QUALITY OF LIFE IN VENOUS LEG ULCERS

Quality of life in Venous Leg Ulcers

Outline of the Study

•Introduction

•Causes and effects

•Clinical treatment

•Problem of venous leg ulcers

•Changes in the skin

•The Wilson and Cleary Model

•Conceptualization of Disease Severity

•Conceptualization of Symptom Status

•Impact of venous leg ulcers on HRQL

•Venous leg ulcer disease burden and HRQL

•Clinical and socio demographic factors

•Patients

•Policies for venous leg ulcers

•Physical effects on patients

•Psychological effects on patients

•Social effects on patients

•Experience of the therapeutic relationship (patient, nurse)

•Review of the effects on patients QOL

•Conclusion

Quality of life in Venous Leg Ulcers

Introduction

I would like to conduct a research on venous leg ulcers because I want to enhance my skills by analysing various researches as to how it can be treated and what measures should be taken to overcome it. I would also like to know how the ulcer patient is taken care of and what practices are most suitable for his recovery. Venous leg ulcers occur as a result of improper functioning of venous valves comprising of the legs.

Causes and effects

Venous ulceration is a chronic recurrent wound of the lower leg. Although improved rates of healing are associated with the utilization of evidence-based protocols and the reorganization of care, after three months of good care, greater than 40% of ulcers will remain unhealed.

By 12 months, about one fifth of ulcer will fail to heal and a smaller proportion may persist for a number of years. Recurrence rates range from 22% to 34% and may be as high as 51% at five years, even with specialist follow-up. In addition to delayed healing and recurrence, the burden of symptoms associated with venous ulceration is no less discouraging. Lower limb swelling, wound drainage, odour, pain, itching and recurrent infection exert a profound effect on all aspects of daily life including mobility, choice of footwear, employment, social roles, physical activity and quality of life.

Healing is an important outcome, however, the proportion healed by three months, reveals little about the individual's perspective about the impact of ulceration, chronicity or recurrence on their life. This is critically important perspective as captured by a self-reported outcome such as health related quality of life (HRQL). QOL of life is important in leg ulcer care (Royal College of Nurses, 2006). An Ontario guideline recommends “that the client's estimate of the QOL should be included in the initial discussion of (treatment), throughout treatment and when the ulcer has healed”. QOL assessment generally has not been widely integrated into clinical practice (Iglesias, 2005, 1705-1718).

Clinical treatment

The assessment of HRQL in leg ulcer care has not been well-defined. HRQL has been widely adopted as an outcome in venous leg ulcer research. Most studies do not use a conceptual model of HRQL. In the absence of a conceptual 2 model, there is an insufficient basis to interpret the impact of person, disease or treatment factors on the HRQL score (Haase & Braden, 1998) and the score has limited clinical utility at the point of care.

A clinically relevant model would guide clinician assessments and ...