Nurse-led education sets out to improve patient concordance and prevent recurrence of leg ulcers

Abstract

A structured nurse-led patient concordance programme is effective in preventing venous leg ulcer recurrence and increasing the time patients spend with their legs elevated at heart level. Having both full ankle movement and full mobility reduces the risk of recurrence.

The clinical effectiveness and cost-effectiveness of home-based, nurse-led health promotion for older people: a systematic review.

“…Eleven studies [21][22][23][24][25][26][27][28][29][30][31] were included in this review, with the number of participants ranging from 51 to 1286. The total number of participants was 5761.…”

“…The 11 studies included RCTs which differed in terms of the target population and the purpose of the health promotion intervention. Four studies were designed to evaluate home-based, nurse-led interventions for particular groups of older people with existing morbidities; these included patients populations with chronic heart failure, 21 Parkinson's disease 22 or venous leg ulcers, 23 and individuals who had suffered a stroke. 24 The focus of health promotion was to slow or prevent further deterioration or complications of the conditions.…”

“…The number of male participants ranged from 25.8% to 58%, with greater proportions of men in the groups with a pre-existing morbidity. [21][22][23][24] Unique citations retrieved by search of electronic databases and reference tracking (n = 2068)…”

“…In five studies, the authors simply state that nurses were given additional training but do not provide further information with respect to their grade or level of qualification. [21][22][23]28,31 In one study, 31 the nurse worked within a multidisciplinary team including physiotherapists and occupational therapists (not doctors). In the other 10 studies, [21][22][23][24][25][26][27][28][29][30] the nurses worked independently, referring to other health-and social-care professionals as necessary.…”

Concordance is not synonymous with compliance or adherence

“…Authors do not write about testing the concept of concordance. They write about achieving concordance [13], promoting it [14], improving it [15], enhancing it [4], even when they admit at the same time that supportive evidence of benefit is rare [13] and although doubts about its benefits have been expressed and possible harms mentioned [16].…”