'When Can I be Free from My Miserable Leg?' A Qualitative Study of Patients' Experiences of Chronic Leg Ulceration in Primary Healthcare
International Archives of Nursing and Health Care
Patients with chronic leg ulcer experience significant unpleasant physical symptoms, including pain, discomfort, copious wound exudate, malodor, altered body image and inconvenience associated with wearing bulky bandages, impaired functional ability and so-Abstract Purpose: Chronic leg ulceration significantly reduces quality of life because of its chronicity and recurrence. This study aimed to gain deep insight into the experiences of patients living with chronic leg ulcer from their
... rom their perspective. Methods: A qualitative design including in-depth video or audio-recorded interviews, with eight participants in the primary healthcare setting was chosen to provide maximum variation of demographics and ulcer experience. Interviews, lasting up to 60 minutes, were transcribed verbatim, coded according to issues identified by the participants and analysed thematically. Ethical approval was obtained from the relevant Institutional Review Boards. Results: Four interlinked themes were identified: physical impact (pain, discomfort, inconvenience); psychosocial wellbeing (embarrassment, loss of self-esteem, frustration, and depression); family consequences (lack of support, self-blame) and concerns about ulcer progression (unpredictable healing, hope). Conclusions: For the participants, physical impacts, typically pain, were the main concern that 'drives me crazy', suggesting that they were not well managed. They resulted in significant psychosocial issues (including suicidal intent) and other consequences (e.g. relationship issues), of which health professionals might not be aware. Prompt access to holistic multidisciplinary team care and family support in the event of 'emotional crisis' with significant physical impacts could lead to a more positive outlook and improved outcomes. The critical role of cultivating patients' positive psychological resources should never be overlooked or underestimated throughout patients' leg ulcer care journey. Further research on factors specific to Singapore, such as climate and family culture, is recommended to achieve proactive patient centered-care.