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Durán-Sáenz I, Verdú-Soriano J, González-de la Torre H, López-Casanova P, Berenguer-Pérez M. Psychometric validation of an instrument to assess undergraduate nursing student's knowledge of the aetiology, prevention and treatment of venous leg ulcers. NURSE EDUCATION TODAY 2024; 142:106340. [PMID: 39154591 DOI: 10.1016/j.nedt.2024.106340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 07/06/2024] [Accepted: 08/01/2024] [Indexed: 08/20/2024]
Abstract
BACKGROUND In the management of individuals with venous leg ulcers, education serves as a pivotal tool for acquiring knowledge, fostering appropriate attitudes, and promoting best practices. Consequently, assessing knowledge, skills, attitudes, confidence, and commitment becomes essential, necessitating the development of suitable evaluation instruments. Pre- and post-test assessments align with Level 2 of Kirkpatrick's model. Moreover, nurse educators should integrate assessment into the teaching-learning sequences. AIM To psychometrically validate an instrument designed to assess undergraduate nursing students' knowledge of the aetiology, prevention, and treatment of venous leg ulcers. DESIGN A multi-phase study was designed to develop the tool and subsequently validate its psychometric properties. SETTING(S) The study was conducted at three sites within the University of the Basque Country and one site within the University of Alicante. PARTICIPANTS A total of 516 students from all four years of the nursing degree program participated. METHODS The construct definition and instrument development were previously published. This article presents the psychometric evaluation, which involved classical item analysis, analysis of psychometric properties according to the Rasch model, differential item functioning analysis, construct validity analysis through hypothesis testing in known groups, and reliability analysis via internal consistency. RESULTS The results validated the Knowledge on Venous Leg Ulcer Questionnaire, reducing it from 72 initial items to 36 definitive items. It was found to be a valid and reliable instrument, capable of detecting statistically significant differences between known groups. Knowledge scores on a 0-100 scale were found to be 33.1 (SD = 19.5) for the first-second year groups, and 48.3 (SD = 17.5) for the third-fourth year groups, demonstrating a progressive and logical increase in knowledge each year. CONCLUSIONS The Knowledge on Venous Leg Ulcer Questionnaire appears to be a valid and reliable instrument for measuring nursing students' knowledge of venous leg ulcers. However, further research in different contexts is required to confirm these results.
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Affiliation(s)
- Iván Durán-Sáenz
- Bioaraba, Basque Nurse Education Research Group, Vitoria-Gasteiz, Spain; Osakidetza Basque Health Service, Araba University Hospital, Vitoria-Gasteiz School of Nursing, Vitoria-Gasteiz, Spain.
| | - José Verdú-Soriano
- Community Nursing, Preventive Medicine, Public Health and History of Science Department, Faculty of Health Sciences, University of Alicante, Carretera San Vicente Del Raspeig s/n, 03690, San Vicente Del Raspeig, Alicante, Spain
| | - Héctor González-de la Torre
- Research Support Unit, Insular Maternal and Child University Hospital Complex, Canary Health Service,35016, Las Palmas de Gran Canaria, Spain; Nursing Department, Faculty of Healthcare Science, Universidad de Las Palmas de Gran Canaria (ULPGC), 35016, Las Palmas de Gran Canaria, Spain
| | - Pablo López-Casanova
- Community Nursing, Preventive Medicine, Public Health and History of Science Department, Faculty of Health Sciences, University of Alicante, Carretera San Vicente Del Raspeig s/n, 03690, San Vicente Del Raspeig, Alicante, Spain
| | - Miriam Berenguer-Pérez
- Community Nursing, Preventive Medicine, Public Health and History of Science Department, Faculty of Health Sciences, University of Alicante, Carretera San Vicente Del Raspeig s/n, 03690, San Vicente Del Raspeig, Alicante, Spain
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Gomes FJP, Henriques MAP, Baixinho CL. The effectiveness of nursing interventions in adherence to self-care for preventing venous ulcer recurrence: A systematic literature review. Int Wound J 2024; 21:e14454. [PMID: 37986660 PMCID: PMC10895201 DOI: 10.1111/iwj.14454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 10/12/2023] [Indexed: 11/22/2023] Open
Abstract
Venous ulcers affect up to 3% of the global population, with a high impact on economies and quality of life. This is exacerbated by its recurrence rates, which reach 70% at 12 months after healing. The perpetuation of these cycles of healing and recurrence is not interrupted or even attenuated by the self-care activities recommended and directed toward their prevention. In this context, we sought to identify the effectiveness of interventions that promote adherence to self-care to prevent venous ulcer recurrence. In August 2022, we conducted a literature search via EBSCO in the following databases: CINAHL Complete, MEDLINE Complete, Cochrane Database of Systematic Reviews, Scopus, and Web of Science. The inclusion criteria were researched in the form of randomised controlled trials or systematic literature reviews, and 99 studies were identified. During the different times of selection, four studies met the defined inclusion criteria and were included. As the main conclusions, the emphasis goes to the importance of the use of compression and the greater effectiveness of higher compression classes for the prevention of recurrence. Different educational methodologies seem to be important to increase knowledge about prevention, specifically regarding the aetiology of recurrence and the implementation of prevention measures.
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Affiliation(s)
- Filipe José Paulo Gomes
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR)Doctoral Program Lisbon University/Nursing School of LisbonLisbonPortugal
| | - Maria Adriana Pereira Henriques
- Nursing School of LisbonNursing School of Lisbon, Portugal/Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR)LisbonPortugal
| | - Cristina Lavareda Baixinho
- Nursing School of LisbonNursing School of Lisbon, Portugal/Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR)LisbonPortugal
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Qiu Y, Osadnik CR, Brusco NK, Sussman G, Reeves J, Gleghorn L, Weller CD, Team V. Association between physical activity levels and healing in people with venous leg ulcers: secondary analysis of prospective cohort data. Front Med (Lausanne) 2023; 10:1305594. [PMID: 38188330 PMCID: PMC10768026 DOI: 10.3389/fmed.2023.1305594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/01/2023] [Indexed: 01/09/2024] Open
Abstract
Aim To explore the relationship between physical activity levels and wound healing and recurrence in people with venous leg ulcers. Methods Questionnaires and medical records were used to collect data, with responses used to group participants into different physical activity groups. The differences in healing and recurrence outcomes of ulcers among different physical activity groups were compared using Chi-square, Kaplan Meier survival analysis, Cox proportional hazards regression analysis, and Kruskal-Wallis test. To measure the strength of the association between physical activity levels and patient outcomes, Spearman's Rho tests were used. We used descriptive analysis to examine how physical activity levels change over 24 weeks. Results Participants were classified into four distinct groups based on physical activity levels reported at baseline and week 12. The survival analysis showed higher physical activity level was associated with a shorter time to healing (log-rank test = 14.78, df = 3; p = 0.002). The persistently moderate-to-vigorous group had a 7.3-fold increased likelihood of healing compared to the persistently sedentary group. High levels of physical activity were also associated with a better quality of life score at baseline (ρ = 0.41, p < 0.000), week 12 (ρ = 0.36, p < 0.001), and week 24 (ρ = 0.49, p < 0.000). Most participants (48.5%) reported low levels of physical activity, which remained low for the entire study period. Conclusion An increased level of physical activity was linked to a shorter healing time and enhanced quality of life. Low levels of physical activity appeared common among people with venous leg ulcers.
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Affiliation(s)
- Yunjing Qiu
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, NSW, Australia
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
| | - Christian R. Osadnik
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, VIC, Australia
| | - Natasha K. Brusco
- Rehabilitation, Ageing and Independent Living Research Centre, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, VIC, Australia
| | - Geoffrey Sussman
- Austin Health, Melbourne, VIC, Australia
- Department of General Practice Faculty of Medicine, Nursing and Health Science Monash University, Melbourne, VIC, Australia
| | | | | | - Carolina D. Weller
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
| | - Victoria Team
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
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Pasek J, Szajkowski S, Cieślar G. Quality of Life in Patients with Venous Leg Ulcers Treated by Means of Local Hyperbaric Oxygen Therapy or Local Ozone Therapy-A Single Center Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2071. [PMID: 38138174 PMCID: PMC10744587 DOI: 10.3390/medicina59122071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/18/2023] [Accepted: 11/22/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: Venous leg ulcers pose a significant medical problem worldwide. The complexity of the problem determines the need for further interdisciplinary activities that will improve the quality of life for treated patients. This study compared the quality of life of patients with venous leg ulcers who received local hyperbaric oxygen therapy or local ozone therapy procedures as part of comprehensive treatment. Materials and Methods: The study included 129 patients (62 men and 57 women) with venous leg ulcers. Group I underwent local hyperbaric oxygen therapy (HBOT), and Group II underwent local ozone therapy (OZONE). In both groups, the patients' quality of life was assessed before the start of the treatment cycle, as well as 10 weeks and 6 months after the completion of the treatment, by means of the EQ-5D-5L questionnaire and the Polish shortened version of the SF-36 scale. Results: After completing the respective therapeutic cycle, both groups showed statistically significant (p < 0.001) improvement in quality of life, according to the EQ-5D-5L questionnaire and the SF-36 scale. Differences were noted between the 1st examination (before treatment) and the 2nd examination (10 weeks after treatment), as well as the 3rd examination (6 months after treatment). In the EQ-5D-5L assessment of anxiety and depression, self-care, and activities of daily living 6 months after the end of treatment, better results were found in the group of patients treated with local hyperbaric oxygen therapy (p < 0.001). In this group, 6 months after the end of the treatment, a statistically significantly higher result on the EQ-VAS scale was also obtained (73.09 ± 19.8 points vs. 68.03 ± 17.37 points, p = 0.043). However, in the SF-36 assessment performed 6 months after the end of treatment, better results-a statistically significantly lower value of the quality of life index-were recorded in the group of patients treated with local ozone therapy (103.13 ± 15.76 points vs. 109.89 ± 15.42 points, p < 0.015). Conclusions: Hyperbaric oxygen therapy and local ozone therapy procedures have a beneficial effect on improving the quality of life of patients with venous leg ulcers.
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Affiliation(s)
- Jarosław Pasek
- Collegium Medicum im dr Władysława Biegańskiego, Jan Długosz University in Częstochowa, 13/15 Armii Krajowej St., 42-200 Częstochowa, Poland
| | - Sebastian Szajkowski
- Faculty of Medical and Social Sciences, Warsaw Medical Academy of Applied Sciences, 8 Rydygiera St., 01-793 Warszawa, Poland;
| | - Grzegorz Cieślar
- Department of Internal Medicine, Angiology and Physical Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 15 Stefana Batorego St., 41-902 Bytom, Poland;
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Cho KA, Cheng MH, Shih WM, Chen SC. Factors associated with health-related quality of life in gynaecologic cancer survivors with lower limb lymphedema: a cross-sectional study in Taiwan. BMC Womens Health 2023; 23:200. [PMID: 37118756 PMCID: PMC10148438 DOI: 10.1186/s12905-023-02340-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 04/08/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUNDS Gynaecological cancer survivors may develop lower limb lymphoedema after surgery, which negatively impacts quality of life. The purposes of this study were (1) to assess the levels of symptom distress, depression, body image, and health-related quality of life (HRQoL); (2) to recognize factors associated with HRQoL related in gynaecologic cancer survivors with lower limb lymphoedema. METHODS A cross-sectional study was conducted with convenience sampling of gynaecologic cancer survivors with lower limb lymphoedema. Gynaecologic cancer survivors were assessed for symptom distress, depression, body image, and HRQoL. Multiple regression analysis was conducted to recognize the factors associated with HRQoL. Independent-samples t-test was used to compare symptom distress, depression, body image, and HRQoL by grade of lymphoedema. RESULTS The most common distressing symptoms of lower limb lymphoedema were lower extremity oedema, lower extremity tightness, and lower extremity stiffness. Worse HRQoL was associated with more symptom distress, less satisfaction with body image, a high grade of lymphoedema, and a longer duration of lower limb lymphoedema. These factors explained 76.5% of the variance in HRQoL. Gynaecologic cancer survivors with late grade lymphoedema experienced lower HRQoL and higher levels of symptom distress, depression, and greater dissatisfaction with body image than those who had early grade lymphoedema. CONCLUSIONS Symptom distress had the strongest association with overall HRQoL and with all individual domains of HRQoL, except mental function. These results suggest that educating gynaecologic cancer survivors to assess lower limb lymphoedema-related problems, providing symptom management, and guiding survivors in physical activity to relieve lower extremity discomfort can improve HRQoL.
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Affiliation(s)
- Kuei-An Cho
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ming-Huei Cheng
- Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, College of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
- Section of Plastic Surgery, The University of Michigan, Ann Arbor, MI, USA
- Center of Lymphedema Microsurgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Whei-Mei Shih
- Graduate Institute of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan, 333, Taiwan
| | - Shu-Ching Chen
- School of Nursing and Geriatric and Long-Term Care Research Center, College of Nursing, Chang Gung University of Science and Technology, 261, Wen-Hua 1st Road, Guishan, Taoyuan, 333, Taiwan.
- Department of Radiation Oncology and Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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Lin HC, Fang CL, Hsu CH, Fan JY. Psychometric Properties of the Traditional Chinese Version of the Venous Leg Ulcer Quality of Life Questionnaire. Adv Skin Wound Care 2023; 36:213-218. [PMID: 36940378 PMCID: PMC10026955 DOI: 10.1097/01.asw.0000919472.71267.a8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Abstract
OBJECTIVE Symptoms and treatment of venous leg ulcers (VLUs) adversely impact patients' quality of life (QoL). There is no QoL tool that considers the linguistic and cultural specificities of patients with VLU in Taiwan. This study aimed to evaluate the psychometric properties of the traditional Chinese version of the Venous Leg Ulcer Quality of Life Questionnaire (VLU-QoL). METHODS The processes of translation and cultural adaptation of the VLU-QoL from English to traditional Chinese included forward translation, back translation, linguistic modification, and expert review. Using a sample of 167 patients with VLU from a hospital in southern Taiwan, the psychometric properties analyzed were internal consistency, test-retest reliability, content validity, convergent validity, and criterion-related. RESULTS The traditional Chinese version of the VLU-QoL demonstrated good overall internal consistency (Cronbach α = .95) and overall test-retest reliability coefficient (r = 0.98). Confirmatory factor analysis was used to assess the convergent validity of the scale; results showed that the Activity, Psychology, and Symptom Distress constructs had acceptable fit and a structure similar to that of the original scale. The scale had its criterion-related validity verified using the Taiwanese version of the 36-item Short-Form Health Survey, demonstrating a good correlation coefficient r that ranged from -0.7 to -0.2 (P < .001). CONCLUSIONS The Chinese version of the VLU-QoL is valid and reliable for assessing the QoL in patients with VLU, delivering a tool that nurses can use to deliver timely and appropriate care to improve patients' QoL.
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Affiliation(s)
- Hsiao-Ching Lin
- Hsiao-Ching Lin, MSN, RN, WOCN, is Wound, Ostomy, and Continence Nurse, Division of Plastic and Reconstruction Surgery, Department of Surgery, Wound Care Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital and Doctoral Student, College of Nursing, Kaohsiung Medical University, Taiwan. Chien-Liang Fang, MD, MBA, is Director, Division of Plastic and Reconstruction Surgery, Department of Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital and Assistant Professor, Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Tai-Chung City. Chin-Hao Hsu, MD, is Attending Physician, Division of Plastic and Reconstruction Surgery, Department of Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital. Jun-Yu Fan, PhD, RN, FAAN, is Professor, Department of Nursing & Graduate Institute of Nursing, Chang Gung University of Science and Technology; and Research Fellow, Division of Nursing, Chang Gung Memorial Hospital, Linkou Branch, Tao-Yuan
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Shankar S, Mk A, Palani T, Nagasubramanian VR. Factors associated with health-related quality of life of south indian population with chronic venous leg ulcers - A hospital based pilot study. JOURNAL OF VASCULAR NURSING 2022; 40:162-166. [PMID: 36435598 DOI: 10.1016/j.jvn.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Venous leg ulcers (VLU) are chronic, recurrent and have a significant impact on the patients' health- related quality of life (HRQoL). This study assessed the association of patient-specific factors on the HRQoL of patients with chronic venous leg ulcers. MATERIALS AND METHODS The study included 21 males and 21 females aged 18 years and above, with chronic VLU. Data on demographics, education, occupation, per capita income, duration of ulcer were subjectively recorded. The socio-economic status was scored based on the Modified Kuppuswamy scale 2019, ulcer severity was assessed using M.A.I.D. Scale and the HRQoL of the patients were assessed using the 36-Item Short-Form Health Survey Version 1.0. The differences in the mean HRQoL scores between patients based on their gender and socio-economic class were assessed using an unpaired sample t-test. The association of age, severity, duration of the ulcer with the HRQoL were assessed using Pearson's correlation. A probability value of < 0.05 was considered statistically significant. RESULTS There were 21 (50%) males and 21 (50%) females with a mean age of 55.45 ± 7.73 years. The mean duration of ulcers was 7.26 ± 3.34 months and the mean ulcer severity score was 2.16 ± 0.96. Role limitations due to the physical health were found to be most impacted due to the disease condition with the least mean score of 26.78 ± 31.90 %. There were no significant differences in the mean scores of the physical and the mental components of HRQoL based on gender but there were significant differences based on socio-economic status. The lower the socio-economic status, the poorer the HRQoL. Age, severity of ulcers and ulcer duration had a significant negative correlation with HRQoL. CONCLUSION The study observed a low HRQoL of patients in physical aspects reflecting on the extensive limitation on the performance of daily physical activities. Patient-specific factors such as age, socio-economic status, severity, and chronicity of ulcers were found to influence HRQoL.
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Affiliation(s)
- Shruthi Shankar
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Chennai, India
| | - Ayyappan Mk
- Department of Vascular Surgery, Sri Ramachandra Medical Center and Hospital, Chennai, India
| | - Thennarasu Palani
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Chennai, India
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Rodríguez-Abad C, Rodríguez-González R, Martínez-Santos AE, Fernández-de-la-Iglesia JDC. Effectiveness of augmented reality in learning about leg ulcer care: A quasi-experimental study in nursing students. NURSE EDUCATION TODAY 2022; 119:105565. [PMID: 36155210 DOI: 10.1016/j.nedt.2022.105565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 08/30/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Chronic wounds are a serious public health problem worldwide. Providing optimal treatment to patients suffering from leg ulcers is a priority for nursing. Therefore, nursing students need to acquire the necessary competencies to provide evidence-based care. Augmented Reality (AR) is an emerging technology in health science education which can help nursing students achieve these skills if it is promoted by both institutions and educationalists. OBJECTIVES To test the effectiveness of an AR-based methodology for teaching-learning aspects of the nursing curriculum (leg ulcer care), as well as to describe how AR influences different learning determinants of nursing students. DESIGN A quasi-experimental study was carried out. PARTICIPANTS/SETTINGS The participants of the study were 137 s-year nursing students from the School of Nursing of the University of Santiago de Compostela (Spain) (average age = 21.59 years, 80.29 % females). Of them, 65 comprised the control group (Non-AR-based teaching) and 72 comprised the experimental group (AR-based teaching). METHODS Pre-post tests were used to measure knowledge and skills about leg ulcer care in both groups. Additionally, two validated questionnaires were selected to identify the influence of AR on learning determinants in the experimental group. The study took place during the 2018/2019 academic year. RESULTS Significantly higher scores (7.68 vs. 6.14) were found in the knowledge post-test in the experimental group (p ≤ 0.001), while the pre-test did not show differences between groups (4.43 vs. 4.32). Also, nursing students indicated high scores in attention, autonomous learning, understanding and motivation to carry out learning objectives using AR. CONCLUSIONS AR is a tool that improves performance related to the specific aspects of the nursing academic curriculum (leg ulcer care), while encouraging positive attitudes towards the teaching-learning process. These findings reinforce the need to include innovative methodologies in nursing classrooms.
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Affiliation(s)
- Carlos Rodríguez-Abad
- University of Santiago de Compostela, Faculty of Nursing, Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Santiago de Compostela, Spain
| | - Raquel Rodríguez-González
- University of Santiago de Compostela, Faculty of Nursing, Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Santiago de Compostela, Spain
| | - Alba-Elena Martínez-Santos
- University of Santiago de Compostela, Faculty of Nursing, Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Santiago de Compostela, Spain; DIPO Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Spain; Dermatology Department, Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
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Kelechi TJ, Mueller M, Madisetti M, Prentice M. Efficacy of a Self-managed Cooling Intervention for Pain and Physical Activity in Individuals With Recently Healed Chronic Venous Leg and Diabetic Foot Ulcers: A Randomized Controlled Trial. J Wound Ostomy Continence Nurs 2022; 49:365-372. [PMID: 35507774 PMCID: PMC9271545 DOI: 10.1097/won.0000000000000880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This aim of this study was to evaluate the clinical efficacy of a self-managed cooling intervention in individuals with recently healed venous leg ulcers (VLUs) and diabetic foot ulcers (DFUs) on pain reduction and physical activity improvement. DESIGN A 6-month longitudinal randomized controlled trial. SUBJECTS AND SETTING The sample comprised 140 individuals with previously healed VLU and DFU who received care in 3 outpatient wound centers in the Southeastern region of the United States. Participants were randomized to the MUSTCOOL or a placebo cooling patch intervention. METHODS The cooling and placebo interventions comprised cooling or cotton-filled patch application to recently healed skin for 30 minutes, 3 times weekly plus standard of care including compression and leg elevation (participants with VLU) or therapeutic footwear and hygiene (participants with DFU) over a 6-month period. Pain severity and intensity were measured with the Brief Pain Inventory and physical activity with the International Physical Activity Questionnaire, which assessed metabolic equivalent of tasks (METs) in minutes per week. Minutes in walking time per week were assessed with an accelerometer. Data were descriptively analyzed for difference changes in scores from baseline to 6 months post-intervention. RESULTS Data were analyzed for 81 participants randomized to cooling and placebo groups (VLUs, n = 26/29) and DFU (n = 12/16). Slight reductions in VLU pain severity (-0.5, -0.2) and interference (-0.4, -0.5) and minimal reductions in DFU pain severity (0, -0.1) and interference (0.4/0.1) were achieved. However, pain scores were low to moderate at baseline (mean 4, 0-10 with 10 worst pain possible) in both groups. For physical activity, the MET values showed low physical activity in both groups at baseline with slight improvements noted in VLU cooling and placebo groups (73/799) and DFU (1921/225), respectively. Walking time for the VLU groups improved by 1420/2523 minutes; the DFU groups improved 135/157 minutes, respectively. Findings for outcomes were not statistically significant within or between groups. CONCLUSIONS Application of the cooling pack compared to placebo was minimally efficacious in reducing posthealing pain and improving function in this posthealed ulcer population. However for pain, scores were initially low; thus outcomes on pain, while lower, were marginal. TRIAL REGISTRATION The study was prospectively registered with ClinicalTrials.gov on December 10, 2015 (Identifier: NCT02626156), https://clinicaltrials.gov/ct2/show/NCT02626156 .
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Affiliation(s)
- Teresa J Kelechi
- Teresa J. Kelechi, PhD, College of Nursing, Medical University of South Carolina, Charleston
- Martina Mueller, PhD, Medical University of South Carolina, Charleston
- Mohan Madisetti, MS, Medical University of South Carolina, Charleston
- Margaret Prentice, MBA, Medical University of South Carolina, Charleston
| | - Martina Mueller
- Teresa J. Kelechi, PhD, College of Nursing, Medical University of South Carolina, Charleston
- Martina Mueller, PhD, Medical University of South Carolina, Charleston
- Mohan Madisetti, MS, Medical University of South Carolina, Charleston
- Margaret Prentice, MBA, Medical University of South Carolina, Charleston
| | - Mohan Madisetti
- Teresa J. Kelechi, PhD, College of Nursing, Medical University of South Carolina, Charleston
- Martina Mueller, PhD, Medical University of South Carolina, Charleston
- Mohan Madisetti, MS, Medical University of South Carolina, Charleston
- Margaret Prentice, MBA, Medical University of South Carolina, Charleston
| | - Margaret Prentice
- Teresa J. Kelechi, PhD, College of Nursing, Medical University of South Carolina, Charleston
- Martina Mueller, PhD, Medical University of South Carolina, Charleston
- Mohan Madisetti, MS, Medical University of South Carolina, Charleston
- Margaret Prentice, MBA, Medical University of South Carolina, Charleston
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Garavello A, Gilardi S, Fiamma P, Toti V, Tozzi M, Fransvea P. Deep Venous Thrombosis and Ulcers of Lower Limbs: Ultrasound Findings in 156 Patients. Int J Angiol 2022; 31:113-119. [PMID: 35833180 PMCID: PMC9272312 DOI: 10.1055/s-0042-1743408] [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: 10/18/2022] Open
Abstract
Venous ulcers (VUs) of lower limbs affect 1% of Western population. In most cases, ultrasounds show only superficial venous insufficiency (SVI), but a deep venous insufficiency (DVI) may also be present without a history of deep vein thrombosis (DVT). To assess SVI and DVI in DVT-positive and DVT-negative patients with VU, a retrospective cohort of 123 patients entered the study (50 male and 73 female, minimum age 29 years and maximum age 90 years, and mean 70.6 years). In 56 patients (45.5%), ulcer was on the right leg, in 52 (42.3%) on the left leg, and in 15 patients (12.2%), ulcer was bilateral, resulting in a total number of 138 limbs in the study. Sixty-six patients suffered DVT, while in 72 anamnesis was negative. Color duplex ultrasound was performed on both limbs, which revealed insufficiencies of superficial and/or deep veins in 18 limbs which had not been affected by an ulcer or a previous DVT. So the study was on 156 limbs. SVI were substantially overlapping in two groups ( p -value = 0.593), while combined SVI and DVI was 72.5% in DVT positive limbs ( p -value = 0.001). In 70% of cases with a femoral vein insufficiency ( p -value = 0.036) or popliteal vein insufficiency (PVI) ( p -value 0,003), a DVT history was present. Of 18 limbs, although not affected by ulcer or previous DVT, eight were positive for DVI (two femoral veins and six popliteal veins). In the patient with VU, the history of DVT is a strong predictor of DVI insufficiency. In DVT-positive patients with ulcer, the number of "combined superficial and deep insufficiencies" appears to be particularly significant and surgical treatment must take this into account. A previous DVT has a low impact on great and small saphenous insufficiencies in ulcer patients; these were substantially overlapping in DVT-positive and DVT-negative patients. The 18 limbs with DVI and SVI without ulcer and DVT history were unexpected result. We think these patients must have a close follow-up to avoid the onset of a VU.
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Affiliation(s)
- Alberto Garavello
- UOC Chirurgia d'Urgenza e del trauma fondazione Policlinico Universitario A.Gemelli IRCCS - Roma
| | - Stefania Gilardi
- Centro Per la Terapia Dell'ulcera Venosa e Arteriosa, Ospedale San Filippo Neri -ASL RM1, Roma, Italy
| | - Paola Fiamma
- Centro Per la Terapia Dell'ulcera Venosa e Arteriosa, Ospedale San Filippo Neri -ASL RM1, Roma, Italy
| | - Valentina Toti
- Centro Per la Terapia Dell'ulcera Venosa e Arteriosa, Ospedale San Filippo Neri -ASL RM1, Roma, Italy
| | | | - Pietro Fransvea
- Dipartimento di Chirurgia D'urgenza, Policlinico Agostino Gemelli, Roma, Italy
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11
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Senft JD, Fleischhauer T, Frasch J, van Rees W, Feißt M, Schwill S, Fink C, Poß-Doering R, Wensing M, Müller-Bühl U, Szecsenyi J. Primary care disease management for venous leg ulceration—study protocol for the Ulcus Cruris Care [UCC] randomized controlled trial (DRKS00026126). Trials 2022; 23:60. [PMID: 35057840 PMCID: PMC8771170 DOI: 10.1186/s13063-021-05944-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/16/2021] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Venous leg ulcers (VLU) have a prevalence of 1–2% in developed countries, and affected patients are severely and long-term impaired in daily activities, work, and social participation. Evidence-based outpatient treatment based on compression therapy is frequently not implemented. The “Ulcus Cruris Care” project was established to develop a disease management concept to improve outpatient treatment for patients with VLU in German primary care. For this purpose, a multifaceted intervention was conceived consisting of an online training for general practitioners and medical assistants, standardized treatment recommendations, e-learning and print-based information for patients, and a software support for case management. The main aims of the Ulcus Cruris Care intervention are to promote standardized treatment according to current scientific knowledge, to facilitate case management for VLU patients exerted by medical assistants, and to support patient education and participation in the treatment process. The UCC trial was designed to evaluate the effectiveness of the Ulcus Cruris Care intervention.
Methods
The UCC trial is a prospective cluster-randomized controlled multicenter trial. Fifty GP practices are intended to be recruited and randomized 1:1 to intervention or control arm. Patients with venous leg ulcers will be recruited by participating GP practices, to include a total of 63 patients in each arm. The primary outcome is time to ulcer healing. Secondary outcomes comprise number and sizes of ulcers, recurrence, pain intensity according to the visual analog scale, health-related quality of life according to EQ-5D-5L, depressiveness according to Patient Health Questionnaire (PHQ-9), patient satisfaction according to the Patient Assessment of Chronic Illness Care (PACIC-5A) query, and adherence to VLU treatment. The outcome analysis of the UCC trial is accompanied by a health economic analysis and a process evaluation.
Discussion
The UCC trial will evaluate whether the Ulcus Cruris Care intervention may lead to faster wound healing, higher health-related quality of life, and lower use of medical resources. If the intervention turns out to have a positive impact on assessed outcomes, comprehensive implementation in primary care may be considered.
Trial registration
The trial protocol (version 1 as of July 19, 2021) has been registered in the German Clinical Trials Register on August 30, 2021 (DRKS00026126).
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12
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Rocha MNB, Serna Gonzalez CV, Borges EL, Santos VLCDG, Rabeh SAN, Nogueira PC. Incidence of Recurrent Venous Ulcer in Patients Treated at an Outpatient Clinic: Historical Cohort. INT J LOW EXTR WOUND 2022:15347346211065929. [PMID: 34981995 DOI: 10.1177/15347346211065929] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The recurrence of venous ulcers is the wound reopening after a period of completed epithelisation of a previous ulcer due to exposure to causal factors and lack of prevention. Venous ulcers have a high recurrence rate that may increase through the years. Epidemiological evidence on its incidence and risk factors is scarce due to the lack of patient follow-up in outpatient clinics and adherence to treatment after healing. The objective was to analyze the incidence of venous ulcers recurrency in outpatients and the risk factors for its occurrence. It is an observational historical cohort with retrospective data collection, performed through electronic medical records. Setting: private health insurance outpatient clinic. The participants were adult patients with healed venous ulcers. Incidence of venous ulcer recurrence was calculated within individuals with healed ulcers from 2014 and 2018 with a follow-up of at least one year. Bivariate analysis and logistic regression were used to explore risk factors considering demographic, clinical, and wound-related variables. As a result, sixty-five (65) of the 134 patients with healed venous ulcers had a recurrence, leading to an incidence of 48.5%, with a mean onset time of 230.1 (SD 267) days. Patients with recurrent venous ulcers were primarily women (39/48.1%), with a mean age of 64 (SD 15.5) years, 57 (50.8%) had some comorbidity, with systemic arterial hypertension as the most frequent (47/51%). Obesity (15/88.2%) increased the risk of venous ulcers recurrence by 8.7 (OR 95% CI 2.1-60.8; P = .009) times. In conclusion, venous ulcers recurrence incidence was 48.5%, with obesity as a risk factor. This study demonstrates that the clinical approach of people with venous ulcers should not finish when the wound is healed. For ulcer recurrence prevention interventions addressing systemic factors, besides topical management of the wound, are essential.
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Affiliation(s)
| | - Carol Viviana Serna Gonzalez
- Graduate Program in Adult Health Nursing, University of São Paulo School of Nursing (28133Universidade de Sao Paulo, Escola de Enfermagem-EEUSP), Sao Paulo, Sao Paulo, Brazil
| | - Eline Lima Borges
- Department of Basic Nursing, 28114Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Vera Lúcia Conceição de Gouveia Santos
- Medical-Surgical Nursing Department, 67816University of Sao Paulo School of Nursing (Universidade de Sao Paulo, Escola de Enfermagem-EEUSP), Sao Paulo, São Paulo, Brazil
| | - Soraia Assad Nasbine Rabeh
- General and Specialized Nursing Department, University of Sao Paulo School of Nursing in Riberão Preto (Universidade de Sao Paulo, Escola de Enfermagem de Ribeirão Preto-EERP/USP), Ribeirão Preto, São Paulo, Brazil
| | - Paula Cristina Nogueira
- Medical-Surgical Nursing Department, 67816University of Sao Paulo School of Nursing (Universidade de Sao Paulo, Escola de Enfermagem-EEUSP), Sao Paulo, São Paulo, Brazil
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13
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Zhu X, Olsson MM, Bajpai R, Järbrink K, Tang WE, Car J. Health-related quality of life and chronic wound characteristics among patients with chronic wounds treated in primary care: A cross-sectional study in Singapore. Int Wound J 2021; 19:1121-1132. [PMID: 34854234 PMCID: PMC9284657 DOI: 10.1111/iwj.13708] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 10/18/2021] [Accepted: 10/20/2021] [Indexed: 12/23/2022] Open
Abstract
Chronic wounds commonly decrease patients' quality of life. Understanding how chronic wounds impact a patient's health‐related quality of life (HRQoL) is important for healthcare service delivery and treatment management. This study explored HRQoL among patients suffering from chronic wounds and investigated associations with patients' socio‐demographics and wound characteristics. Two hundred and thirty‐three patients across six primary care clinics were assessed and responded to a survey that collected information on socio‐demographic, wound characteristics, and HRQoL using the EQ‐5D‐5L instrument. Data were analysed by descriptive statistics and generalised linear models. The mean age of patients was 61.2 (SD: 14.6) years; 68.2% were males; and 61.8% were of Chinese origin. Arterial ulcers had the greatest negative impact on HRQoL related to mobility, self‐care, pain/discomfort and anxiety/depression, and the lowest VAS mean score 62.31 (SD: 28.3; range: 0‐100) indicating the worst health. HRQoL related to mobility was significantly associated with age (β = 0.008, P < .001), non‐Chinese ethnicity (β = 0.25, P = .001), mixed ulcers (β = −0.41, P = .022), atypical hard‐to‐heal wounds (β = −0.38, P = .021), wounds with low (β = 0.24, P = .044) to moderate (β = 0.29, P = .018) exudate level, and a wound duration ≥6 months (β = 0.19, P = .033). The findings can be used to improve healthcare delivery for patients with chronic wound to optimise their HRQoL.
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Affiliation(s)
- Xiaoli Zhu
- Nursing Services, National Healthcare Group Polyclinics, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
| | - Maja Magdalena Olsson
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Centre for Healthcare Transformation, School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Ram Bajpai
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,School of Medicine, Keele University, Staffordshire, UK
| | - Krister Järbrink
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Wern Ee Tang
- Clinical Research Unit, National Healthcare Group Polyclinics, Singapore, Singapore
| | - Josip Car
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
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14
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Atkin L, Bullock L, Chadwick P, Elwell R, Gardner S, Goodwin T, Hopkins A, O'Connor C, Sneddon M, Wiles K, Williams K. Making Legs Matter: A Case for System Change and Transformation in Lower-Limb Management. J Wound Care 2021; 30:S1-S25. [PMID: 34756097 DOI: 10.12968/jowc.2021.30.sup11.s1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This consensus document is endorsed by The Queen's Nursing Institute (QNI) and The Queen's Nursing Institute Scotland (QNIS).
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Affiliation(s)
- Leanne Atkin
- Legs Matter Chair; Vascular Nurse Consultant, Mid Yorks NHS Trust/University of Huddersfield, UK
| | - Lynn Bullock
- PA to Ellie Lindsay, The Lindsay Leg Club Foundation, UK
| | - Paul Chadwick
- National Clinical Director, The College of Podiatry, UK
| | - Rebecca Elwell
- Macmillan Lymphoedema ANP and Team Leader, Lymphoedema Clinic, Royal Stoke University Hospital, University Hospitals of North Midlands NHS Trust, UK
| | | | | | | | | | - Margaret Sneddon
- Honorary Senior Research Fellow, University of Glasgow; Chair, British Lymphology Society, UK
| | | | - Kate Williams
- Tissue Viability Nurse, Leeds Community Health NHS Trust, UK
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15
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Lin HC, Fang CL, Hung CC, Fan JY. Potential predictors of quality of life in patients with venous leg ulcers: A cross-sectional study in Taiwan. Int Wound J 2021; 19:1039-1050. [PMID: 34611998 PMCID: PMC9284624 DOI: 10.1111/iwj.13700] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/15/2021] [Accepted: 09/22/2021] [Indexed: 11/29/2022] Open
Abstract
Internationally, the impact of venous leg ulcers (VLUs) on the quality of life is well recognised; however, in Taiwan, the focus is only on chronic wound management. This cross‐sectional correlational study conducted at the cardiovascular and plastic surgery clinics of a regional teaching hospital between August 2019 and June 2020 investigates venous clinical severity, pain, fatigue, depression, sleep quality, quality of life, and related factors among 167 patients with VLUs. The potential predictors of the quality of life in terms of activities were venous clinical severity (P < 0.001), pain (P = 0.004), and fatigue (P < 0.001) after adjusting for covariates. The potential predictors of the quality of life in terms of the psychological domain were marital status (single/divorced) (P = 0.016), marital status (widowed) (P = 0.027), venous clinical severity (P < 0.001), pain (P = 0.001), and fatigue (P = 0.002). The potential predictors of the quality of life with regard to symptoms were venous clinical severity (P < 0.001), pain (P < 0.001), fatigue (P = 0.001), and depression (P = 0.038). These potential predictors can serve as the basis of interventions for patients with VLUs, such as those related to nutrition or training in wound dressing.
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Affiliation(s)
- Hsiao-Ching Lin
- Department of Surgery, Division of Plastic Surgery, Wound Care Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan
| | - Chien-Liang Fang
- Department of Surgery, Division of Plastic Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan.,Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Tai-Chung City, Taiwan
| | - Chang-Chiao Hung
- Department of Nursing & Graduate Institute of Nursing, Chang Gung University of Science and Technology, Chia-Yi, Taiwan
| | - Jun-Yu Fan
- Division of Nursing, Chang Gung Memorial Hospital, Linkou Branch, Tao-Yuan, Taiwan
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Jones J, Hampton S. Use of a superabsorbent dressing in the management of exudate in hard-to-heal wounds. Br J Community Nurs 2021; 26:S20-S29. [PMID: 33688756 DOI: 10.12968/bjcn.2021.26.sup3.s20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
With the shift in demographics towards an ageing population with multimorbidity, the number of hard-to-heal (chronic) wounds is increasing each year. This poses a challenge for both health professionals, for whom wound management is becoming more complex, and for patients, who have to cope with exudate production, malodour and pain. This article summarises understanding of healing in such wounds and how best to meet the challenge of exudate, which is a ubiquitous hallmark of hard-to-heal wounds. The role of superabsorbent dressings is considered, with particular reference to Kliniderm superabsorbent in the management of people with these challenging wounds.
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Affiliation(s)
| | - Sylvie Hampton
- Tissue Viability Consultant Nurse, Director of Wound Care Consultancy Ltd. (this author contributed all the case studies)
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Kaizer UADO, Domingues EAR, Paganelli ABDTS. QUALIDADE DE VIDA EM PESSOAS COM ÚLCERA VENOSA E AS CARACTERÍSTICAS E SINTOMAS ASSOCIADOS À FERIDA. ESTIMA 2021. [DOI: 10.30886/estima.v19.968_pt] [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:avaliar a qualidade de vida de pessoas com úlcera venosa e correlacionar com as características clínicas e sintomas associados à ferida. Método: estudo quantitativo, transversal e analítico. Para as análises das associações das variáveis qualitativas foram aplicados os testes Qui-quadrado e exato de Fisher, e para as variáveis quantitativas, o coeficiente de correlação de Spearman. Utilizou-se o instrumento Pressure Ulcer Scale for Healing para a avaliação da ferida e o Freiburg Life Quality Assessment Wound-wk para análise da qualidade de vida. Fizeram parte do estudo 103 sujeitos com tempo de feridas superior a seis semanas, de etiologia venosa. Resultados: houve correlação das características clínicas da úlcera venosa e sintomas associados com a qualidade de vida. Nas dimensões sintomas físicos, pessoas com úlcera venosa apresentraram pior escore em relação ao sintoma dor (p<0,0001). Associadas a isso, as características clínicas como a aparência (p< 0,0001) e a área (p=0,0037) da ferida também manifestaram correlação. Em relação à escala de avaliação da ferida (área, tecido na ferida e exsudato), o pior escore interferiu nos sintomas físicos. Conclusão: a dor, tamanho da ferida e seu aspecto influenciam negativamente na qualidade de vida de pessoas com úlcera venosa
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18
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Kaizer UADO, Domingues EAR, Paganelli ABDTS. QUALITY OF LIFE IN PEOPLE WITH VENOUS ULCERS AND THE CHARACTERISTICS AND SYMPTOMS ASSOCIATED WITH THE WOUND. ESTIMA 2021. [DOI: 10.30886/estima.v19.968_in] [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
Objective: to evaluate the quality of life of people with venous ulcers and correlate with the clinical characteristics and symptoms associated with the wound. Method: quantitative, cross-sectional and analytical study. For analyzes of associations of qualitative variables, the Chi-square and Fisher’s exact tests were applied, and for quantitative variables, Spearman’s correlation coefficient. The Pressure Ulcer Scale for Healing instrument was used to assess the wound and the Freiburg Life Quality Assessment Wound-wk for quality of life analysis. The study included 103 subjects with a wound time of more than six weeks, of venous etiology. Results: there was a correlation between the clinical characteristics of the venous ulcer and symptoms associated with quality of life. In the physical symptoms dimensions, people with venous ulcers had a worse score in relation to the pain symptom (p <0.0001). Associated with this, clinical characteristics such as the appearance (p <0.0001) and the area (p = 0.0037) of the wound also showed a correlation. Regarding the wound assessment scale (area, tissue in the wound and exudate), the worst score interfered with physical symptoms. Conclusion: the pain, size of the wound and its aspect negatively influences the quality of life of people with venous ulcers.
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Prevalence and characteristics of older people with pressure ulcers and legs ulcers, in nursing homes in Barcelona. J Tissue Viability 2021; 30:108-115. [PMID: 33485786 DOI: 10.1016/j.jtv.2021.01.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 01/07/2021] [Accepted: 01/07/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Nursing home residents are vulnerable to chronic wounds. However, the prevalence data are scarce. AIM The purpose of this study was to determine the prevalence of pressure ulcers and/or leg ulcers in nursing home residents, and describe the characteristics of the nursing homes, the residents and the wounds, as well as possible associations between these characteristics. METHODS This was a cross-sectional survey of nursing home residents over the age of 65 in 168 facilities in Barcelona. Those presenting category II-IV pressure ulcers and/or leg ulcers were included. The data were collected by observation/examination. Descriptive, bivariate, and multivariate analyses were performed. RESULTS The overall prevalence of pressure ulcers and leg ulcers combined was 4.4% (3.5% were pressure ulcers and 0.9% were leg ulcers). In small nursing homes with less nursing staff, the overall prevalence was greater than in large nursing homes (5.6% vs 3.8% [p = 0.01]). As expected, residents with pressure ulcers had higher pressure ulcer risk, worse dependence and cognitive status, urinary and faecal incontinence, and most were underweight. However, residents with leg ulcers had worse venous and arterial impairment and also were overweight. A multivariate analysis showed that pressure ulcers were statistically significantly associated with faecal incontinence (OR = 0.28, 95% CI = 0.09-0.81) and dyslipidaemia (OR = 0.21, 95% CI = 0.06-0.66), and leg ulcers were statistically significantly associated with venous insufficiency (OR = 4.93, 95% CI = 1.65-15.34). The characteristics of gluteal and ischial pressure ulcers, a high prevalence of infection, and a low reference to biofilm by nurses, in both types of wounds, suggest that these aspects are not adequately taken into account. CONCLUSIONS Pressure ulcers and leg ulcers, mainly pressure ulcers, remain a public health problem in nursing homes. Further studies are required to confirm the associations found in this study.
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Mosteiro-Miguéns DG, Herrera-Jiménez C, Lorenzo-Ruiz H, Domínguez-Martís EM, Novío S. Successful Treatment of a Venous Leg Ulcer With Manuka Honey: A Case Study. J Wound Ostomy Continence Nurs 2021; 48:79-82. [PMID: 33427815 DOI: 10.1097/won.0000000000000712] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Refractory venous leg ulcers (VLUs) often require extended time to heal, and they carry a high risk of recurrence. This case study describes our experiences with a patient with a VLU refractory to multiple treatment strategies who was successfully treated with Manuka honey. CASE Mr S. was a 76-year-old man with multiple comorbid conditions and hypersensitivity to silver-based compounds, who developed 3 VLUs of his right lower extremity. He experienced 90 days of unsuccessful treatments using an iodized cadexomer ointment, hydrodetersive fiber dressings, hydrocolloid meshes, compression therapy, and antibiotic treatment without progression toward wound healing. We then initiated treatment with Manuka honey and continued compression therapy. His primary VLU was completely epithelialized within 38 days, and an adjacent VLU also showed progression toward healing. Mr S. reported clinically relevant improvement in wound-related pain at 17 days. CONCLUSION The use of Manuka honey proved effective in this patient with a VLU refractory to other treatment strategies.
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Affiliation(s)
- Diego Gabriel Mosteiro-Miguéns
- Diego Gabriel Mosteiro-Miguéns, Badalona Serveis Assistencials (BSA), Health Care Centre of Morera-Pomar, Badalona, Barcelona, Spain
- Cristina Herrera-Jiménez, Badalona Serveis Assistencials (BSA), Health Care Centre of Morera-Pomar, Badalona, Barcelona, Spain
- Héctor Lorenzo-Ruiz, Badalona Serveis Assistencials (BSA), Health Care Centre of Morera-Pomar, Badalona, Barcelona, Spain
- Eva María Domínguez-Martís, Master in Health Care, Management and Care, Galician Public Health Care Service, Health Care Centre of Concepción Arenal, Santiago de Compostela, A Coruña, Spain
- Silvia Novío, Doctor of Dental Medicine, Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Faculty of Nursing, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Cristina Herrera-Jiménez
- Diego Gabriel Mosteiro-Miguéns, Badalona Serveis Assistencials (BSA), Health Care Centre of Morera-Pomar, Badalona, Barcelona, Spain
- Cristina Herrera-Jiménez, Badalona Serveis Assistencials (BSA), Health Care Centre of Morera-Pomar, Badalona, Barcelona, Spain
- Héctor Lorenzo-Ruiz, Badalona Serveis Assistencials (BSA), Health Care Centre of Morera-Pomar, Badalona, Barcelona, Spain
- Eva María Domínguez-Martís, Master in Health Care, Management and Care, Galician Public Health Care Service, Health Care Centre of Concepción Arenal, Santiago de Compostela, A Coruña, Spain
- Silvia Novío, Doctor of Dental Medicine, Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Faculty of Nursing, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Héctor Lorenzo-Ruiz
- Diego Gabriel Mosteiro-Miguéns, Badalona Serveis Assistencials (BSA), Health Care Centre of Morera-Pomar, Badalona, Barcelona, Spain
- Cristina Herrera-Jiménez, Badalona Serveis Assistencials (BSA), Health Care Centre of Morera-Pomar, Badalona, Barcelona, Spain
- Héctor Lorenzo-Ruiz, Badalona Serveis Assistencials (BSA), Health Care Centre of Morera-Pomar, Badalona, Barcelona, Spain
- Eva María Domínguez-Martís, Master in Health Care, Management and Care, Galician Public Health Care Service, Health Care Centre of Concepción Arenal, Santiago de Compostela, A Coruña, Spain
- Silvia Novío, Doctor of Dental Medicine, Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Faculty of Nursing, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Eva María Domínguez-Martís
- Diego Gabriel Mosteiro-Miguéns, Badalona Serveis Assistencials (BSA), Health Care Centre of Morera-Pomar, Badalona, Barcelona, Spain
- Cristina Herrera-Jiménez, Badalona Serveis Assistencials (BSA), Health Care Centre of Morera-Pomar, Badalona, Barcelona, Spain
- Héctor Lorenzo-Ruiz, Badalona Serveis Assistencials (BSA), Health Care Centre of Morera-Pomar, Badalona, Barcelona, Spain
- Eva María Domínguez-Martís, Master in Health Care, Management and Care, Galician Public Health Care Service, Health Care Centre of Concepción Arenal, Santiago de Compostela, A Coruña, Spain
- Silvia Novío, Doctor of Dental Medicine, Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Faculty of Nursing, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Silvia Novío
- Diego Gabriel Mosteiro-Miguéns, Badalona Serveis Assistencials (BSA), Health Care Centre of Morera-Pomar, Badalona, Barcelona, Spain
- Cristina Herrera-Jiménez, Badalona Serveis Assistencials (BSA), Health Care Centre of Morera-Pomar, Badalona, Barcelona, Spain
- Héctor Lorenzo-Ruiz, Badalona Serveis Assistencials (BSA), Health Care Centre of Morera-Pomar, Badalona, Barcelona, Spain
- Eva María Domínguez-Martís, Master in Health Care, Management and Care, Galician Public Health Care Service, Health Care Centre of Concepción Arenal, Santiago de Compostela, A Coruña, Spain
- Silvia Novío, Doctor of Dental Medicine, Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Faculty of Nursing, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
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González-de la Torre H, Verdú-Soriano J, Quintana-Lorenzo ML, Berenguer-Pérez M, Lavín RS, Soldevilla-Ágreda J. Specialised wound care clinics in Spain: distribution and characteristics. J Wound Care 2020; 29:764-775. [PMID: 33320747 DOI: 10.12968/jowc.2020.29.12.764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To determine the number of specialised wound care units/clinics (SWCUs) in Spain, at present, and to describe their most important characteristics. METHOD This was an observational study with a descriptive-analytical, cross-sectional, multicentre approach, where the studied population consisted of SWCUs in Spain. A specific data-collection questionnaire was designed using a modified Delphi method, consisting of four rounds, with the collaboration of 10 wound experts. The final questionnaire included 49 items distributed across four dimensions/areas with a content validity index (CVI-Total for pertinence=0.96 and CVI-Total for relevance=0.94. RESULTS A total of 42 SWCUs were included in the study. Most SWCUs were based in hospitals (n=15, 35.7%) or healthcare centres, covering a specific healthcare area (n=17, 40.5%). SWCU coordinators were primarily nurses (n=33, 78.6%). Staff members' professions in SWCUs included registered nurses (n=38 units, 92.7%), nursing assistants (n=8 units, 19.5%), podiatrists (n=8 units, 19.5%), vascular surgeons (n=7 units, 17%), osteopaths (n=2 units, 4.8%) and medical doctors from different specialties (n=3 units, 7.2%). For wound aetiology, the most prevalent wounds managed were diabetic foot ulcers (n=38 units, 90.5%), followed by venous leg ulcers (n=36 units, 85.7%) and arterial ischaemic ulcers (n=36 units, 85.7%). A statistically significant association was found between the number of staff members in a SWCU and the existence of resistance/opposition barriers when developing a SWCU (Chi-square test, p=0.049; Cramér's V=0.34; 34%), as well as between resistance/opposition barriers when developing a SWCU and a nurse as coordinator of a SWCU (MacNemar test, p=0.007, Cramér's V=0.35; 35%). CONCLUSION The typical SWCU implemented in Spain is located in a hospital or integrated in a healthcare structure that offers coverage to a whole health area and providing services for people with hard-to-heal wounds (wound management and prevention) and health professionals (advice, consultancy and training/education). Despite the growing number of SWCUs in Spain, the future of this new organisational model is uncertain, as there can be barriers to creating them and some deficiencies, such as low staff numbers, which need to be addressed.
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Affiliation(s)
- Héctor González-de la Torre
- Complejo Hospitalario Materno-Infantil Insular de Gran Canaria, Servicio Canario de Salud, Las Palmas de Gran Canaria, Spain
| | - José Verdú-Soriano
- Department of Community Nursing, Preventive Medicine, Public Health and History of Science, Faculty of Health Sciences, University of Alicante, Spain
| | - María L Quintana-Lorenzo
- Gerencia de Atención Primaria de Gran Canaria, Servicio Canario de Salud, Las Palmas de Gran Canaria, Spain
| | - Miriam Berenguer-Pérez
- Department of Community Nursing, Preventive Medicine, Public Health and History of Science, Faculty of Health Sciences, University of Alicante, Spain
| | - Raquel Sarabia Lavín
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Cantabria, Santander, Spain
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22
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Folguera-Álvarez C, Garrido-Elustondo S, Rico-Blázquez MM, Esparza-Garrido MI, Verdú-Soriano J. [Effectiveness of double-layered compression therapy against crepe bandage for healing venous ulcers in primary care. Randomized clinical trial]. Aten Primaria 2020; 52:712-721. [PMID: 32278578 PMCID: PMC8054279 DOI: 10.1016/j.aprim.2020.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 01/19/2020] [Accepted: 01/22/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate if the two-layer bandage is more effective than the crepe bandage in the healing of venous ulcers after 12 weeks of follow-up. DESIGN Randomized multicentre controlled clinical trial. LOCATION 22 Primary Health Centers of Madrid. PARTICIPANTS Over 18 years old, with diagnosis of venous ulcers. 93 patients were randomized, 56 in the double layer group and 37 in the crepe group. Withdrawals: 16 in double layer group, 7 in crepe group. INTERVENTIONS Control group: usual clinical practice: treatment of the wound and bandage with crepe. Experimental group: same usual clinical practice for wound treatment and bandage with double layer. MAIN MEASUREMENTS Primary outcome: complete healing at 12 weeks. SECONDARY OUTCOMES severity of ulceration, health-related quality of life, adverse events. Blind evaluation of the response variable. RESULTS Complete healing: in crepe group, 25, 67.5% (95% CI 50.2-81.9) and in double layer group, 32, 57.1% (95% CI 43.2-70.3). No evidence of a difference in both groups, RR=1.10 (95% CI 0.864-1.424). The basal severity of the ulcers is associated with the healing time. HR=0.86 (95% CI 0.78-0.94). Our data showed a significant improvement in health-related quality of life, total and in the of cosmesis and emotional dimensions. No evidence of a difference in both groups. We didn't find serious adverse events in any of the groups. CONCLUSIONS We didn't find significant differences in the healing between the two bandages evaluated. Both are appropriate for ulcer healing and to improve the health-related quality of life.
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Affiliation(s)
- Carmen Folguera-Álvarez
- Centro de Salud La Paz, Gerencia Asistencial de Atención Primaria de Madrid, Madrid, España; Facultad de Enfermería, Universidad Complutense, Madrid, España.
| | - Sofía Garrido-Elustondo
- REDISECC: Red de Investigación en Servicios de Salud en Enfermedades Crónicas; Unidad Docente Multiprofesional Sureste, Gerencia Asistencial de Atención Primaria de Madrid, Madrid, España
| | - Mili Milagros Rico-Blázquez
- REDISECC: Red de Investigación en Servicios de Salud en Enfermedades Crónicas; Unidad de Investigación, Gerencia Asistencial de Atención Primaria de Madrid, Madrid, España; Facultad de Enfermería, Universidad Complutense, Madrid, España
| | | | - José Verdú-Soriano
- Departamento de Enfermería Comunitaria, Medicina Preventiva, Salud Pública e Historia de la Ciencia, Facultad de Ciencias de la Salud, Universidad de Alicante, San Vicente del Raspeig, Alicante, España
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23
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Folguera-Álvarez C, Garrido-Elustondo S, Rico-Blázquez M, Verdú-Soriano J. Factors Associated With the Quality of Life of Patients With Venous Leg Ulcers in Primary Care: Cross-Sectional Study. INT J LOW EXTR WOUND 2020; 21:521-528. [PMID: 33103540 DOI: 10.1177/1534734620967562] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The presence of venous leg ulcers (VLU) is associated with emotional disorders in individuals who have conditions, such as depression, anxiety, and sleeping problems, which result in a reduced perceived quality of life by these individuals. The study aim was to describe the perceived quality of life and associated factors for individuals with VLU. We conducted a cross-sectional study in 22 primary care health centers with a sample of 93 individuals with VLU. The variables collected were the following: perceived quality of life measured with Spanish version of the Charing Cross Venous Ulcer Questionnaire (CCVUQ-e), ulcer severity measured with the RESVECH 2.0 Score, demographic variables, and those related to the healing process. The results showed a mean CCVUQ-e score of 47.4 ± 11.8 points (Mean ± SD), with the most affected dimension being the emotional status, followed by cosmesis, social interaction, and domestic activities. The mean RESVECH 2.0 score was 11.1 ± 3.7 points. An association was found between ulcer-related pain and poorer quality of life (P < .05, t test) and between erythema in perilesional skin and poorer quality life (P < .05, t test). The signs of infection and inflammation in the VLUs were as follows: increasing exudate, friable tissue, and biofilm-compatible tissue, which were associated with a poorer quality of life (P < .05, t test). The multivariate model was statistically significant and explained a variability of 26% in the CCVUQ-e score. This study confirms that wound severity, pain, and signs of infection in VLU decrease the perceived quality of life of individuals with these wounds.
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Affiliation(s)
- Carmen Folguera-Álvarez
- La Paz Healthcare Centre, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain.,Universidad Complutense de Madrid, Madrid, Spain
| | - Sofia Garrido-Elustondo
- Health Services Research on Chronic Patients Network (REDISSEC), Instituto de Salud Carlos III, Madrid, Spain.,Research Unit. Gerencia Asistencial Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
| | - Milagros Rico-Blázquez
- Universidad Complutense de Madrid, Madrid, Spain.,Research Unit. Gerencia Asistencial Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
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24
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Morilla‐Herrera JC, Morales‐Asencio JM, Gómez‐González AJ, Díez‐De Los Ríos A, Lupiáñez‐Pérez I, Acosta‐Andrade C, Aranda‐Gallardo M, Moya‐Suárez AB, Kaknani‐Uttumchandani S, García‐Mayor S. Effectiveness of a hydrophobic dressing for microorganisms' colonization of vascular ulcers: Protocol for a randomized controlled trial (CUCO-UV Study). J Adv Nurs 2020; 76:2191-2197. [PMID: 32395842 PMCID: PMC7496185 DOI: 10.1111/jan.14412] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/09/2020] [Accepted: 04/28/2020] [Indexed: 01/08/2023]
Abstract
AIM To determine the effectiveness of a hydrophobic dressing (Cutimed Sorbact® ) against a silver dressing (Aquacel® Ag Extra) in the level of colonization of chronic venous leg ulcers. The secondary endpoints are health-related quality of life, level of pain, and time to complete healing. DESIGN Open randomized controlled trial, with blinded endpoint. METHODS Patients with chronic venous leg ulcers with signs of critical colonization will be randomized in a concealed sequence using computer software to receive one of the alternative dressings. A total of 204 participants recruited in Primary Health Care and nursing homes will be necessary to assure statistical power. Measures will include sociodemographic variables, wound-related variables (area, exudate, and time to healing), level of pain, adverse effects, and health-related quality of life. Smear samples will be collected from the ulcers and will be subject to DNA-typing technique through polymerase chain reaction to obtain the level of colony-forming units. Measures will be collected at baseline, 4, 8, and 12 weeks. DISCUSSION Elevated levels of microorganisms prevent wound healing and favour its chronification. The main target when colonization is present is to reduce the bacterial load to levels that promote immune system mobilization. Hydrophobic dressings prevent the formation of biofilm in the wound by means of physical effect, so that the possibility of antimicrobial resistance is significantly reduced. IMPACT Current evidence about the effectiveness of dressings to minimize venous leg ulcers colonization is very limited. Previous studies have important methodological flaws. This study will permit to obtain the effectiveness of hydrophobic dressings against silver dressings with a robust design based on conditions of routine clinical practice in Primary Health Care and nursing homes.
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Affiliation(s)
- Juan C. Morilla‐Herrera
- Department of NursingUniversity of Málaga, Faculty of Health SciencesMalagaSpain
- Distrito Sanitario Málaga – Valle del GuadalhorceMalagaSpain
- Instituto de Investigación Biomédica de Málaga (IBIMA)MalagaSpain
| | - José M. Morales‐Asencio
- Department of NursingUniversity of Málaga, Faculty of Health SciencesMalagaSpain
- Instituto de Investigación Biomédica de Málaga (IBIMA)MalagaSpain
| | | | | | - Inmaculada Lupiáñez‐Pérez
- Department of NursingUniversity of Málaga, Faculty of Health SciencesMalagaSpain
- Distrito Sanitario Málaga – Valle del GuadalhorceMalagaSpain
- Instituto de Investigación Biomédica de Málaga (IBIMA)MalagaSpain
| | | | - Marta Aranda‐Gallardo
- Instituto de Investigación Biomédica de Málaga (IBIMA)MalagaSpain
- Agencia Sanitaria Costa del SolMarbellaSpain
| | - Ana B. Moya‐Suárez
- Instituto de Investigación Biomédica de Málaga (IBIMA)MalagaSpain
- Agencia Sanitaria Costa del SolMarbellaSpain
| | - Shakira Kaknani‐Uttumchandani
- Department of NursingUniversity of Málaga, Faculty of Health SciencesMalagaSpain
- Instituto de Investigación Biomédica de Málaga (IBIMA)MalagaSpain
| | - Silvia García‐Mayor
- Department of NursingUniversity of Málaga, Faculty of Health SciencesMalagaSpain
- Instituto de Investigación Biomédica de Málaga (IBIMA)MalagaSpain
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25
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Sommer R, von Stülpnagel CC, Fife CE, Blasingame M, Anders MJ, Thompson D, Augustin M, da Silva N, Blome C. Development and psychometric evaluation of the U.S. English Wound-QoL questionnaire to assess health-related quality of life in people with chronic wounds. Wound Repair Regen 2020; 28:609-616. [PMID: 33372379 DOI: 10.1111/wrr.12837] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/22/2020] [Accepted: 05/14/2020] [Indexed: 11/27/2022]
Abstract
People with chronic wounds perceive an impaired health-related quality of life (HRQoL). For the assessment of HRQoL, valid instruments are needed. Therefore, the Wound-QoL questionnaire was originally developed and psychometrically validated for use in Germany. As the Wound-QoL is to be used in numerous countries, international versions are required. Therefore, this study aimed to psychometrically validate the U.S. English Wound-QoL version. Upon translation into U.S. English, psychometric testing was performed based on cross-sectional data deriving from the U.S. Wound Registry. Besides descriptive statistics, internal consistency and concurrent validity were tested. In addition, a graded response model was used. The sample consisted of 599 people with chronic wounds of different etiologies. Participants were between 18 and 95 years old, mean age was 63.7 (SD = 15.9) years. Gender was distributed almost equally, with 47.4% female patients. High internal consistency, low floor and ceiling effects of the subscales could be largely confirmed. The internal consistency of the global score was excellent, with α > .9. Concurrent validity between the Wound-QoL and pain, the surface area of the largest wound, total surface area, and total number of active wounds could be confirmed. In contrast, item response theory (IRT) analyses could not fully confirm the factorial model underlying the Wound-QoL subscales. Furthermore, the items regarding smell and discharge and the items on problems with hitting the wound against something, climbing stairs and feeling dependent on help from others showed a low item information in their belonging dimensions. In conclusion, the newly validated Wound-QoL is available for HRQoL measurement in people with chronic wounds in the United States. It showed good psychometric properties, demonstrating its reliability and validity. Therefore, the instrument may be used to assess HRQoL in clinical practice. However, IRT analyses showed that the instrument may benefit from future refinement.
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Affiliation(s)
- Rachel Sommer
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Catharina C von Stülpnagel
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Caroline E Fife
- Baylor College of Medicine, Houston, Texas, USA.,The U.S. Wound Registry, The Woodlands, Texas, USA
| | | | | | - Debi Thompson
- CHI St. Luke's Wound Clinic, The Woodlands, Texas, USA
| | - Matthias Augustin
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Neuza da Silva
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Christine Blome
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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26
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Krupová L, Pokorná A. Quality of life in patients with non-healing wounds, with particular focus on assesment tools - a literature review. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2020. [DOI: 10.15452/cejnm.2020.11.0010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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27
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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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28
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Sommer R, Hampel-Kalthoff C, Kalthoff B, Neht C, Scherfer E, Winkler M, Blome C. Differences between patient- and proxy-reported HRQoL using the Wound-QoL. Wound Repair Regen 2018; 26:293-296. [PMID: 30118159 DOI: 10.1111/wrr.12662] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 06/11/2018] [Accepted: 07/08/2018] [Indexed: 12/01/2022]
Abstract
The purpose of this study was to examine the patient- and proxy-report agreement on the Wound-quality of life (QoL) questionnaire to assess health-related QoL in patients with chronic wounds. Patients and their proxies (in this case, relatives) were recruited via different nursing services in Germany and asked to complete the Wound-QoL. Intraclass correlation coefficients were calculated for each Wound-QoL scale and the total score, and weighted Cohen's Kappa coefficients for individual items. Proxies tended to report lower health-related QoL in the Wound-QoL than their relatives with chronic wounds. Agreement between the two perspectives was moderate on single-item level and excellent on scale level. Proxy-reports can be helpful, if patients are unable to provide information, although caution remains when interpreting the results. However, the patient's own perspective remains preferable.
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Affiliation(s)
- Rachel Sommer
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | | | - Christopher Neht
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | | | - Christine Blome
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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29
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Bobbink P, Morin D, Probst S. Evaluation of needs and treatment benefits in outpatient care for leg ulcer patients: a pilot study. J Wound Care 2018; 27:527-533. [DOI: 10.12968/jowc.2018.27.8.527] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Paul Bobbink
- Lecturer, HES-SO University of Applied Sciences and Arts Western Switzerland, School of Health Sciences, Geneva
| | - Diane Morin
- Professor Emeritus, Faculty of Nursing, Laval University, Quebec, Canada, Faculty of Biology and Medicine, Lausanne University, Switzerland
| | - Sebastian Probst
- Professor of Tissue Viability and Wound Care, HES-SO University of Applied Sciences and Arts Western Switzerland, School of Health Sciences, Geneva
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30
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Influence of ulceration etiology on the global quality of life and its specific dimensions, including the control of pain, in patients with lower limb vascular insufficiency. Postepy Dermatol Alergol 2018; 34:471-477. [PMID: 29507563 PMCID: PMC5831284 DOI: 10.5114/ada.2017.71116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/24/2016] [Accepted: 07/20/2016] [Indexed: 11/26/2022] Open
Abstract
Introduction The results of previous studies suggest that the quality of life in patients with lower limb ulcerations is markedly poorer than in the general population – with regard to physical, mental and social spheres. This complex character of that parameter necessitates comprehensive analyses of its specific aspects, including the level of the acceptance of illness and associated pain symptoms. Aim To compare the quality of life and its specific dimensions in patients with lower limb ulcerations of various etiology. Material and methods Patients with the ulcerations resulting from venous (n = 101) or arterial pathologies (n = 98), or having mixed etiology (n = 99) were examined with the: 1) Skindex-29 instrument, 2) Acceptance of Illness Scale, 3) Beliefs about Pain Control Questionnaire, and 4) Coping Strategy Questionnaire. Results The average quality of life related to physical symptoms was significantly higher in patients with venous ulcerations. Patients with ulcerations of arterial etiology more frequently used catastrophizing, and less often ignored pain sensations, used coping self-statements, and increased their activity levels; they were characterized by lower levels of control and poorer ability to decrease the pain. The internal locus of pain control increased proportionally to the global quality of life scores and levels of illness acceptance. Control over pain and ability to decrease the pain were more effective in individuals who used ignoring pain sensations, increasing the activity level, coping self-statements, and reinterpreting pain than in those using catastrophizing or praying and hoping strategies. Conclusions Physical complaints seem to be the basic determinant of the quality of life in patients with the lower limb ulceration, irrespective of its etiology.
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31
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Castro B, Bastida F, Segovia T, López Casanova P, Soldevilla J, Verdú-Soriano J. The use of an antioxidant dressing on hard-to-heal wounds: a multicentre, prospective case series. J Wound Care 2017; 26:742-750. [DOI: 10.12968/jowc.2017.26.12.742] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- B. Castro
- PhD Chief Scientist Officer, Histocell S.L., Bizkaia Science and Technology Park, Derio, Bizkaia (Spain)
| | - F.D. Bastida
- Senior Scientist–Wound Care, Histocell S.L., Bizkaia Science and Technology Park, Derio, Bizkaia (Spain)
| | - T. Segovia
- Supervisor, Multidisciplinary Chronic Wounds Unit, Executive Member of Spanish Pressure Ulcers and Chronic Wounds Advisory Panel, University Hospital Puerta del Hierro, Majadahonda, Madrid (Spain)
| | - P. López Casanova
- PhD Community Health Nurse, Health Department of Alcoy, Alicante (Spain)
| | - J.J. Soldevilla
- Professor, Nursing School, University of La Rioja, Logroño (Spain); Hospital de San Pedro, Servicio Riojano de Salud, La Rioja, (Spain); Head of Spanish Pressure Ulcers and Chronic Wounds Advisory Panel
| | - J. Verdú-Soriano
- Professor, Histocell S.L., Bizkaia Science and Technology Park, Derio, Bizkaia (Spain)
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32
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Sommer R, Augustin M, Hampel-Kalthoff C, Blome C. The Wound-QoL questionnaire on quality of life in chronic wounds is highly reliable. Wound Repair Regen 2017; 25:730-732. [DOI: 10.1111/wrr.12578] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 08/16/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Rachel Sommer
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
| | - Matthias Augustin
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
| | | | - Christine Blome
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
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33
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Tavares APC, Sá SPC, Oliveira BGRBD, Sousa AI. Quality of life of elderly patients with leg ulcers. ESCOLA ANNA NERY 2017. [DOI: 10.1590/2177-9465-ean-2017-0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objectives: To identify compromised domains of the 36-Item Short Form Survey (SF-36) for elderly individuals with leg ulcers and correlate their clinical and sociodemographic variables with the SF-36's components. Method: Exploratory and cross-sectional study conducted with 50 elderly individuals with leg ulcers. The instruments were the sociodemographic and clinical form and the SF-36. The Statistical Package for the Social Sciences was used to analyze data. Results: Most were married, retired, and received one times the minimum wage, were Caucasians or of mixed race, and had hypertension. In regard to the SF-36, the most compromised domain was physical limitations, while social aspects and general health status were the less compromised domains. The SF-36 domains were not correlated with age, income, duration or size of the lesion or pain. Conclusion: The ulcer-related biopsychosocial aspects need to be considered in order to devise more effective nursing interventions.
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