación de los factores psicosociales con la curación de úlceras venosas es escasa.
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Shi C, Wang C, Liu H, Li Q, Li R, Zhang Y, Liu Y, Shao Y, Wang J. Selection of Appropriate Wound Dressing for Various Wounds. Front Bioeng Biotechnol 2020; 8:182. [PMID: 32266224 PMCID: PMC7096556 DOI: 10.3389/fbioe.2020.00182] [Citation(s) in RCA: 195] [Impact Index Per Article: 48.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 02/24/2020] [Indexed: 12/30/2022] Open
Abstract
There are many factors involved in wound healing, and the healing process is not static. The therapeutic effect of modern wound dressings in the clinical management of wounds is documented. However, there are few reports regarding the reasonable selection of dressings for certain types of wounds in the clinic. In this article, we retrospect the history of wound dressing development and the classification of modern wound dressings. In addition, the pros and cons of mainstream modern wound dressings for the healing of different wounds, such as diabetic foot ulcers, pressure ulcers, burns and scalds, and chronic leg ulcers, as well as the physiological mechanisms involved in wound healing are summarized. This article provides a clinical guideline for selecting suitable wound dressings according to the types of wounds.
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Affiliation(s)
- Chenyu Shi
- School of Nursing, Jilin University, Changchun, China.,Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
| | - Chenyu Wang
- Department of Plastic and Reconstructive Surgery, The First Hospital of Jilin University, Changchun, China
| | - He Liu
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
| | - Qiuju Li
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
| | - Ronghang Li
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
| | - Yan Zhang
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
| | - Yuzhe Liu
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
| | - Ying Shao
- Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China.,Department of Plastic and Reconstructive Surgery, The First Hospital of Jilin University, Changchun, China
| | - Jincheng Wang
- School of Nursing, Jilin University, Changchun, China.,Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China
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Nurhikmah L, Gayatri D, Nuraini T. Body image related to quality of life diabetic ulcer patients. ENFERMERIA CLINICA 2019. [DOI: 10.1016/j.enfcli.2019.04.049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Oliveira ACD, Rocha DDM, Bezerra SMG, Andrade EMLR, Santos AMRD, Nogueira LT. Qualidade de vida de pessoas com feridas crônicas. ACTA PAUL ENFERM 2019. [DOI: 10.1590/1982-0194201900027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Resumo Objetivo: Avaliar a qualidade de vida de pessoas com feridas crônicas. Métodos: Estudo transversal realizado com 176 pessoas com feridas crônicas em acompanhamento ambulatorial e domiciliar em um serviço público de saúde. Foram utilizados: formulário para a caracterização sociodemográfica, clínica e terapêutica e o questionário Cardiff Wound Impact Schedule para a mensuração da qualidade de vida. As análises foram descritivas e inferenciais empregando-se os testes t de Student, ANOVA, Mann Whitney e Kruskal-Wallis. Resultados: Dentre as pessoas acompanhadas em domicílio, predominaram lesões de origem vasculogênicas, com tempo de existência superior a 12 meses e área de até 25 cm2. No ambiente ambulatorial, prevaleceram feridas vasculogênicas e traumáticas, com tempo máximo de seis meses e extensão de até 25 cm2. Os fatores clínicos associados à qualidade de vida foram: tempo de duração da lesão, etiologia da lesão, grande extensão, aspecto do exsudato, presença de odor e de dor. O domínio de QV “bem-estar” apresentou maior impacto negativo decorrente da presença de lesão. Conclusão: Os fatores clínicos influenciaram diretamente os domínios de QV, sendo necessária a utilização de estratégias diferenciadas com o intuito de reduzir o impacto na QV por se tratarem de aspectos que poderiam ser atenuados ou evitados mediante a avaliação da lesão e a escolha do tratamento adequado.
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Lemes JS, Amaral KVA, Nunes CAB, Campos ACA, Batista AN, Malaquias SG. Instruments to Assess the Subjective Repercussions of People with Chronic Wounds: Integrative Review. AQUICHAN 2019. [DOI: 10.5294/aqui.2019.19.1.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: To analyze the instruments described in the literature for extended assessment in people with chronic wound. Materials and methods: Study of integrative review of the literature. The search was conducted on databases including PUBMED, Web of Science, SciELO, CINAHL, Science Direct (Elsevier), Scopus, and Biblioteca Virtual da Saúde (BVS). Results: The search found 19 060 articles; after relevance tests, 41 were left. The instrument most used in the studies of this review was the Short Form 36 Health Survery (SF-36), which is a tool to assess quality of life (QOL). Conclusion: A diversity of instruments was identified for extended assessment of people with wounds, with those investigating QOL being the most frequent. The repercussions are, mostly, contained in the QOL assessment instruments, but superficially and/or not explicitly, as in the SF-36, the means most-frequently identified in the studies of this review. These findings suggest the likelihood of differentiated implications of these instruments according to the etiology of the lesions, psychosocial and psychospiritual needs of the individual, as well as the context to which they are destined, like teaching, clinical practice, or research.
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Bôas NCRV, Salomé GM, Ferreira LM. Frailty syndrome and functional disability among older adults with and without diabetes and foot ulcers. J Wound Care 2018; 27:409-416. [DOI: 10.12968/jowc.2018.27.7.409] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Geraldo Magela Salomé
- Affiliate Professor; Professional Master's Program in Applied Health Sciences, UNIVÁS, Pouso Alegre, MG, Brazil, Pouso Alegre, MG, Brazil
| | - Lydia Masako Ferreira
- Full Professor and Head; Division of Plastic Surgery, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
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Salomé GM, Ferreira LM. Impact of non-adherent Ibuprofen foam dressing in the lives of patients with venous ulcers. ACTA ACUST UNITED AC 2018; 44:116-124. [PMID: 28658329 DOI: 10.1590/0100-69912017002002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Accepted: 12/15/2016] [Indexed: 01/10/2023]
Abstract
Objective to evaluate pain in patients with lower limb venous ulcer who used non-adherent Ibuprofen foam dressing (IFD). Methods we conducted a prospective study of patients with lower limb venous ulcers treated from April 2013 to August 2014. We used the Numerical Scale and McGill Pain Questionnaire, performing the assessments at the moment of inclusion of the patient in the study and every eight days thereafter, totaling five consultations. We divided the patients into two groups: 40 in the Study Group (SG), who were treated with IFD, and 40 in the Control Group (CG), treated with primary dressing, according to tissue type and exudate. Results at the first consultation, patients from both groups reported intense pain. On the fifth day, SG patients reported no pain and the majority of CG reported moderate pain. Regarding the McGill Pain Questionnaire, most patients of both groups reported sensations related to sensory, affective, evaluative and miscellaneous descriptors at the beginning of data collection; after the second assessment, there was slight improvement among the patients in the SG. After the third consultation, they no longer reported the mentioned descriptors. CG patients displayed all the sensations of these descriptors until the fifth visit. Conclusion non-adherent Ibuprofen foam dressing is effective in reducing the pain of patients with venous ulcers.
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Affiliation(s)
- Geraldo Magela Salomé
- - Sapucaí Valley University, Professional Master's Degree in Applied Health Sciences, Pouso Alegre, MG, Brazil
| | - Lydia Masako Ferreira
- - Sapucaí Valley University, Professional Master's Degree in Applied Health Sciences, Pouso Alegre, MG, Brazil
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Salomé GM, Ferreira LM. The impact of decongestive physical therapy and elastic bandaging on the control of pain in patients with venous ulcers. ACTA ACUST UNITED AC 2018; 45:e1385. [PMID: 29617491 DOI: 10.1590/0100-6991e-20181385] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 01/09/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVE to evaluate pain in individuals with venous ulcers treated with elastic bandage and decongestant physical therapy. METHODS we studied 90 patients, divided into three groups with 30 patients each: a group treated with elastic bandage and decongestant physical therapy; a group treated with elastic bandage; and a group treated only with primary dressing according to tissue type and presence of exudate. We used the Pain Numerical Scale to quantify pain intensity and the McGill Pain Questionnaire for pain qualitative assessment. RESULTS in the first evaluation, all patients who participated in the study reported intense pain. In the fifth evaluation, the majority of patients treated with elastic bandaging and decongestant physical therapy did not report pain; the majority of patients in the elastic bandage group reported mild pain; and most patients treated only with primary dressing reported mild to moderate pain. During all five assessments using the McGill questionnaire, most patients in the elastic bandaging and primary dressing groups used descriptors of the sensory, affective, evaluative and miscellaneous groups to describe their pain. However, in the fourth and fifth evaluations, most patients who received decongestant physical therapy combined with elastic bandaging treatment did not use any of the descriptors. CONCLUSION patients treated with decongestant physical therapy and elastic bandage presented pain improvement from the third evaluation performed on.
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Affiliation(s)
- Geraldo Magela Salomé
- - University of Vale do Sapucaí, Master's Degree in Health Science, Pouso Alegre, MG, Brazil
| | - Lydia Masako Ferreira
- - University of Vale do Sapucaí, Master's Degree in Health Science, Pouso Alegre, MG, Brazil
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