Abstract
Background: Venous leg ulcers (VLUs), the most common type of leg ulcerations, have long healing times and high recurrence rates; reimbursement rules and a general shortage of nursing staff have put self-treatment into focus. The study aimed to investigate why and how patients with VLUs self-treat their ulcers. Methods: Patients with VLUs (N = 32) were selected by criterion sampling for a multicentric qualitative study using semi-structured interviews. The interviews were analyzed via inductive qualitative content analysis. Results: More than two-thirds of participants sometimes self-treated VLU and one quarter changed their prescribed treatment. Experiences were expressed through four themes as follows: (a) current local VLU therapy; (b) VLU self-treatment; (c) patient education; and (d) psychosocial issues. The main reasons for self-treatment were a lack of healthcare resources, reimbursement restrictions, and dissatisfaction with conventional treatment together with insufficient knowledge about the wound-healing process and possible side effects. No educational materials were provided for patients or caregivers. Many patients adopted homemade remedies. Conclusion: Patients with VLUs practice self-care due to limited healthcare availability, a low awareness of the causes of their condition, and the effects of therapy on VLU healing. Future educational intervention is needed to enhance self-treatment.
Highlights
A venous leg ulcer (VLU) is an open skin lesion that usually occurs on the medial side of the lower leg between the ankle and the knee as a result of chronic venous insufficiency (CVI) and ambulatory venous hypertension, and that shows little progress towards healing within 4–6 weeks of initial occurrence [1]
Of the whole population, and 3% of those >80 years old, in Westernized countries [2]. In addition to their long healing time, the 12-month recurrence rate of VLUs ranges from 18% to 28% [3]
VLUs can be treated by general practitioners, home-care or community nurses, hospital wards, and specialized clinics
Summary
A venous leg ulcer (VLU) is an open skin lesion that usually occurs on the medial side of the lower leg between the ankle and the knee as a result of chronic venous insufficiency (CVI) and ambulatory venous hypertension, and that shows little progress towards healing within 4–6 weeks of initial occurrence [1]. Several researchers have found that improved compliance leads to enhanced diagnostic effectiveness and disease treatment, with considerable economic benefits [17,18] These days, the patient—health care provider relationship has a wide scope, ranging from compliance [19,20,21] to concordance, as a shared decision-making process [22,23]. Quality health knowledge contributes to increased awareness of health care, which improves patients’ self-care abilities and helps them avoid unhealthy behaviors and adopt healthy lifestyles Specific patient characteristics, such as educational level, occupation, rural/urban residence, and region of residence, are associated with knowledge of chronic diseases and the development of self-management behaviors [26,27,28,29,30,31]. Self-treaters in this study were considered as patients who had VLUs and changed their wound dressings by themselves, on a regular or irregular basis, whether they were following the prescribed treatment or were changing it
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