Encouraging patients to self‐care – the preliminary development and validation of the VeLUSET^©, a self‐efficacy tool for venous leg ulcer patients, aged 60 years and over

Abstract

Venous leg ulceration has a high recurrence rate. Patients with healed or frequently recurring venous ulceration are required to perform self-care behaviours to prevent recurrence or promote healing, but evidence suggests that many find these difficult to perform. Bandura's self-efficacy theory is a widely used and robust behaviour change model and underpins many interventions designed to promote self-care in a variety of chronic conditions. By identifying areas where patients may experience difficulty in performing self-care, interventions can be developed to strengthen their self-efficacy beliefs in performing these activities successfully. There are currently a variety of self-efficacy scales available to measure self-efficacy in a variety of conditions; but not a disease-specific scale for use with venous ulcer patients. The aim of this study, therefore, was to develop and validate a disease-specific, patient-focused self-efficacy scale for patients with healed venous leg ulceration. This scale will need further validation studies; however, it is ready for use in clinical practice and will enable practitioners to identify those patients who may need additional support in performing self-care activities to prevent recurrence.

Systematic review assessing the measurement properties of patient-reported outcomes for venous leg ulcers

“…The evidence for internal consistency (Cronbach's α = 0·93) indicated that some of the items in the questionnaire could be made redundant. The test–retest reliability showed a strong positive relationship between test and retest scores ( r  = 0·92, P  < 0·001) at baseline and 4 weeks32.…”

“…Following further qualitative research with patients and experts, items were further reduced to 60. The acceptability of the instrument in the validation phase was poor, with only 41 per cent of the data complete32. The evidence for internal consistency (Cronbach's α = 0·93) indicated that some of the items in the questionnaire could be made redundant.…”

“…1). Ten studies31, 32, 33, 34, 35, 36, 37, 38, 39, 40 (reporting on 4 generic and 6 condition‐specific PROMs) were included in the review after detailed examination of 37 full‐text articles.…”

“…Four studies32 34, 38 39 described the development and validation of the Sheffield Preference‐based Venous Ulcer‐5D questionnaire (SPVU‐5D)38, CXVUQ39, Venous Leg Ulcer Self‐Efficacy Tool (VeLUSET)32 and Venous Leg Ulcer Quality of Life (VLU‐QoL) questionnaire34. The remaining studies assessed existing measures: the Nottingham Health Profile (NHP)33, EuroQol Five Dimensions (EQ‐5D™; EuroQol Group, Rotterdam, The Netherlands)35 36, 40, Medical Outcomes Study 36‐item Short Form Health Survey (SF‐36®; Optum, Eden Prairie, Minnesota, USA)33 36, 39 40, Medical Outcomes Study 12‐item Short Form Health Survey (SF‐12®; Optum)35, Hyland leg and ulcer questionnaire35, Venous Insufficiency Epidemiological and Economic Study Quality of Life/Symptoms (VEINES QoL/Sym)31 and CXVUQ36.…”

“…The VeLUSET is a self‐efficacy questionnaire designed for patients aged 60 years and over32. A focus group study was conducted to identify themes relevant to patients with VLU.…”