Living with a venous leg ulcer: a descriptive study of patients’experiences

Abstract

This study aimed to describe the experience of living with a venous leg ulcer from the patient's perspective, to answer the question‘What is it like to live with a venous leg ulcer?’Investigating the experience of illness is important in understanding how disease processes affect people, how they understand and cope with these processes, and how care may be given most effectively Little research was identified which examined these areas with reference to people with leg ulceration A qualitative approach was taken in the following study, using phenomenological methods to describe the experience of venous leg ulceration Informal unstructured interviews were conducted with 13 informants, guided by their descriptive priorities Tape recordings were then transcribed and analysed for recurrent themes and their meanings It was found that certain symptoms of ulceration, principally pain, were the overwhelming feature of the experience These symptoms caused significant restrictions in people's lives, particularly in their ability to walk and go out Treatment was not described as being efficacious in ameliorating these symptoms, but nevertheless great confidence and trust was placed in the expertise of nurses People coped with the experience mainly by a process of normalizing its components It is concluded that if treatment is to meet the needs of those suffering venous leg ulceration, then symptom control must be the highest priority

The impact of chronic venous leg ulcers: a systematic review

“…48 Where leakage was associated with malodour, the impact was even greater and the symptoms were often inadequately managed. 45,47 These symptoms were of particular concern and had an even greater impact when the patient was working. 11 Participants felt that mechanisms to manage exudate and odour were consistently inadequate, with the odour being described as the worst thing associated with ulceration.…”

“…7,44,45 Pain was overwhelming, incessant and unrelenting; it had profound effects on the patient, impacting on their sleep, mobility and day-to-day functioning and was exacerbated by both dressings and treatment regimens. 10,[47][48] Pain, for some, was a 'constant companion', it persistently reminded them of the unremitting nature of their ulceration, [47][48][49] controlling their existence and making them angry, sad and 'to cry in despair'. 50,p.239 The control of pain was also problematic; 45,47,48,51 respondents often under-reported pain 47,48 and were reluctant to take analgesia which was deemed ineffective.…”

“…11 Participants felt that mechanisms to manage exudate and odour were consistently inadequate, with the odour being described as the worst thing associated with ulceration. 45,47,48 The leakage and odour resulted in limitations to social contacts, self-consciousness and a feeling that matters that should remain private had somehow become public with efforts to improve symptoms most often proving to be inadequate. 13,47 Mobility and daily living.…”

“…Eight of the eleven studies referred to issues due to leakage from the wound and the associated malodour 10,11,45,[47][48][49][50][51] Exudate was unbearable and devastating, 11 with the unpredictability of dressing leakage causing distress and shame. 51 There were reports of wet shoes, wet bedding and concerns of what people might think.…”

Provisional Matrix Deposition in Hemostasis and Venous Insufficiency: Tissue Preconditioning for Nonhealing Venous Ulcers

“…66, 71 These wounds lead to long-term poor health, pain, immobility, psychological and financial hardship, 72 and consume a significant proportion of health care expenditure in developed nations. Despite their high incidence and cost to patients and society, the processes involved in the transition from healthy tissue to chronic dermal ulceration remains undercharacterized.…”