Elderly persons' experiences of living with venous leg ulcer : living in a dialectal relationship between freedom and imprisonment

The aim was to illuminate elderly persons&apos; experiences of living with venous leg ulcer. Fifteen persons 74-89 years of age with active leg ulcer were interviewed. Data were analysed utilizing a phenomenological-hermeneutic approach inspired by Ricoeur. The analysis includes dialectic movement between understanding and explanation of the text as a whole and its parts, In the structural analysis four themes were identified: emotional consequences of altered body image, living a restricted life, achievement of well-being in connection with a painful wound and bandage, and struggle between hope and despair with regard to a lengthy healing process. The comprehensive understanding indicated that the meaning of living with venous leg ulcer can be understood as a dialectal relationship between, on the one hand the feeling of being imprisoned in the body, the bandage and the home, and on the other hand, hope of freedom from a burdensome body. The results indicate that the concept, body of image, is vitally relevant to the caring, of elderly people with venous leg ulcer. The study shows the importance of recognizing the persons&apos; perceptions of their leg ulcers and the impact of these perceptions on well-being. Nurses can thereby anticipate problems and provide more sensitive care.</p

The impact of chronic venous leg ulcers: a systematic review.

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

A follow-up study of leg ulcer patients in South Stockholm

The objective of this study was to follow up patients with leg ulcers, previously identified in an epidemiological study in South Stockholm. Rate of healing, non-healing, recurrence, amputation and mortality were recorded. A total of 254 patients were identified for follow-up after 18 months, using a questionnaire; at the time of the follow-up study, 61% of the ulcers were healed, 29% of the patients still had open ulcers, and 8% of the ulcers had recurred after healing. During this period, 20% of the patients had died, with arterial disease (39%) being more common than venous insufficiency. A further objective was to investigate 21 patients with non-healed venous leg ulcers by means of a structured assessment instrument, and to study if wound healing could be encouraged by using a triple-layer bandage for three months. Patients with non-healed venous leg ulcers treated in community care were recruited for assessment by means of a standardised form and given a triple-layer bandaging treatment for a three-month period. Two ulcers had healed and nine ulcers had improved and were healing. In the group of patients with healed or improved ulcers, five had normal mobility. Venous aetiology was also more common than arterial aetiology </jats:p

Mental health-promoting dialogues from the perspective of community-dwelling seniors with multimorbidity

&Aring;ke Grundberg,1 Britt Ebbeskog,2 Sanna Aila Gustafsson,3 Dorota Religa11Division of Neurogeriatrics, 2Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, 3Psychiatric Research Centre, School of Health and Medical Sciences, &Ouml;rebro University, &Ouml;rebro, SwedenAbstract: Mental health promotion needs to be studied more deeply within the context of primary care, because persons with multiple chronic conditions are at risk of developing poor mental health. In order to make progress in the understanding of mental health promotion, the aim of this study was to describe the experiences of health-promoting dialogues from the perspective of community-dwelling seniors with multimorbidity &ndash; what these seniors believe is important for achieving a dialogue that may promote their mental health. Seven interviews with six women and one man, aged 83&ndash;96 years, were analyzed using qualitative content analysis. The results were summarized into nine subcategories and three categories. The underlying meaning of the text was formulated into an overarching theme that embraced every category, &ldquo;perceived and well-managed as a unique individual&rdquo;. These seniors with multimorbidity missed someone to talk to about their mental health, and needed partners that were accessible for health dialogues that could promote mental health. The participants missed friends and relatives to talk to and they (crucially) lacked health care or social service providers for health-promoting dialogues that may promote mental health. An optimal level of care can be achieved through involvement, continuity, and by providing a health-promoting dialogue based on seniors&rsquo; needs and wishes, with the remembrance that general health promotion also may promote mental health. Implications for clinical practice and further research are discussed.Keywords: aged, care of older people, mental health-promotion, municipal car