Relationships between preventive activities, psychosocial factors and recurrence of venous leg ulcers: a prospective study
Article first published online: 26 APR 2011
© 2011 Blackwell Publishing Ltd
Journal of Advanced Nursing
Volume 67, Issue 10, pages 2180–2190, October 2011
How to Cite
Finlayson, K., Edwards, H. and Courtney, M. (2011), Relationships between preventive activities, psychosocial factors and recurrence of venous leg ulcers: a prospective study. Journal of Advanced Nursing, 67: 2180–2190. doi: 10.1111/j.1365-2648.2011.05653.x
- Issue published online: 7 SEP 2011
- Article first published online: 26 APR 2011
- Accepted for publication 5 February 2011
- chronic disease;
- venous leg ulcers
finlayson k., edwards h. & courtney m. (2011) Relationships between preventive activities, psychosocial factors and recurrence of venous leg ulcers: a prospective study. Journal of Advanced Nursing 67(9), 2180–2190.
Aim. The aim of this study was to identify relationships between preventive activities, psychosocial factors and leg ulcer recurrence in patients with chronic venous leg ulcers.
Background. Chronic venous leg ulcers are slow to heal and frequently recur, resulting in years of suffering and intensive use of healthcare resources.
Methods. A prospective longitudinal study was undertaken with a sample of 80 patients with a venous leg ulcer recruited when their ulcer healed. Data were collected from 2006 to 2009 from medical records on demographics, medical history and ulcer history; and from self-report questionnaires on physical activity, nutrition, preventive activities and psychosocial measures. Follow-up data were collected via questionnaires every 3 months for 12 months after healing. Median time to recurrence was calculated using the Kaplan–Meier method. A Cox proportional-hazards regression model was used to adjust for potential confounders and determine effects of preventive strategies and psychosocial factors on recurrence.
Results. There were 35 recurrences in a sample of 80 participants. Median time to recurrence was 27 weeks. After adjustment for potential confounders, a Cox proportional hazards regression model found that at least an hour/day of leg elevation, 6 or more days/week in Class 2 (20–25 mmHg) or 3 (30–40 mmHg) compression hosiery, higher social support scale scores and higher General Self-Efficacy scores remained significantly associated (P < 0·05) with a lower risk of recurrence, while male gender and a history of deep vein thrombosis remained statistically significant risk factors for recurrence.
Conclusion. Results indicate that leg elevation, compression hosiery, high levels of self-efficacy and strong social support will help prevent recurrence.