1
|
Jacinto MAG, Oliveira ACDS, Martínez CSG, Schlosser TCM, Dantas BADS, Torres GDV. Healing of Venous Leg Ulcers Influenced by Individual Aspects: Cluster Analysis in a Specialist Wound Management Clinic. J Prim Care Community Health 2024; 15:21501319231223458. [PMID: 38288560 PMCID: PMC10826402 DOI: 10.1177/21501319231223458] [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] [Received: 10/13/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 02/01/2024] Open
Abstract
INTRODUCTION/OBJECTIVE Venous Leg Ulcers (VLU) present a challenging healing process. Attaining healing is a primary treatment objective, commonly pursued in Primary Health Care (PHC) or Specialist Wound Management Clinics. Our objective was to examine the association and interplay between sociodemographic, health, clinical, and care factors with the outcomes of VLU treatment in patients undergoing care at a Specialist Wound Management Clinic. METHODS Longitudinal, observational study took place in a center for the treatment of chronic injuries linked to PHC. The sociodemographic aspects, health status and habits, clinical and care aspects of patients with VLU were scrutinized over a 1-year period. RESULTS The sample comprised 103 participants, with some still under treatment (Treatment Group-TG/ n = 60) and others having achieved VLU healing (Healing Group-HG/ n = 43). An association between sociodemographic, health, clinical, and care factors and the healing outcome (HG) was identified. A moderate correlation was observed between factors predisposing to healing in the sociodemographic group and health habits. Notably, among sociodemographic factors, the older age group and improvements in health, particularly the reduced use of alcohol/smoking, appeared to exert the most significant influence on healing. Additionally, specialized service monitoring and the application of compression therapy were contributory factors. CONCLUSIONS These findings substantiate the hypothesis that sociodemographic, health, clinical, and care-related aspects are intertwined with VLU healing. Protective factors associated with healing interacted synergistically, fostering a positive outcome over one year of treatment.
Collapse
|
2
|
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.
Collapse
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;
| |
Collapse
|
3
|
Júnior SADO, Oliveira ACDS, Dantas Araújo MP, Dantas BADS, Sánchez MDCG, Torres GDV. Influence of pain on the quality of life in patients with venous ulcers: Cross-sectional association and correlation study in a brazilian primary health care lesions treatment center. PLoS One 2023; 18:e0290180. [PMID: 37582120 PMCID: PMC10426926 DOI: 10.1371/journal.pone.0290180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/03/2023] [Indexed: 08/17/2023] Open
Abstract
We aimed to verify the association and correlation between pain and QoL in people with VU treated in a Brazilian Primary Health Care (PHC) lesions treatment center. This is an observational, cross-sectional study with a quantitative approach, carried out in a service specialized in the treatment of chronic injuries, linked to 29 PHC units. Sociodemographic and health characterization instruments were used. The Short Form Health Survey-36 (SF-36) and Visual Analogue Pain Scale (VAPS) also were used. The Kruskal-Wallis test verified the association between the scalar variables of QoL and pain intensity. With Spearman's correlation test, we verified the level of correlation between the scales applied. A total of 103 patients participated in the study. Higher QoL scores associated with moderate pain were found, especially in the Physical role functioning, Physical functioning, and Vitality domains. Correlation analysis showed its greatest (moderate) strength in the interaction between the highest scores in the Physical role functioning and Emotional role functioning domains with the lowest pain levels.
Collapse
|
4
|
de Oliveira Viana Pereira DM, de Souza Oliveira AC, de Oliveira Júnior SA, Jacinto MAG, Dionísio AJ, Lima AEO, da Silva Dantas BA, de Oliveira Sousa SL, Martínez CSG, de Vasconcelos Torres G. Correlation between Generic and Disease-Specific Quality of Life Questionnaires in Patients with Venous Ulcerations: A Cross-Sectional Study Carried out in a Primary Health Care Setting in Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3583. [PMID: 36834277 PMCID: PMC9961915 DOI: 10.3390/ijerph20043583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
Venous Ulcers (VU) are a serious health problem that affect the Quality of Life (QoL). They are evaluated by many different scales in the literature. We aimed to analyze the correlation between the Medical Outcomes Short-Form Health QoL (SF-36) and Charing Cross Venous Ulcer Questionnaire (CCVUQ) scales. This is a cross-sectional study conducted in a Brazilian center specializing in chronic VU of the Primary Health Care (PHC) provided to patients with active VU. The general QoL instrument SF-36 and the CCVUQ, specific for people with VU, were used. Spearman's Rho Test determined the correlation between the variables analyzed. Our sample had a total of 150 patients. We found a direct correlation between the domestic activities division (CCVUQ) aspect and the SF-36 Physical role functioning (strong), and Physical functioning (moderate) domains. The Social interaction division (CCVUQ) aspect presented moderate correlation with the domains of the SF-36 Physical role functioning and Physical functioning. The Vitality domain (SF-36) showed moderate correlation with the aspects of CCVUQ Cosmesis division and Emotional status division. The greatest forces of direct correlation were observed between the physical, functional and vitality aspects of SF-36 with those represented by domestic activities and social interaction in the CCVUQ.
Collapse
Affiliation(s)
| | | | - Severino Azevedo de Oliveira Júnior
- Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte (UFRN), Av. Olavo Lacerda Montenegro n. 2685, Parnamirim 59158-400, Brazil
| | - Maria Angélica Gomes Jacinto
- Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte (UFRN), Av. dos Caiapós n. 121, Bairro Pitimbú, Natal 59067-400, Brazil
| | - Alessandra Justino Dionísio
- Departamento de Enfermagem, Universidade Federal do Rio Grande do Norte (UFRN), Rua dos Palmares, 30, Parque das Árvores, Parnamirim 59154-145, Brazil
| | - Alana Ellen Oliveira Lima
- Departamento de Enfermagem, Universidade Federal do Rio Grande do Norte (UFRN), Av. Maria Lacerda Montenegro nº 339, Parnamirim 59152-900, Brazil
| | - Bruno Araújo da Silva Dantas
- Faculdade de Ciências da Saúde do Trairi, Universidade Federal do Rio Grande do Norte (UFRN), Rua Alice Azevedo, 30, Natal 59080-015, Brazil
| | | | - Carmelo Sergio Gómez Martínez
- Facultad de Enfermería, Universidad Católica de Murcia (UCAM), Calle Orden de Santiago, num 5, Abarán-Murcia, 30550 Murcia, Spain
| | - Gilson de Vasconcelos Torres
- Centro de Ciências da Saúde, Research Productivity Scholarship (CNPQ/PQ1D), Universidade Federal do Rio Grande do Norte (UFRN), Rua das Massarandubas, 292, Nova Parnamirim, Parnamirim 59150-630, Brazil
| |
Collapse
|
5
|
Colombi AFDA, Borges EL, Xavier FG, Bringuente MEDO, Prado TND. SELF-ASSESSMENT OF PRIMARY CARE NURSES ABOUT CARE FOR PEOPLE WITH VENOUS ULCERS: A CROSS-CUTTING STUDY. ESTIMA 2022. [DOI: 10.30886/estima.v20.1247_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 identify the self-knowledge of primary care nurses about care for people with venous ulcers. Method: This is a cross-sectional study with 40 nurses working in health units. Two data collection instruments were used: characterization, developed by the author, and self-assessment on venous ulcers. Results: All questions of the self-assessment instrument reached medians classified as little level of knowledge, except questions related to the application of elastic compression therapy, with the median = 3 (moderate), and the evaluation of lower limbs to investigate arterial involvement, with 3.50, between little and moderate. The item cleaning the lesion stood out, which obtained median = 4 (little) and the highest average found in the responses, 4.03 (little). Conclusion:The nurse’s self-assessment reached moderate and low scores of clinical practice in terms of knowing (theoretical knowledge) and doing (practical knowledge) in the care of people with venous ulcers. Venous ulcer is a complex wound and requires knowledge from nurses about the pathophysiology and appropriate treatment, interfering with the improvement of the person’s quality of life. It is believed that this study can encourage the reflection of this professional and education actions in the services.
Collapse
|
6
|
Colombi AFDA, Borges EL, Xavier FG, Bringuente MEDO, Prado TND. AUTOAVALIAÇÃO DE ENFERMEIROS DA ATENÇÃO PRIMÁRIA SOBRE ASSISTÊNCIA À PESSOA COM ÚLCERAS VENOSAS: UM ESTUDO DE CORTE TRANSVERSA. ESTIMA 2022. [DOI: 10.30886/estima.v20.1247_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:Identificar o autoconhecimento de enfermeiros da atenção primária sobre assistência à pessoa com úlceras venosas. Método: Trata-se de um estudo de corte transversal com 40 enfermeiros lotados em unidades de saúde. Utilizaram-se dois instrumentos de coleta de dados: caracterização, elaborada pelo autor, e autoavaliação sobre úlcera venosa. Resultados: Todas as questões do instrumento autoavaliativo alcançaram medianas classificadas como nível de conhecimento pouco, à exceção das questões relativas à aplicação de terapia compressiva elástica com mediana = 3 (moderado) e à avaliação de membros inferiores para investigar comprometimento arterial, 3,50, entre pouco e moderado. Destacou-se o item limpeza da lesão, o qual obteve a mediana = 4 (pouco) e a maior média encontrada das respostas, 4,03 (pouco). Conclusão: A autoavaliação do enfermeiro atingiu os escores moderado e pouco da prática clínica no que tange ao saber (conhecimento teórico) e ao fazer (conhecimento prático) no cuidado à pessoa com úlcera venosa. A úlcera venosa é uma ferida complexa e exige do enfermeiro conhecimento sobre a fisiopatologia e o tratamento adequado, interferindo na melhora da qualidade de vida dessa pessoa. Acredita-se que este estudo possa fomentar a reflexão desse profissional e ações de educação nos serviços.
Collapse
|
7
|
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.
Collapse
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
| |
Collapse
|
8
|
Allen LL, Uphold CR, Koniaris-Rambaud C, House K, Gray F, Fitzgerald L, Vaughan C, Johnson TM. Palliative care aspects of wound healing in complex patients: a case report. J Wound Care 2021; 30:845-852. [PMID: 34644138 DOI: 10.12968/jowc.2021.30.10.845] [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: 12/27/2022]
Abstract
DECLARATION OF INTEREST The authors have no conflicts of interest to declare.
Collapse
Affiliation(s)
- Latricia L Allen
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Decatur, GA, US.,Atlanta Department of Veterans Affairs Medical Center, Decatur, GA, US.,Department of Medicine, Emory University, Atlanta, GA, US
| | - Constance R Uphold
- VA Geriatric Research Education and Clinical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, US
| | - Christine Koniaris-Rambaud
- Department of Medicine, Emory University, Atlanta, GA, US.,Department of Family and Preventive Medicine, Emory University, Atlanta, GA, US
| | - Kim House
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Decatur, GA, US.,Atlanta Department of Veterans Affairs Medical Center, Decatur, GA, US.,Department of Medicine, Emory University, Atlanta, GA, US
| | - Frances Gray
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Decatur, GA, US.,Atlanta Department of Veterans Affairs Medical Center, Decatur, GA, US
| | - Linda Fitzgerald
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Decatur, GA, US.,Atlanta Department of Veterans Affairs Medical Center, Decatur, GA, US
| | - Camille Vaughan
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Decatur, GA, US.,Atlanta Department of Veterans Affairs Medical Center, Decatur, GA, US.,Department of Medicine, Emory University, Atlanta, GA, US
| | - Theodore M Johnson
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Decatur, GA, US.,Atlanta Department of Veterans Affairs Medical Center, Decatur, GA, US.,Department of Medicine, Emory University, Atlanta, GA, US.,Department of Family and Preventive Medicine, Emory University, Atlanta, GA, US
| |
Collapse
|