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Experiences of undergoing venous leg ulcer management: A reflective lifeworld research study
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Halmstad University, Sweden.ORCID iD: 0000-0001-7875-0985
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.ORCID iD: 0000-0003-4630-7385
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linnaeus University, Linnaeus Knowledge Environments, Sustainable Health.ORCID iD: 0000-0003-1020-5141
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linnaeus University, Linnaeus Knowledge Environments, Sustainable Health. Region Kalmar County, Sweden. (DISA;DISA-IDP)ORCID iD: 0000-0002-4257-282X
2023 (English)In: International Wound Journal, ISSN 1742-4801, E-ISSN 1742-481X, Vol. 20, no 6, p. 1857-1865Article in journal (Refereed) Published
Sustainable development
SDG 3: Ensure healthy lives and promote well-being for all at all ages
Abstract [en]

Venous leg ulcers have multiple consequences for the patient. Ulcer management can be lengthy and recurrence is common. As the patient is the expert on their experiences and life, the aim of the present study was to describe patients' lived experiences of undergoing management for a venous leg ulcer. The study encompassed 16 phenomenological interviews. The analysis led to a description of the phenomenon's essence, further described by three constituents. The essential meaning of the phenomenon is described as being in an oscillation between hope and despair. Ulcer management is challenging for the patient, who feels unseen and lives with doubts during the management period. This study is considered enriching as it puts words to the patients' suffering during ulcer management and shows that reliable relationships and competence can reduce patient doubts. This knowledge should enable improvement of patient care and treatment during ulcer management.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023. Vol. 20, no 6, p. 1857-1865
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
URN: urn:nbn:se:lnu:diva-117730DOI: 10.1111/iwj.14044ISI: 000914185900001PubMedID: 36457152Scopus ID: 2-s2.0-85143762876OAI: oai:DiVA.org:lnu-117730DiVA, id: diva2:1715506
Funder
The Kamprad Family Foundation, 20190132Available from: 2022-12-02 Created: 2022-12-02 Last updated: 2024-05-23Bibliographically approved
In thesis
1. Living with a venous leg ulcer: Lived experiences and the presence of self-care in daily life
Open this publication in new window or tab >>Living with a venous leg ulcer: Lived experiences and the presence of self-care in daily life
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim of this thesis was to describe the lived experiences of patients with hard-to-heal venous leg ulcers before and after healing, as well as the understanding of the role and presence of self-care activities in ulcer management.

Methods: The thesis is based on four studies, with differing designs. In Studies I and II, a phenomenological approach was used. To describe lived experiences of undergoing ulcer management, 16 persons were interviewed (I), and to describe lived experiences of daily life after healing,15 persons were interviewed (II). Study III was a registry-based, quantitative study. In total, data from 699 patients with venous leg ulcers(VLUs) were analyzed. Logistic regressions were performed to describe associations between advice given on self-care and its impact on ulcer healing. Study IV, which focused on patient experiences of the feasibility of an intervention for self-care, was based on eleven interviews with six patients with VLUs. The data from the interviews underwent qualitative content analysis.

Results: Ulcer management aims at ulcer healing. In the protracted process, patients often experience hopelessness. When healing is slow, patients doubt the professionals’ knowledge. A patient’s trust in professionals and the entire healthcare system may erode if treatment and information vary between different professionals (Study I). Study II revealed that daily life after healing was still strongly affected by the ulcer. Memories from a lost period in life were ever-present. Life after healing was changed – for some, life was not very eventful. The patients’ own knowledge was often limited, and there was a struggle to do what was best for the own body to prevent a new ulcer. Study III revealed that advice on nutrition and physical activity had no impact on healing time. Only 44% of the sample were advised on both nutrition and physical activity. It was common to have an ulcer for a long time before seeking help; about half of the sample had an ulcer for >84 days before registration. Other findings were that the median age among the 699 patients was 77 years, the majority were female, and comorbidity was common. The intervention tested in Study IV offered welcomed information. However, even among those experiencing some sense of recognition, the link to their own situation and life was unclear. The technical solution with videos on a flash drive was difficult for most people to use. The importance of close cooperation with professionals was highlighted.

Conclusion: Venous leg ulcers have a profound impact on patients and their life situations. Ulcer management can, in different ways, impose suffering on patients. Not being listened to or seen as a person is anexperience that leaves its marks on a patient. When healing is slow, and someone has to be blamed, relationships with professionals are damaged. The role of self-care is unclear for most patients, which makes self-care harder. Those who tried a video-based intervention for self-care showed difficulties in relating it to their own life. Enabling a caring relationship can enhance patients’ understanding of information and advice. Patients must be invited to share their own experiences, to create a foundation for self-care. The provision of advice alone is not the solution to the issues related to self-care.

Place, publisher, year, edition, pages
Växjö: Linnaeus University Press, 2024. p. 96
Series
Linnaeus University Dissertations ; 527
Keywords
caring relationship, intervention, lifeworld, lived experiences, self-care, suffering, ulcer management, venous leg ulcer
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science; Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-129427 (URN)10.15626/LUD.527.2024 (DOI)9789180821612 (ISBN)9789180821629 (ISBN)
Public defence
2024-06-14, IKEA-salen, hus N, Georg Lückligs väg 3, Växjö, 13:00 (Swedish)
Opponent
Supervisors
Funder
The Kamprad Family Foundation, 20190132
Available from: 2024-05-24 Created: 2024-05-23 Last updated: 2024-06-03Bibliographically approved

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Rosenburg, MarcusLindqvist, GunillaTuvesson, HannaFagerström, Cecilia

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