Abstract
To describe general practitioners' (GPs') knowledge and the development of their knowledge regarding leg ulcer treatment when treating patients with leg ulceration at primary healthcare centers. Earlier research regarding GPs' knowledge of leg ulcer treatment in a primary healthcare context has focused primarily on the assessment of wounds and knowledge of wound care products. Less is known about GPs' understandings of their own knowledge and knowledge development regarding leg ulceration in the everyday clinical context. This study, therefore, sets out to highlight these aspects from the GPs' perspective. Semi-structured interviews were conducted with 16 individual GPs working at both private and county council run healthcare centers. The data were analyzed inductively using a thematic analysis. Four themes were identified. 'Education and training' describe the GPs' views regarding their knowledge and knowledge development in relation to leg ulcer treatment. 'Experience' refers to GPs' thoughts about the importance of clinical experience when treating leg ulcers. 'Prioritization' describes the issues GPs raised around managing the different knowledge areas in their clinical work. 'Time constraints' explore the relationship between GPs' sense of time pressure and their opportunities to participate in professional development courses. The study shows that the GPs working in primary healthcare are aware of the need for ongoing competence development concerning leg ulceration. They describe their current knowledge of leg ulcer treatment as insufficient and point to the lack of relevant courses that are adapted for their level of knowledge and the limited opportunities for clinical training.
Highlights
Leg ulceration is a chronic and persistent ailment, take years to heal and frequently recur (OMeara et al, 2012)
The general practitioners’ (GPs) highlighted the importance of their initial medical education, mainly because it had provided them with their essential professional knowledge about leg ulcer treatment
The GPs acknowledged that their shortcomings regarding leg ulcer care, in relation to leg ulcer treatment, were due to their basic medical education, which largely focused on other clinical areas, such as internal medicine, surgery and acute medical conditions
Summary
Leg ulceration is a chronic and persistent ailment, take years to heal and frequently recur (OMeara et al, 2012). Managing the treatment of chronic leg ulcers is, a continually evolving process, with frequent introductions of new evidence/research that routinely lead to the development of new treatment methods and products (SBU, 2014; Münter, 2016; Rosenbaum et al, 2018). Given that the elderly are at a much greater risk of developing an active leg ulcer, as the population ages, the number of patients requiring treatment is likely to increase (SBU, 2014). It is, worrying that several studies identify deficiencies in the management of leg ulceration in general practice (Sadler et al, 2006; Templeton and Telford, 2010; Gray et al, 2019). Patients are being treated incorrectly or are being treated without a diagnosis (Weller and Evans, 2012; Sinha and Sreedharan, 2014; Mooij and Huisman, 2016, Gray et al, 2018)
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