Quality of Life and Strategies of Coping with Disease in Patients with Chronic Leg Ulcers

Abstract

Background: One of the most innovative approaches in dermatology is the use of disease-specific quality of life (QoL) measures in outcome research. Especially in diseases with a high chronicity, such as leg ulcers, studies including psychological outcome measures are indispensible. Further-more, dermatologic studies have neglected to examine other psychosocial parameters influencing self-reported QoL. Objective: The aim of this study was to determine in patients with chronic leg ulcers whether there are subjective well-being changes during inpatient treatment and what kinds of factors are associated with self-reported QoL. Methods: 81 inpatients with chronic leg ulcers of venous and mixed venous-arterial etiology were investigated at the beginning and at the end of inpatient treatment by two instruments: 1) a generic health status measure, the Nottingham Health Profile (NHP), and 2) a disease-specific QoL-instrument, the Freiburg Questionnaire of QoL in venous diseases (FLQA). Coping strategies and social support were assessed as well. Results: Quality of life was markedly impaired in ulcer patients who were high in comorbidity and who reported having no support available. Most QoL areas improved significantly during inpatient treatment. However, it was possible to predict some areas of QoL by the way patients coped with their disease. Conclusions: This study shows the effects of inpatient treatment on QoL areas, but also points to limitations which should be accounted for when using self-report QoL instruments as outcome measures in dermatology.