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Green, J; Jester, R; McKinley, R; Pooler, A (2014)
Publisher: Mark Allen Healthcare
Languages: English
Types: Article
Subjects: RA
OBJECTIVE: Chronic venous leg ulcers are common, intractable and often recurrent, but care tends to be wound focused, potentially overlooking the significant impact the condition has on patients' lives. A systematic review was undertaken to explore the factors that impact on the quality of life of patients with chronic venous leg ulceration. METHOD: Eligible articles published between 1990 and 2013 were identified via electronic searches of research databases (MEDLINE, CINAHL, BNI, EMBASE, PsycINFO, AMED and HMIC, Cochrane Collaboration database and Google Scholar). RESULTS: There were 23 studies (11 qualitative and 12 quantitative) that met the inclusion criteria. There were then the subject of a full review. The qualitative studies were collapsed into four core themes: physical, psychological, social implications and the nurse-patient relationship. The quantitative studies were grouped according to the tool applied. The review demonstrated that chronic venous leg ulcers impact negatively upon all areas of daily living. Pain, exudate, odour and the impact on mobility were daily challenges. The ability to engage with everyday functioning was restricted either owing to the ulcer, the dressing or to a self-imposed isolation in response to the impact of symptoms. Depression and low mood were common and yet, despite this, some studies reported that participants remained hopeful. CONCLUSION: Studies suggest that chronic venous leg ulceration negatively affects the quality of life of the patient and that such issues receive inadequate attention during current consultations. If such negative implications are to be effectively addressed, key issues need to be considered during every consultation. DECLARATION OF INTEREST: This study was funded by West Midlands Strategic Health Authority. The authors have no conflicts of interest to declare.
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1. Posnett, J. & Franks,P. (2007). The costs of skin breakdown and ulceration in the UK. In Smith and Nephew Foundation Skin Breakdown - The silent epidemic. UK: snfoundation.
    • 2. Persoon, A., Heinen, M., van der Vleuten, C., de Rooij, M., van de Kerkhof, P. & van Achterberg, T. Leg Ulcers: a review of their impact on daily life. Journal of Clinical Nursing. 2004; 13, 341- 354.
    • 3. Nelzen, O., Bergqvist, D. & Lindhagen, A. (1997). Long term prognosis for patients with chronic leg ulcers: a prospective study. European Journal of Vascular and Endovascular Surgery. 13, 500-508.
    • 4. SIGN (2010). 120: Management of chronic venous leg ulcers. A national clinical guideline. Accessed at: http://sign.ac.uk/guidelines/fulltext/120/recommendations.html on 17/11/14 2250hrs.
    • 5. BMJ Clinical Evidence (2011). Leg Ulcers: Venous. Accessed at: http://cks.nice.org.uk/legulcer-venous#!topicsummary on 17/11/14 2245hrs.
    • 6. Franks, P. & Moffatt, C.J. Leg Ulcers in Smith and Nephew Foundation (2007) Skin Breakdown - The silent epidemic. 2007; UK: snfoundation.
    • 7. Briggs, M. & Flemming, K. Living with leg ulceration: a synthesis of qualitative research. Journal of Advanced Nursing. 2007; 59 (4), 319-328.
    • 8. Krasner, D. Painful venous ulcers: themes and stories about their impact on quality of life. Ostomy Wound Manage 1998,44(9):38-46.
    • 9. Callam, M., Ruckley, C., Harper, D. & Dale, J. Chronic ulceration of the leg: extent of the problem and provision of care. British Medical Journal. 1985; 290,1855-1856.
    • 10. Hyde, C., Ward, B., Horsfall, J. & Winder, G. Older women's experience of living with chronic leg ulceration. International Journal of Nursing Practice. 1999; 5,189-198.
    • 11. Rich, A. & McLachlan, L. How living with a leg ulcer affects people's daily life: a nurse-led study. Journal of Wound Care. 2003; 12 (2), 51-54.
    • 12. Herber, O. R., Schnepp, W. & Rieger, M. A. A systematic review on the impact of leg ulceration on patients. Health and Quality of Life Outcomes. 2007; 5, 44-56.
    • 13. Chase, S., Melloni, M. & Savage, A. A forever healing: The lived experience of venous ulcer disease. Journal of Vascular Nursing. 1997; XV, 73-78.
    • 14. Franks, P. & Moffatt, C. Who suffers most from leg ulceration? Journal of Wound Care. 1998; 7 (8), 383-385.
    • 15. Franks, P. & Moffatt, C.J. Health related quality of life in patients with venous ulceration: Use of the Nottingham health profile. Quality of Life Research. 2001; 10, 693-700.
    • 16. Jull, A., Walker, N., Hackett, M., Jones, M., Rodgers, A., Birchall, N., Norton, R. & MacMahon, S. Leg ulceration and perceived health: a population based case-study control. Age and Ageing. 2004; 33, 236-241.
    • 17. Centre for Reviews and Dissemination. Systematic Reviews. CRD's guidance for undertaking reviews in health care. 2009; CRD: York.
    • 18. Booth, A., Papaioannou, D. & Sutton, A. Systematic approaches to a successful literature review. 2012; Thousand Oaks, CA: Sage.
    • 19. Popay, J., Roberts, H., Sowden, A., Petticrew, M., Britten, N., Arai, L., Roen, K. & Rodgers, M. Developing guidance on the conduct of narrative synthesis in systematic reviews. Journal of Epidemiology Community Health. 2005; 59 Suppl 1, A7.
    • 20. Lucas, P. J., Baird, J., Aria, L., Law, C. & Roberts, H. M. Worked examples of alternative methods for the synthesis of qualitative and quantitative research in systematic reviews. BMC Medical Research Methodology. 2007; 7(4), 2-13.
    • 21. Rodgers, M., Sowden, A., Petticrew, M., Arai, L., Roberts, H., Britten, N. & Popay, J. Testing methodological guidance on the conduct of narrative synthesis in systematic reviews. Evaluation. 2009; 15 (1), 49-74.
    • 22. Guarnera, G., Tinelli, G., Abeni, D., Di Pietro, C., Sampogna, F. & Tabolli, S. Pain and quality of life in patients with vascular leg ulcers: an Italian multicentre study. Journal of Wound Care. 2007; 16 (8), 347-351.
    • 23. Watson, J., Kang'ombe, A., Soares, M., Chuang, L., Worthy, G., Bland, M., Iglesias, C., Cullum, N., Torgerson, D. & Nelson, E, A. Use of weekly, low dose, high frequency ultrasound for hard to heal venous leg ulcers: the VenUS II controlled trial. BMJ. 2011. Acessed: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3050437/pdf/bmj.d1092.pdf
    • 26. Collins, K., Morrell, J., Peters, J. & Walters, S. Variations in venous leg ulcer care in the community. British Journal of Community Nursing. 1998; 3, 6-12.
    • 27. Edwards, H., Courtney, M., Finlayson, K., Lewis, C., Lindsay, E. & Dumble, J. Improved healing rates for chronic venous leg ulcers: Pilot study results from a randomised controlled trial of a community nursing intervention. International Journal of Nursing Practice. 2005; 11, 169-176.
    • 28. Hareendran, A., Bradbury, A., Budd, J., Geroulakos, G., Hobbs, R., Kenkre, J. & Symonds, T. Measuring the impact of venous leg ulcers on quality of life. Journal of Wound Care. 2005; 14 (2), 53- 57.
    • 29. Walters, S., Morrell, C.J. & Dixon, S. Measuring health-related quality of life in patients with venous ulceration. Quality of Life Research. 1999; 8, 327-336.
    • 30. Iglesias, C. P., Birks, Y., Nelson, E. A., Scanlon, E. & Cullum, N. A. Quality of life of people with venous leg ulcers: A comparison of the discriminative and responsive characteristics of two generic and a disease specific instruments. Quality of Life Research. 2005; 14, 1705-1718.
    • 31. National Collaborating Centre for Methods and Tools (2012). Defining your question: PICO and PS. Hamilton, ON: McMaster University. Retrieved: http://www.nccmt.ca/registry/view/eng/138.html accessed at 08.40am on 22/07/2013.
    • 32. Hicks, C. (2004). Research Methods for Clinical Therapists.London: Churchill Livingstone, 1 33. Moher, D., Liberati, A., Tetzlaff, J.& Altman, D. G. The PRISMA Group. (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The PRISMA Statement. PLoS Med 6(6): e1000097. doi:10.1371/journal.pmed1000097
    • 35. Higgins, J. P. T. & Green, S. (ed) (2011). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. The Cochrane Collaboration, 2011. Available from www.cochranehandbook.org.
    • 36. Goldsmith, M. R., Bankhead, C. R. & Austoker, J. (2007). Synthesising quantitative and qualitative research in evidence- based patient information. J Epidemiol Community Health. 61, 262-270.
    • 37. Mays, N., Pope, C. & Popay, J. (2005). Systematically reviewing qualitative and quantitative evidence to inform management and policy-making in the health field. J Health Serv Res Policy. 10:S6-20.
    • 38. Hawker, S., Payne, S., Kerr, C., Hardey, M. & Powell, J. Appraising the evidence: reviewing disparate data systematically. Qualitative Health Research. 2002; 12 (9), 1284-1299.
    • 39. Thomas, J., Harden, A., Oakley, A., Oliver, S., Sutcliffe, K., rees, R., Brunton, G. and Kavanagh, J. (2004). Integrating qualitative research with trials in systematic reviews. BMJ. 328, 7446, 1010- 2.
    • 40. Briggs, M. (2009) Synthesizing data from Management Association Journal. 9 (2), pp. 24-25.
    • 41. Ware, J. & Sherbourne, C. The MOS 36-item Short-Form health survey (SF-36): 1. Conceptual Framework and item selection. Medical Care. 1992; 30, 473-483.
    • 42. Hunt, S., McEwen, J. & McKenna, S. Measuring health status. London: Croom Helm, 1985.
    • 43. Review Manager (RevMan) [Computer program]. (2012). Version 5.2. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration.
    • 44. Brown, A. Chronic leg ulcers, part 2: do they affect a patient's social life? British Journal of Nursing. 2005b; 14 (18), 986-989.
    • 45. Bland, M. Coping with leg ulcers. Kai Taki Nursing New Zealand. April, 13-14, 1996.
    • 46. Charles, H. Does leg ulcer treatment improve patients' quality of life? Journal of Wound Care. 2004; 13 (6), 209-213.
    • 47. Walshe, C. Living with a venous leg ulcer: a descriptive study of patients' experiences. Journal of Advanced Nursing. 1995; 22, 1092-1100.
    • 48. Douglas, V. Living with a chronic leg ulcer: an insight into patients' experiences and feelings. Journal of Wound Care. 2001; 10 (9), 355-360.
    • 49. Hopkins, A. Disrupted lives: investigating coping strategies for non-healing leg ulcers. British Journal of Nursing. 2004; 13 (9), 556-563.
    • 50. Ebbeskog, B & Ekman, S. Elderly people's experiences: the meaning of living with venous leg ulcer. European Wound Management Association Journal. 2001; 1 (1), 21-23.
    • 51. Byrne, O. & Kelly, M. (2010). Living with a chronic leg ulcer. Journal of Community Nursing. 2010; 24(5), 46-54.
    • 52. Brown, A. Chronic leg ulcers, part 1: do they affect a patient's social life? British Journal of Nursing. 2005a; 14 (17), 894-898.
    • 53. Cox, D.R., Fitzpatrick, R., Fletcher, A.E., Gore, S.M., Spiegelhalter, D.J. & Jones, D.R. Quality-ofLife Assessment: Can We Keep It Simple? Journal of the Royal Statistical Society. 1992; 155 (3), 353-393
    • 54. Charles, H. (2004). Does leg ulcer treatment improve patients' quality of life? Journal of Wound Care. 13 (6), 209-213.
    • 55. Chase, S., Whittemore, R., Crosby, N., Freney, D., Howes, P. & Phillips, T. Living with chronic venous leg ulcers: a descriptive study of knowledge and functional status. Journal of Community Health Nursing. 2000; 17 (1), 1-13.
    • 56. Faria, E., Blanes, L., Hochman, B., Filho, M. & Ferreirra, L. Health-related quality of life, selfesteem, and functional status of patients with leg ulcers. Wounds. 2011; 23 (1), 4-10.
    • 57. Franks, P., McCullagh, L. & Moffatt, C. J. Assessing quality of life with chronic venous leg ulceration using the Medical Outcomes Short Form-36 questionnaire. Ostomy Wound Management. 2003; 49, 26-37.
    • 58. Lindholm, C., Bjellerup, M., Christensen, O. & Zederfeldt, B. Quality of Life in Chronic Leg Ulcer Patients. Acta Derm Venereol. 1993; 73, 440-443.
    • 59. Franks, P., Moffatt, C.J., Doherty, D.C., Smithdale, R. & Martin, R. Longer-term changes in quality of life in chronic leg ulceration. Wound Repair and Regeneration. 2006; 14, 536 - 541.
    • 60. Furtado, K., Pina, E. Moffatt, C.J. & Franks, P, J. Leg ulceration in Portugal: quality of life. International Wound Journal. 2008; 5 (1), 34-39.
    • 61. Wissing, U., Ek, A., Wengstrom, Y., Skold, G. & Unosson, M. Can individualised nutritional support improve healing in therapy-resistant leg ulcers? Journal of Wound Care. 2002; 11(1), 15-20.
    • 62. Heinen, M. M., Persoon, A., van de Kerkhof, P., Ptero, M. & Achterberg, T. Ulcer-related problems and health care needs in patients with venous leg ulceration: A descriptive, crosssectional study. International Journal of Nursing Studies. 2007; 44, 1296-1303.
    • 63. Lawton, M.P., Moss, M., Fulcomer, M. & Kleban, M.H. A research and service oriented Multilevel Assessment Instrument. Journal of Gerontology. 1982; 37, 91-99.
    • 64. de Bruin, A. F., Diederiks, J. P., de Witte, L. P., Stevens, F. C. & Philipsen, H. Assessing the responsiveness of a functional status measure: the Sickness Impact Profile versus the SIP68. Journal of Clinical Epidemiology. 1997; 50 (5): 529-540
    • 65. Cantril, H. The pattern of human concerns. New Brunswick: Rutgers University Press, 1965.
    • 66. Mahoney, F. I. & Barthell, D. W. Functional Evaluation: the Barthell Index. Maryland State Medical Journal. 1965; 14, 61-65.
    • 67. Freeman, G. & Hughes, J. Continuity of care and the patient experience. London, King's Fund, 2010.
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