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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] [MESH Headings] [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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Nowak M, Piechota D, Baranska-Rybak W. Gdansk Wound-QoL Questionnaire: Pilot Study on Health-Related Quality of Life of Patients with Chronic Ulcers with Emphasis on Professional Physician-Patient Relations. Dermatol Pract Concept 2024; 14:dpc.1403a138. [PMID: 39122485 PMCID: PMC11314753 DOI: 10.5826/dpc.1403a138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2024] [Indexed: 08/12/2024] Open
Abstract
INTRODUCTION Chronic wounds lower health-related quality of life (QoL), as they affect various aspects of life due to pain, odor, tedious treatment, and stigma from society. Implementing proper treatment, where patient is well informed and active is a key for best outcomes. OBJECTIVES The aim of the study was to evaluate health-related QoL among the patients with chronic ulcers, with the use of new scale Gdansk Wound QoL. METHODS We enrolled 108 patients who met the inclusion criteria. Before the education on day 0 patients were asked to fill in Gdansk Wound-QoL questionnaire, that was developed in cooperation between dermatologists, general and plastic surgeons, as well as wound nurses, as well as fill the follow-up Gdansk Would-QoL questionnaire on day 30, which was also the end of the study. RESULTS Study participants (N = 108) were on average 76.1 ± 10.8 years and all of whom had a venous ulcer on their lower limbs of average wound area of 10.8 cm2. QoL, according to the Gdansk Wound-QoL questionnaire, increased on average by 36.7% after 30 days trial. Moreover, on the follow-up visit 94.4% of the patients stated that their knowledge on the disease has increased and everyone was satisfied with the course of treatment proposed by the current doctor. Furthermore, 44.4% of the study group increased their activity at the end of the study. CONCLUSIONS This pilot descriptive observational study shows that Gdansk Wound-QoL questionnaire can provide professionals in wound care good feedback on health-related QoL of patients with chronic wounds. This information has the potential to enhance patients well-being and overall comfort.
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Affiliation(s)
- Marcela Nowak
- Department of Dermatology, Venerology and Allergology, Gdanski Uniwersytet Medyczny, Gdansk, Poland
- Department of Dermatology and Venereology in Östergötland, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Dorota Piechota
- Department of Dermatology, Venerology and Allergology, Gdanski Uniwersytet Medyczny, Gdansk, Poland
| | - Wioletta Baranska-Rybak
- Department of Dermatology, Venerology and Allergology, Gdanski Uniwersytet Medyczny, Gdansk, Poland
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Wang G, Zheng J, Wu H, Wu Y. Effects of electromagnetic therapy in treating patients with venous leg ulcers: An overview of systematic reviews. Int Wound J 2024; 21:e14852. [PMID: 38584310 PMCID: PMC10999496 DOI: 10.1111/iwj.14852] [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: 01/18/2024] [Revised: 03/09/2024] [Accepted: 03/11/2024] [Indexed: 04/09/2024] Open
Abstract
This study aims to evaluate the effects of electromagnetic therapy (EMT) on the treatment of venous leg ulcers (VLUs) by synthesising and appraising available meta-analyses (MAs) and systematic reviews (SRs). A comprehensive literature search was conducted across major databases up to 10 January 2024, focusing on SRs/MAs that investigated the use of EMT for VLUs. Selection criteria followed the PICO framework, and dual-author extraction was used for accuracy. Quality assessment tools included AMSTAR2, ROBIS, PRISMA, and GRADE. The search yielded five eligible studies. The reviews collectively presented moderate methodological quality and a low risk of bias in several domains. Reporting quality was high, albeit with inconsistencies in fulfilling certain PRISMA checklist items. The evidence quality, primarily downgraded due to small sample sizes, was rated as moderate. Whilst some studies suggest potential benefits of EMT in the treatment of VLUs, the overall evidence is inconclusive due to methodological limitations and limited sample sizes. This review underscores the need for future research with more rigorous methodologies and larger cohorts to provide clearer insights into the efficacy of EMT for VLUs.
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Affiliation(s)
- Guofeng Wang
- Department of Respiratory and Critical Care MedicineThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)HangzhouChina
| | - Jie Zheng
- The First Clinical Medical SchoolGuangzhou University of Chinese MedicineGuangzhouChina
| | - Hongxue Wu
- Department of Respiratory and Critical Care MedicineThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)HangzhouChina
| | - Yucheng Wu
- Department of Respiratory and Critical Care MedicineThe First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)HangzhouChina
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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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Lommi M, Raffaele B, Tolentino Diaz MY, Montini G, Puleio C, Porcelli B. Nursing outcomes in wound care management: A mixed method study. Nurs Open 2023; 10:2249-2263. [PMID: 36478413 PMCID: PMC10006662 DOI: 10.1002/nop2.1477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/19/2022] [Accepted: 11/04/2022] [Indexed: 12/12/2022] Open
Abstract
AIM The aim of the study was to analyse the management of chronic wound outcomes and the experience of patients with chronic ulcers. DESIGN Explanatory mixed method. METHODS This study consisted in a sequential explanatory mixed method with a quantitative and a qualitative phase. In the first phase, quantitative data were collected during a longitudinal study, in a convenience sample of 44 patients presenting at a nursing outpatients' clinic. Linear regression was conducted to evaluate the associations between variables. In phase two, 14 patients from the initial sample were interviewed, and the data were analysed using Giorgi's descriptive phenomenological method. RESULTS The participants, mostly males, in conditions of comorbidity and polypharmacotherapy, were mainly affected by venous leg ulcers. An association between the quality of life of patients (both physical and mental) and some socio-demographic and clinical factors has been confirmed. I Variance analysis showed a significant wound improvement across all the measurement times. The themes identified through the qualitative analysis were: "Cared by self," "Cared by Healthcare Providers" and "Quality of life".
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Affiliation(s)
- Marzia Lommi
- UOC Care to the Person, Local Health Authority Roma 2, Italy, Rome, Italy
| | - Barbara Raffaele
- UOC Care to the Person, Local Health Authority Roma 2, Italy, Rome, Italy
| | | | - Graziella Montini
- UOC Care to the Person, Local Health Authority Roma 2, Italy, Rome, Italy
| | - Cinzia Puleio
- UOC Care to the Person, Local Health Authority Roma 2, Italy, Rome, Italy
| | - Barbara Porcelli
- UOC Care to the Person, Local Health Authority Roma 2, Italy, Rome, Italy
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Liu S, Team V, Qiu Y, Weller CD. Investigating Quality of Life Instrument Measurement Properties for Adults with Active Venous Leg Ulcers: A Systematic Review. Wound Repair Regen 2022; 30:468-486. [PMID: 35639021 PMCID: PMC9545457 DOI: 10.1111/wrr.13034] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 04/07/2022] [Accepted: 05/24/2022] [Indexed: 11/30/2022]
Abstract
The primary objective of this systematic review was to identify which quality of life instruments have been applied in published studies of patients with active venous leg ulcers. Our secondary objective was to map the measurement properties of each identified quality of life instrument and to inform future recommendations for clinical practice and research. We searched CINAHL, Ovid Medline, Ovid Emcare and ProQuest to identify studies published from 1 January 2000 to 31 July 2021. Eleven studies that utilised quality of life instruments in adults with active venous leg ulcers met the inclusion criteria. Thirteen quality of life instruments were identified as some studies utilised both generic and condition‐specific quality of life instruments. Six out of nine (6/9) instruments were rated ‘very good’ of methodological quality on internal consistency; 1/7 studies rated ‘adequate’ on reliability; 2/4 rated ‘adequate’ on content validity; 3/6 studies rated ‘adequate’ on structural validity; 5/6 rated ‘adequate’ on hypotheses testing for construct and 2/6 studies rated ‘adequate’ on responsiveness. There is limited evidence of measurement properties of quality of life instruments for people with active venous leg ulcers. The Venous Leg Ulcer Quality of Life Questionnaire (VLU‐QoL) could be provisionally recommended for use although from our review it is clear further studies to assess VLU‐QoL measurement properties are needed to inform future recommendations for clinical practice and research.
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Affiliation(s)
- Shiwen Liu
- School of Nursing and Midwifery, Monash University, Level 5 Alfred Centre, 99 Commercial Road, Melbourne, VIC, Australia
| | - Victoria Team
- School of Nursing and Midwifery, Monash University, Level 5 Alfred Centre, 99 Commercial Road, Melbourne, VIC, Australia
| | - Yunjing Qiu
- School of Nursing and Midwifery, Monash University, Level 5 Alfred Centre, 99 Commercial Road, Melbourne, VIC, Australia
| | - Carolina D Weller
- School of Nursing and Midwifery, Monash University, Level 5 Alfred Centre, 99 Commercial Road, Melbourne, VIC, Australia
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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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Love S, White JR, Vestal B. Using compression therapy in a primary care setting to treat complications of chronic venous insufficiency. J Am Assoc Nurse Pract 2019; 33:484-490. [PMID: 31868823 DOI: 10.1097/jxx.0000000000000350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 09/11/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patients with chronic venous insufficiency (CVI) are prone to developing complications such as slow-healing venous leg ulcers. LOCAL PROBLEM Nurse practitioners can assess patients for complications of CVI during routine examinations. If found, they can implement compression therapy and possibly prevent the development of slow-healing venous leg ulcers. METHODS A retrospective chart review of patient occurrences with complications due to CVI between 2011 and 2018 was conducted to evaluate patient outcomes when treated with compression therapy by their primary care providers (PCPs). Patients were identified by the Unna boot's Current Procedural Technology code, the compression therapy used by the providers. Patients included in the review had the diagnosis of or symptoms of CVI. Patient outcomes were identified as improved, unchanged, or deteriorated. INTERVENTIONS The use of compression therapy for patients with documented complication of CVI. The Unna boot was the compression device used at this practice. RESULTS There were 60 occurrences distributed among 40 patients who met the inclusion criteria. Of the 60 occurrences, 54 or 90% of patient occurrences had an improvement of symptoms. According to the Wound Healing Society Guidelines, high compression therapy, such as the Unna boot, is classified as most supportive, for treatment of venous ulcers. CONCLUSIONS The results of this study demonstrate the positive impact PCPs, including nurse practitioners, may have when initiating compression therapy for patients with complications of CVI.
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Affiliation(s)
- Sherry Love
- Capstone College of Nursing at The University of Alabama, Tuscaloosa, Alabama
- King University School of Nursing, Bristol, Tennessee
| | - Justin R White
- Capstone College of Nursing at The University of Alabama, Tuscaloosa, Alabama
| | - Brittney Vestal
- Capstone College of Nursing at The University of Alabama, Tuscaloosa, Alabama
- King University School of Nursing, Bristol, Tennessee
- Internal Medicine and Pediatrics, Bristol, Tennessee
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Green J, Jester R, McKinley R, Pooler A. Chronic venous leg ulcer care: Putting the patient at the heart of leg ulcer care. Part 1: exploring the consultation. Br J Community Nurs 2018; 23:S30-S38. [PMID: 29493307 DOI: 10.12968/bjcn.2018.23.sup3.s30] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This article, the first of two, summarises a study that explored the lived experiences of patients with leg ulcers and the impact of this condition on their quality of life. The study had four study phases; phases 1 and 2 employed qualitative methods and are reported here. Initially, unstructured interviews were held; these revealed significant issues for the patients including the dominance of pain, issues relating to exudate and odour, social isolation and psychological effects. A checklist based on these issues was completed by the researcher during observations of routine care for these same patients; this revealed the extent and depth to which these matters were addressed. On many occasions, significant issues were not disclosed or explored during consultations. These findings confirmed that participants with chronic venous leg ulcers have concerns far beyond wound care.
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Affiliation(s)
- Julie Green
- Queen's Nurse, Royal College of Nursing, Professional Nursing Committee member, Royal College of Nursing, District Nurse, Forum Chair and member of the Association of District Nurse Educators: Director of Postgraduate Studies and Senior Lecturer, Keele University School of Nursing and Midwifery, Clinical Education Centre, University Hospitals of North Midlands NHS Trust, Royal Stoke University Hospital, Newcastle Road, Stoke-on-Trent ST4 6QG
| | - Rebecca Jester
- Professor of Nursing, Faculty of Education, Health and Wellbeing, Institute of Health, University of Wolverhampton, WV1 1LY
| | - Robert McKinley
- Professor of Nursing, Faculty of Education, Health and Wellbeing, Institute of Health, University of Wolverhampton, WV1 1LY
| | - Alison Pooler
- Lecturer, Director of Learning and Teaching, School of Nursing and Midwifery, Keele University, Staffordshire, ST4 6QG
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