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1.
Rev. enferm. UERJ ; 27: e40876, jan.-dez. 2019.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1095022

RESUMO

Objetivo: analisar as repercussões das úlceras venosas de perna para a vida laboral de homens em idade produtiva. Método: estudo qualitativo e descritivo cujo objeto tratou de homens com úlceras venosas e as implicações para sua atuação no mundo do trabalho. Participaram do estudo 22 homens atendidos em dois ambulatórios, pertencentes ao complexo de saúde de uma universidade pública do Rio de Janeiro. O instrumento de coleta foi a entrevista semiestruturada e os dados coletados foram tratados por meio da análise temática de conteúdo. Resultados: evidenciou-se que há dificuldades para estes homens atuarem no mercado de trabalho. Além disso, apresentaram medo do desemprego e sentimento de incapacidade. Por outro lado, o acolhimento dos colegas de trabalho foi um aspecto positivo para minimizar tal sentimento. Conclusão: é importante a criação de políticas públicas que contribuam para melhor qualidade de vida para minimizar impactos nas dimensões biopsicossocial dessa população trabalhadora.


Objective: to analyze the repercussions of venous leg ulcers for the working life of men of productive age. Method: qualitative and descriptive research whose object dealt with men with venous ulcers and its implications for their work in the world of work. Twenty-two men attended at two outpatient clinics belonging to the health complex of a public university in Rio de Janeiro participated in the study. The collection instrument was the semistructured interview and data were treated through the thematic content analysis. Results: the study evidenced that there are difficulties for these men to act in the labor market, in addition, they present fear of unemployment and feeling of incapacity. On the other hand, the reception of co-workers was a positive aspect to minimize this feeling. Conclusion: it is important to create public policies that contribute to a better quality of life to minimize impacts on the biopsychosocial dimensions of this population of workers.


Objetivo: analizar las repercusiones de las úlceras venosas de las piernas para la vida laboral de los hombres en edad productiva. Método: investigación cualitativa y descriptiva cuyo objeto se ocupó de hombres con úlceras venosas y sus implicaciones para su trabajo en el mundo del trabajo. Veintidós hombres atendidos en dos clínicas ambulatorias pertenecientes al complejo de salud de una universidad pública en Río de Janeiro participaron en el estudio. El instrumento de recolección fue la entrevista semiestructurada y los datos se trataron a través del análisis de contenido temático. Resultados: el estudio evidenció que existen dificultades para que estos hombres actúen en el mercado laboral, además, presentan temor al desempleo y sensación de incapacidad. Por otro lado, la recepción de compañeros de trabajo fue un aspecto positivo para minimizar este sentimiento. Conclusión: es importante crear políticas públicas que contribuyan a una mejor calidad de vida para minimizar los impactos en las dimensiones biopsicosociales de esta población de trabajadores.


Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Idoso , Úlcera Varicosa/psicologia , Saúde do Trabalhador , Enfermagem , Úlcera da Perna , Úlcera da Perna/psicologia , Homens , Úlcera Varicosa/complicações , Insuficiência Venosa , Epidemiologia Descritiva , Pesquisa Qualitativa , Saúde do Homem , Úlcera da Perna/complicações , Úlcera da Perna/patologia
2.
Int Wound J ; 16(6): 1559-1569, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31606948

RESUMO

Exercise training can improve lower-limb cutaneous microvascular reactivity in adults with venous leg ulceration; however, there is a lack of research on patients' views about the acceptability and feasibility of exercise interventions. The aim of this study was to explore participants' experiences of the trial "Exploring the Feasibility of Implementing a Supervised Exercise Training and Compression Hosiery Intervention in Patients with Venous Ulceration" (FISCU). Semi-structured face-to-face and telephone interviews were used to investigate participants' experiences (n = 16) of taking part in the FISCU trial. Data were analysed using thematic analysis. Three overarching themes were identified, along with 11 sub-themes: (a) sedentary cautious living (because of pain and reduced mobility, treatment and perceived control, and advice to rest and be careful), (b) key components of the exercise trial (including motivation, an individualised intervention supervised by a specialist exercise professional, and satisfaction with the intervention), and (c) benefits of exercise (physical benefits and healing, psychological well-being, positive impact on comorbidities, and an improved self-management strategy). This study found that an exercise intervention was viewed by participants as positive, acceptable, and feasible while living with a venous leg ulcer. An individualised and supervised exercise programme was key to build confidence to exercise.


Assuntos
Terapia por Exercício , Satisfação do Paciente , Úlcera Varicosa/terapia , Idoso , Medo/psicologia , Feminino , Humanos , Controle Interno-Externo , Entrevistas como Assunto , Masculino , Saúde Mental , Limitação da Mobilidade , Dor/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Sujeitos da Pesquisa , Descanso , Autocuidado , Úlcera Varicosa/psicologia , Cicatrização
3.
Rev Gaucha Enferm ; 40: e20180024, 2019 Jun 10.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31188978

RESUMO

OBJECTIVE: To understand the experience of adults and older people with adherence to venous ulcer care. METHOD: A qualitative study based on the concepts of Alfred Schütz's social phenomenology was carried out with 12 adults and older people undergoing venous ulcer treatment in a specialized service in the state of Minas Gerais. The interviews were carried out from October to November 2015, analyzed, categorized, and discussed based on the theoretical-philosophical framework adopted and on thematic literature. RESULTS: The following thematic categories emerged from the interviews: "beliefs and personal and social activities hindering adherence to care"; "being protagonists in the care relationship with venous ulcers", and "motivation for adherence to care". CONCLUSIONS: The intersubjective relationship established between patients with venous ulcers and healthcare professionals emerged as a driving force for adherence to care. Promoting the reciprocity relationship of perspectives between these social actors may promote greater adherence to venous ulcer care.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Motivação , Cooperação do Paciente , Úlcera Varicosa/terapia , Idoso , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Relações Enfermeiro-Paciente , Cooperação do Paciente/psicologia , Participação do Paciente , Satisfação do Paciente , Pesquisa Qualitativa , Qualidade de Vida , Comportamento Social , Úlcera Varicosa/psicologia
4.
Biol Res Nurs ; 21(4): 407-419, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31142148

RESUMO

The prevalence and incidence of chronic venous leg ulcers (CVLUs) are increasing worldwide, as are the associated financial costs. Although it has long been known that their underlying etiology is venous insufficiency, the molecular aspects of healing versus nonhealing, as well as the psychoneurologic symptoms (PNS; pain, cognitive dysfunction, fatigue, depression, and anxiety) associated with CVLUs remain understudied. In this biobehaviorally focused review, we aim to elucidate the complex mechanisms that link the biological and molecular aspects of CLVUs with their PNS. Innovations in "omics" research have increased our understanding of important wound microenvironmental factors (e.g., inflammation, microbial pathogenic biofilm, epigenetic processes) that may adversely alter the wound bed's molecular milieu so that microbes evade immune detection. Although these molecular factors are not singularly responsible for wound healing, they are major components of wound development, nonhealing, and PNS that, until now, have not been amenable to systematic study, especially over time. Further, this review explores our current understanding of the molecular mechanisms by which the immune activation that contributes to the development and persistence of CVLUs also leads to the development, persistence, and severity of wound-related PNS. We also make recommendations for future research that will expand the field of biobehavioral wound science. Biobehavioral research that focuses on the interrelated mechanisms of PNS will lead to symptom-management interventions that improve quality of life for the population burdened by CVLUs.


Assuntos
Ansiedade/psicologia , Disfunção Cognitiva/psicologia , Depressão/psicologia , Fadiga/psicologia , Qualidade de Vida/psicologia , Úlcera Varicosa/psicologia , Idoso , Humanos , Masculino , Prevalência
5.
Qual Life Res ; 28(7): 1903-1911, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30778889

RESUMO

PURPOSE: Given the importance of measuring health-related quality of life (HRQoL) for cost-utility studies, this study aimed to determine the validity and responsiveness of two preference-based HRQoL instruments, the EuroQol-five dimensions-five levels questionnaire (EQ-5D-5L) and the Sheffield Preference-based Venous Ulcer questionnaire (SPVU-5D) in patients with venous leg ulcers (VLUs) in an Australian setting. METHODS: This study analysed de-identified data collected from 80 patients with VLUs recruited by a prospective study in Brisbane, Queensland, Australia. Patients were asked to complete EQ-5D-5L and SPVU-5D surveys at baseline, 1-month, 3-month and 6-month follow-up as part of the prospective study. Baseline data and follow-up data were pooled to test the construct validity and level of agreement of the two instruments. Follow-up data were used to test the responsiveness. RESULTS: The ceiling effects were negligible for EQ-5D-5L and SPVU-5D utility scores. Both instruments were able to discriminate between healed VLU and unhealed VLU and showed great responsiveness when healing status changed over time. Weak to strong correlations were found between dimensions of EQ-5D-5L and SPVU-5D. The utility scores produced from EQ-5D-5L were generally lower. CONCLUSIONS: This study found that both EQ-5D-5L and SPVU-5D were valid and responsive in detecting change of VLU healing status among a small Australian population. Both instruments may be used in economic evaluation studies that involve patients with healed or unhealed VLUs. However, given the limitations presented in this study, further research is necessary to make sound recommendations on the preferred instrument in economic evaluation of VLU-related interventions.


Assuntos
Análise Custo-Benefício/métodos , Psicometria/métodos , Qualidade de Vida/psicologia , Inquéritos e Questionários , Úlcera Varicosa/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália , Grupos de Populações Continentais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Queensland , Resultado do Tratamento
6.
Adv Ther ; 36(Suppl 1): 1-4, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30758739

RESUMO

Chronic venous disease (CVD) is widespread, underdiagnosed, and can progress to chronic venous insufficiency and venous ulcers, which can require extensive treatment and hospitalization. These conditions negatively impact patient quality of life and place substantial burdens on healthcare resources. The two main risk factors for CVD are age and obesity. Thus, with the growing prevalence of obesity and the increasing longevity of the population, the burden of CVD is expected to increase dramatically in the coming decades. Appropriate lifestyle changes and care, which may include treatment with venoactive drugs, can slow disease progression, improve quality of life, and are likely to reduce healthcare costs. Physicians should be aware of this growing problem and of the effective treatments available for CVD. We recommend the accompanying short summaries from a symposium held at the recent European Venous Forum as a means for our colleagues to learn more about the burden and suffering associated with CVD.Funding: Servier.


Assuntos
Efeitos Psicossociais da Doença , Qualidade de Vida/psicologia , Insuficiência Venosa/psicologia , Adaptação Psicológica , Doença Crônica/psicologia , Congressos como Assunto , Humanos , Fatores de Risco , Resultado do Tratamento , Úlcera Varicosa/psicologia
7.
Rev. gaúch. enferm ; 40: e20180024, 2019.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1004095

RESUMO

Resumo OBJETIVO Compreender a experiência de pessoas adultas e idosas frente à adesão aos cuidados com a úlcera varicosa. MÉTODO Pesquisa qualitativa fundamentada em pressupostos da Fenomenologia Social de Alfred Schütz, com 12 pessoas adultas e idosas, em tratamento de úlcera varicosa em Serviço Especializado, em Minas Gerais. Os depoimentos foram obtidos de outubro a novembro de 2015 e analisados, categorizados e discutidos a partir do referencial teórico-filosófico adotado e literatura temática. RESULTADOS Dos depoimentos emergiram as categorias temáticas: "Crenças, atividades pessoais e sociais dificultando a adesão ao cuidado"; "Ser protagonista na relação de cuidado com a úlcera varicosa" e "Motivação para aderir ao cuidado". CONCLUSÕES A relação intersubjetiva estabelecida entre as pessoas com úlcera varicosa e os profissionais de saúde emergiu como força potencializadora da adesão ao cuidado. Valorizar a relação de reciprocidade de perspectivas entre estes atores sociais pode promover maior adesão ao cuidado com a úlcera varicosa.


Resumen OBJETIVO Comprender la experiencia de adultos y ancianos en el cuidado de la úlcera varicosa. MÉTODO Investigación cualitativa fundamentada en supuestos de la Fenomenología Social de Alfred Schütz, con 12 personas adultas / ancianas, en tratamiento de la úlcera varicosa en Servicio Especializado, en Minas Gerais. Los testimonios fueron obtenidos de octubre a noviembre de 2015, siendo analizados, categorizados y discutidos a partir del referencial teórico-filosófico y literatura temática. RESULTADOS De los testimonios surgieron las categorías: "Creencias, actividades personales y sociales dificultando la adhesión al cuidado"; "Ser protagonista en la relación de cuidado con la úlcera varicosa" y "Motivación para adherirse al cuidado". CONCLUSIONES La relación intersubjetiva establecida entre las personas con úlcera varicosa y los profesionales de salud emergió como fuerza potencializadora de la adhesión al cuidado. Valorar la relación de reciprocidad de perspectivas entre estos actores sociales puede promover mayor adhesión al cuidado con la úlcera varicosa.


Abstract OBJECTIVE To understand the experience of adults and older people with adherence to venous ulcer care. METHOD A qualitative study based on the concepts of Alfred Schütz's social phenomenology was carried out with 12 adults and older people undergoing venous ulcer treatment in a specialized service in the state of Minas Gerais. The interviews were carried out from October to November 2015, analyzed, categorized, and discussed based on the theoretical-philosophical framework adopted and on thematic literature. RESULTS The following thematic categories emerged from the interviews: "beliefs and personal and social activities hindering adherence to care"; "being protagonists in the care relationship with venous ulcers", and "motivation for adherence to care". CONCLUSIONS The intersubjective relationship established between patients with venous ulcers and healthcare professionals emerged as a driving force for adherence to care. Promoting the reciprocity relationship of perspectives between these social actors may promote greater adherence to venous ulcer care.


Assuntos
Humanos , Masculino , Feminino , Idoso , Úlcera Varicosa/terapia , Conhecimentos, Atitudes e Prática em Saúde , Motivação , Participação do Paciente , Qualidade de Vida , Comportamento Social , Úlcera Varicosa/psicologia , Brasil , Cooperação do Paciente/psicologia , Satisfação do Paciente , Pesquisa Qualitativa , Pessoa de Meia-Idade , Relações Enfermeiro-Paciente
8.
Rev Bras Enferm ; 71(5): 2469-2476, 2018.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30304178

RESUMO

OBJECTIVE: to verify the application of the Merleau-Pontyan perspective on the physical and psychological implications of chronic venous ulcers in the existence of people who experience the disease. METHOD: a qualitative study, of the descriptive phenomenological type, developed with 36 patients. The field of investigation was the Outpatient Clinic of Wound Repair of the Hospital Universitário Antônio Pedro. The collection occurred from June to December 2016, through a phenomenological interview. RESULTS: the experiences inherent in people who have venous ulcers pass through the world and "return" to the body itself, reflecting on the biopsychosocial aspects and the sensitivity left on the being. CONCLUSION: the biological characteristics of the subject affected by the venous ulcer have repercussions on their physical aspect, promoting influences along with the emotional and social changes originating from the clinical picture on the social aspects and consequently reverberating on the quality of life of this individual.


Assuntos
Imagem Corporal/psicologia , Efeitos Psicossociais da Doença , Úlcera Varicosa/psicologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Úlcera Varicosa/complicações , Cicatrização
9.
Rev. bras. enferm ; 71(5): 2469-2476, Sep.-Oct. 2018.
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-958709

RESUMO

ABSTRACT Objective: to verify the application of the Merleau-Pontyan perspective on the physical and psychological implications of chronic venous ulcers in the existence of people who experience the disease. Method: a qualitative study, of the descriptive phenomenological type, developed with 36 patients. The field of investigation was the Outpatient Clinic of Wound Repair of the Hospital Universitário Antônio Pedro. The collection occurred from June to December 2016, through a phenomenological interview. Results: the experiences inherent in people who have venous ulcers pass through the world and "return" to the body itself, reflecting on the biopsychosocial aspects and the sensitivity left on the being. Conclusion: the biological characteristics of the subject affected by the venous ulcer have repercussions on their physical aspect, promoting influences along with the emotional and social changes originating from the clinical picture on the social aspects and consequently reverberating on the quality of life of this individual.


RESUMEN Objetivo: verificar la aplicación de la perspectiva Merleau-Pontiana sobre las implicaciones físicas y psicológicas de las úlceras venosas crónicas en la existencia de las personas que experimentan la enfermedad. Método: estudio de abordaje cualitativo, del tipo fenomenológico descriptivo, desarrollado con 36 pacientes. El campo de investigación fue el Ambulatorio de Reparación de Heridas del Hospital Universitario Antônio Pedro. La recolección ocurrió de junio a diciembre de 2016, por medio de una entrevista fenomenológica. Resultados: las experiencias vivenciales inherentes a las personas que poseen las úlceras venosas atravesan por el mundo y "retornan" al cuerpo propio, reflexionando sobre los aspectos biopsicosociales y sobre la sensibilidad que reposa sobre el ser. Conclusión: la característica biológica del sujeto acometido por la úlcera venosa repercutirá sobre su aspecto físico, promoviendo influencias junto a las alteraciones emocionales y sociales oriundas del cuadro clínico sobre los aspectos sociales y consecuentemente reverberando sobre la calidad de vida de este individuo.


RESUMO Objetivo: verificar a aplicação da perspectiva Merleau-Pontiana sobre as implicações físicas e psicológicas das úlceras venosas crônicas na existência das pessoas que vivenciam a doença. Método: estudo de abordagem qualitativa, do tipo fenomenológico descritivo, desenvolvido com 36 pacientes. O campo de investigação foi o Ambulatório de Reparo de Feridas do Hospital Universitário Antônio Pedro. A coleta ocorreu de junho a dezembro de 2016, por meio de uma entrevista fenomenológica. Resultados: as experiências vivenciais inerentes às pessoas que possuem as úlceras venosas perpassam pelo mundo e "retornam" ao corpo próprio, refletindo sobre os aspectos biopsicossociais e sobre a sensibilidade que repousa sobre o ser. Conclusão: a característica biológica do sujeito acometido pela úlcera venosa repercutirá sobre seu aspecto físico, promovendo influências juntamente às alterações emocionais e sociais oriundas do quadro clínico sobre os aspectos sociais e consequentemente reverberando sobre a qualidade de vida deste indivíduo.


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Úlcera Varicosa/psicologia , Imagem Corporal/psicologia , Efeitos Psicossociais da Doença , Úlcera Varicosa/complicações , Cicatrização , Pesquisa Qualitativa , Pessoa de Meia-Idade
10.
Rev Bras Enferm ; 71(4): 2021-2029, 2018.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30156692

RESUMO

OBJECTIVE: To analyze knowledge gathered about the impact of venous ulcers on patients' quality of life. METHOD: Systematic bibliographic review study with an integrative approach. Databases of MEDLINE, LILACS, IBECS, CINAHL Complete, Web of Science, Scopus, and CUIDEN Plus were used for selection with the PICOT guiding criteria, through the DeCS and MeSH: adult, aged, varicose ulcer, and quality of life, in Portuguese, Spanish, and English. The inclusion criteria were: full original articles available in the databases selected with adherence to the theme in Portuguese, Spanish, and English, published from 2007 to 2016. RESULTS: The sample included 14 national and international articles with different methodological approaches and investigative contexts, published from 2012 to 2016. CONCLUSION: Chronic venous ulcers act on patients' bio-psycho-social-spiritual and socioeconomic spheres, having a negative impact on their quality of life.


Assuntos
Qualidade de Vida/psicologia , Úlcera Varicosa/complicações , Humanos , Úlcera Varicosa/psicologia
11.
Rev. bras. enferm ; 71(4): 2021-2029, Jul.-Aug. 2018. tab, graf
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-958655

RESUMO

ABSTRACT Objective: To analyze knowledge gathered about the impact of venous ulcers on patients' quality of life. Method: Systematic bibliographic review study with an integrative approach. Databases of MEDLINE, LILACS, IBECS, CINAHL Complete, Web of Science, Scopus, and CUIDEN Plus were used for selection with the PICOT guiding criteria, through the DeCS and MeSH: adult, aged, varicose ulcer, and quality of life, in Portuguese, Spanish, and English. The inclusion criteria were: full original articles available in the databases selected with adherence to the theme in Portuguese, Spanish, and English, published from 2007 to 2016. Results: The sample included 14 national and international articles with different methodological approaches and investigative contexts, published from 2012 to 2016. Conclusion: Chronic venous ulcers act on patients' bio-psycho-social-spiritual and socioeconomic spheres, having a negative impact on their quality of life.


RESUMEN Objetivo: Analizar las producciones de conocimiento sobre el impacto de las úlceras venosas en la calidad de vida de los pacientes. Método: Estudio de revisión bibliográfica sistemática, tipo integrativa. Para la selección, se utilizaron las bases de datos MEDLINE; LILACS; IBECS; CINAHL Complete; Web of Science; Scopus y CUIDEN Plus, con criterios orientadores PICOT; mediante DECs y MeSH: adulto, anciano, úlcera varicosa y calidad de vida, en portugués, español e inglés. Fueron criterios de inclusión: artículos originales integralmente disponibles en las citadas bases, referentes a la temática, en idiomas Portugués, Español e Inglés, publicados entre los años 2007 y 2016. Resultados: La muestra incluyó 14 artículos nacionales e internacionales con diversos abordajes metodológicos y contextos de investigación, en publicaciones realizadas desde 2012 hasta 2016. Conclusión: Las úlceras venosas crónicas actúan sobre las esferas biopsicoespiritual y socioeconómica de los pacientes, con repercusiones negativas en la calidad de vida.


RESUMO Objetivo: analisar as produções de conhecimento sobre o impacto das úlceras venosas na qualidade de vida dos pacientes. Método: estudo de revisão bibliográfica sistemática, do tipo integrativa. Utilizaram-se, para seleção, as bases de dados MEDLINE; LILACS; IBECS; CINAHL Complete; Web of Science; Scopus e CUIDEN Plus, pelos critérios orientadores PICOT; através do DECs e MeSH: adulto, idoso, úlcera varicosa e qualidade de vida, nos idiomas português, espanhol e inglês. Os critérios de inclusão foram: artigos originais disponibilizados na íntegra, nas bases de dados selecionadas, com aderência à temática nos idiomas Português, Espanhol e Inglês, publicados entre os anos de 2007 e 2016. Resultados: a amostra incluiu 14 artigos nacionais e internacionais com diversas abordagens metodológicas e contextos investigativos, publicados entre os anos de 2012 e 2016. Conclusão: as úlceras venosas crônicas atuam sobre as esferas biopsicoespiritual e socioeconômica dos pacientes, repercutindo negativamente sobre a qualidade de vida.


Assuntos
Humanos , Qualidade de Vida/psicologia , Úlcera Varicosa/complicações , Úlcera Varicosa/psicologia
12.
Wound Repair Regen ; 26(2): 206-212, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-30015365

RESUMO

Venous insufficiency is the most common cause of leg ulceration, but the impact of venous leg ulceration on health-related quality of life has not been adequately assessed. This study compared data from randomized controlled trials to population norms obtained from a large national population survey. We combined the baseline Short Form-36 (SF-36) version 1 data from two New Zealand randomized controlled trials that recruited participants with VLU and compared the pooled data to the population scores obtained from the New Zealand Health Survey using general linear regression to adjust for age, sex, and ethnicity differences between the cohorts. Baseline SF-36 scores obtained from 618 trial participants were compared to the SF-36 scores obtained from the 12,529 participants in the New Zealand Health Survey. Participants with VLU had significantly lower crude SF-36 scores across all eight SF-36 domains, but there was interaction between age and group. Adjusted mean differences for participants aged 65 years or younger were -25.8, -32.1, -21.2, -9.6, -7.6, -23.9, -21.5, and -9.3, respectively, for Physical Functioning, Role Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role Emotional, and Mental Health whereas the adjusted mean differences for older participants were -15.7, -23.8, -13.8, -0.3 (nonsignificant), -4.6, -15.3, -21.2, and -6.6. This study is the first to compare a VLU population to norms from a general population survey and the first to show VLU interacts with age creating stronger impact in younger patients compared their age cohort. Younger patients may have need of more pastoral care as a consequence.


Assuntos
Úlcera da Perna/psicologia , Qualidade de Vida , Úlcera Varicosa/psicologia , Cicatrização/fisiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Indicadores Básicos de Saúde , Inquéritos Epidemiológicos , Humanos , Úlcera da Perna/complicações , Úlcera da Perna/fisiopatologia , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Perfil de Impacto da Doença , Úlcera Varicosa/complicações , Úlcera Varicosa/fisiopatologia
13.
Int Wound J ; 15(5): 798-806, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29808613

RESUMO

This study aimed to evaluate the effect of strategies of a lifestyle orientation programme on patients with venous ulcer in elastic compression therapy. This was a single-blind, 2-arm, randomised clinical controlled trial. The primary outcome included the reduction of the wound surface area. The secondary outcomes included the perception of pain, questionnaire of ulcer status, and quality of life. Seventy-one patients with ulcers of venous aetiology were randomised into 2 arms: control group (CG) and intervention group (IG), with a 12-week follow up. The CG was provided with the routine guidelines of the health services. Meanwhile, the IG was provided with lifestyle guidelines regarding the physiopathology of a venous ulcer, importance of compression therapy, physical exercises and rest in 4 face-to-face and 2 telephone interviews. The IG had significant improvement on the wound healing on 30, 60, and 90 days of follow up when compared with the CG (P = .0197; P = .0472; P = .0116). There were no statistical differences between groups; both had improvement in the quality of life and pain perception. Our results demonstrated that elastic compression therapy along with guidelines on lifestyle is effective adjunctive treatment to promote wound healing in patients with leg ulcers.


Assuntos
Educação de Pacientes como Assunto/métodos , Qualidade de Vida/psicologia , Úlcera Varicosa/psicologia , Úlcera Varicosa/terapia , Cicatrização/fisiologia , Idoso , Idoso de 80 Anos ou mais , Bandagens Compressivas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Método Simples-Cego , Resultado do Tratamento
14.
PLoS One ; 13(4): e0195990, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29689069

RESUMO

BACKGROUND: Venous ulcers constitute an important public health problem as they can cause disability with consequences for multiple dimensions of quality of life. OBJECTIVE: To describe the quality of life in patients with venous leg ulcer treated in primary care in two cities from Brazil and Portugal. METHODS: This was a cross-sectional comparative study with a non-probabilistic sample of 171 patients with venous leg ulcers who were treated in primary care in two cities from Brazil and Portugal, namely, Natal and Évora. A form covering sociodemographic and health data and the Medical Outcomes Study 36-Item Short-Form Health Survey were used, and descriptive and inferential analyses were performed. RESULTS: Significant differences in age and income were observed between the two samples. Patients with venous leg ulcer from Brazil had lower income and were younger than those from Portugal. Quality of life scores were significantly higher in Portugal for the physical aspects, pain, and social functioning, among domains, and for the physical health dimension and total score of QOL. CONCLUSION: The quality of life was better in Portugal than in Brazil and the differences between the countries need further investigation.


Assuntos
Úlcera da Perna/terapia , Qualidade de Vida/psicologia , Úlcera Varicosa/terapia , Idoso , Idoso de 80 Anos ou mais , Brasil , Estudos Transversais , Feminino , Humanos , Úlcera da Perna/psicologia , Masculino , Pessoa de Meia-Idade , Portugal , Atenção Primária à Saúde , Fatores Socioeconômicos , Inquéritos e Questionários , Úlcera Varicosa/psicologia
15.
Br J Community Nurs ; 23(Sup3): S30-S38, 2018 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-29493307

RESUMO

This article, the first of two, summarises a study that explored the lived experiences of patients with leg ulcers and the impact of this condition on their quality of life. The study had four study phases; phases 1 and 2 employed qualitative methods and are reported here. Initially, unstructured interviews were held; these revealed significant issues for the patients including the dominance of pain, issues relating to exudate and odour, social isolation and psychological effects. A checklist based on these issues was completed by the researcher during observations of routine care for these same patients; this revealed the extent and depth to which these matters were addressed. On many occasions, significant issues were not disclosed or explored during consultations. These findings confirmed that participants with chronic venous leg ulcers have concerns far beyond wound care.


Assuntos
Qualidade de Vida , Úlcera Varicosa/enfermagem , Úlcera Varicosa/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Inglaterra , Enfermagem Baseada em Evidências , Exsudatos e Transudatos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação em Enfermagem , Manejo da Dor , Medição da Dor , Pesquisa Qualitativa , Isolamento Social
16.
J Clin Nurs ; 27(5-6): e931-e939, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28793373

RESUMO

AIMS AND OBJECTIVES: To gain insight into the experience of recurrent venous leg ulcers from the individual's perspective and provide knowledge on potential risks of recurrence not previously investigated. BACKGROUND: Venous leg ulcers are a consequence of chronic venous disease and frequently recur. They are costly and can impact on physical and psychological health. Despite research suggesting the risk can be reduced through compression and lifestyle changes, recurrence rates are often high. This study provides an insight into individual's perceptions of the cause of their ulcers and how they try to avoid them. DESIGN: A qualitative design guided by the Chronic Illness Trajectory Model and Social Cognitive Theory. METHOD: A purposive sample of three males and four females were recruited from a community nursing clinic. Participants were ulcer free, had experienced at least two previous venous leg ulcers and could speak and comprehend English. An interpretive descriptive approach was taken using semi-structured interviews and thematic analysis. RESULTS: Three themes each containing three categories emerged: The Increasing Influence of the Recurring Wound on Mind and Body, Reflection on Past Experiences and Optimism in the Face of Adversity. Most participants reported traumatic injury and lower leg surgery triggered ulcer recurrence. Failure to replace compression stockings was also deemed a cause. Compression was reported essential, but some participants were unaware of the level they were wearing and how often it should be replaced. Other preventive activities included avoiding injury and securing immediate assistance if wounding occurred. CONCLUSION: Clinicians need to be aware that lower leg surgery may trigger recurrent venous ulceration and that individuals require ongoing emotional, physical and financial support throughout the trajectory of venous disease. The continued use of old compression stockings should be avoided and recurrence prevented by adoption of evidence-based practice rather than reflection on past experiences. RELEVANCE TO CLINICAL PRACTICE: This research raises the awareness of factors from the individual's perspective which can influence the recurrence of venous leg ulcers.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Úlcera Varicosa/etiologia , Úlcera Varicosa/prevenção & controle , Adulto , Doença Crônica , Feminino , Humanos , Traumatismos da Perna/complicações , Masculino , Pessoa de Meia-Idade , Recidiva , Risco , Prevenção Secundária , Meias de Compressão/estatística & dados numéricos , Úlcera Varicosa/psicologia
17.
J Health Psychol ; 23(5): 691-700, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-27387513

RESUMO

This study assessed the relationships between self-efficacy, outcome expectations, fear-avoidance beliefs and adherence to an exercise for a home-based exercise programme for adults with venous leg ulcers. Patients ( n=63) were randomised to receive either an intervention or usual care group. Of those in the exercise intervention group, 59per cent adhered to the exercise protocol more than 75per cent of the time. There was a significant relationship between self-efficacy and outcome expectations, and both of these constructs were significantly related to adherence to the leg exercise programme. Adherence significantly correlated with wound healing indicating a possible pathway to healing.


Assuntos
Cultura , Terapia por Exercício/psicologia , Cooperação do Paciente/psicologia , Autoeficácia , Úlcera Varicosa/terapia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , Teoria Psicológica , Autocuidado/psicologia , Úlcera Varicosa/psicologia , Cicatrização
18.
J Adv Nurs ; 74(3): 550-563, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28960514

RESUMO

AIM: To systematically identify, evaluate and synthesize qualitative research that examined the symptoms and health-related quality of life themes that are important from the perspective of patients with venous leg ulceration. BACKGROUND: Venous leg ulceration is a common chronic condition; the symptoms and associated treatments have a negative effect on health-related quality of life. Qualitative research methods can provide insight into the personal experiences of patients with venous leg ulceration. DESIGN: Qualitative evidence synthesis (using framework synthesis). DATA SOURCES: Multiple electronic databases including MEDLINE, EMBASE, PsycINFO and CINAHL were comprehensively searched from inception to November 2015. REVIEW METHODS: Systematic identification, quality assessment and synthesis of existing qualitative research were performed; framework synthesis was conducted on included studies. An inductive approach was used and emergent themes were identified. The final stage in the synthesis involved the development of new interpretations. RESULTS: Thirteen studies met the inclusion criteria; the overall quality of the included studies was good. Four overarching themes were identified; physical impact, psychological impact, social impact and treatment and, in these, further subthemes were identified. Ulcer and treatment-related pain, as well as odour and exudate appeared to have significant and direct negative effects on quality of life, with additional and cumulative effects on sleep, mobility and mood. CONCLUSION: The themes identified in this review should be considered by professionals providing services, care and treatment for venous leg ulcer patients and in the selection, or development, of patient-reported outcome measures for use with this population.


Assuntos
Úlcera da Perna/psicologia , Medidas de Resultados Relatados pelo Paciente , Úlcera Varicosa/psicologia , Humanos , Úlcera da Perna/enfermagem , Úlcera da Perna/fisiopatologia , Relações Enfermeiro-Paciente , Pesquisa Qualitativa , Qualidade de Vida , Reprodutibilidade dos Testes , Comportamento Social , Úlcera Varicosa/enfermagem , Úlcera Varicosa/fisiopatologia
19.
Int Wound J ; 15(2): 283-290, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29250935

RESUMO

Leg ulcers are hard to heal. Infection causes delayed healing, negatively impacting patients' quality of life, the healthcare system, and society. Early recognition of patients at high risk of infection is essential to prevent complications and reduce negative impacts. However, at present, factors associated with infection in this population are not yet clearly understood. The study aimed to identify factors that were significantly associated with infection in chronic leg ulcers. A sample of 561 patients with chronic leg ulcers, who were previously recruited at outpatient clinics and community settings within Australia between 2008 and 2015, were selected for the current analysis. The prevalence of infection in the sample at study recruitment was 7.8%. A multivariate logistic regression model was used to identify factors associated with infection. The study identified 7 factors that were significantly independently associated with infection, including depression, chronic pulmonary disease, anti-coagulant use, calf ankle circumference ratio < 1.3, ulcer area ≥ 10 cm2 , slough in the wound bed tissue, and ulcers with heavy exudate. These findings could assist clinicians in the early recognition of patients at risk of infection and individualise treatment for these patients, thereby promoting wound healing.


Assuntos
Antibacterianos/uso terapêutico , Doença Crônica/terapia , Infecções/tratamento farmacológico , Qualidade de Vida/psicologia , Medição de Risco , Úlcera Varicosa/terapia , Cicatrização/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália , Doença Crônica/psicologia , Feminino , Humanos , Controle de Infecções/métodos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Úlcera Varicosa/psicologia
20.
Rev Bras Enferm ; 70(2): 287-293, 2017 Apr.
Artigo em Português, Inglês | MEDLINE | ID: mdl-28403291

RESUMO

OBJECTIVE: to compare the impact of home visits, before and after instructions, on the functional capacity of adult and elderly patients with venous ulcers, by means of the KATZ-EIAVD Scale. METHOD: experimental, clinical, randomized, non-blind and controlled study, developed with 32 patients (case and control groups). The research settings were the Wound Care Clinic of the University Hospital Antonio Pedro, and the homes of patients assisted in this clinic. Data collection took place from February to June 2014, by means of a health unit evaluation tool, the KATZ-EIAVD Scale, and a script of instructions to be given to the research subjects that had received a home visit. RESULTS: the studied population present excellent independence for activities of daily living, with no significant variation among them. CONCLUSION: the studied groups have functional capacity with similar progress.


Assuntos
Atividades Cotidianas/psicologia , Visita Domiciliar , Qualidade da Assistência à Saúde/normas , Úlcera Varicosa/complicações , Adulto , Idoso , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estatísticas não Paramétricas , Úlcera Varicosa/psicologia
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