Kathleen Finlayson1, Helen Edwards, Mary Courtney. 1. Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, Queensland 4059, Australia. k.finlayson@qut.edu.au
Abstract
BACKGROUND: Chronic venous leg ulcers have a significant impact on older individuals' well-being and health care resources. Unfortunately after healing, up to 70% recur. OBJECTIVE: To examine the relationships between leg ulcer recurrence and physical activity, compression, nutrition, health, psychosocial indicators and self-care activities in order to provide information for preventive strategies. DESIGN: Survey and retrospective chart review. SETTINGS: Two metropolitan hospital and three community-based leg ulcer clinics. SUBJECTS: A sample of 122 community living patients with leg ulcer of venous aetiology which had healed between 12 and 36 months prior to the survey. METHODS: Data were collected from medical records on demographics, medical history and previous ulcer history and treatments; and from self-report questionnaires on physical activity, nutrition, psychosocial measures, ulcer recurrences and history, compression and other self-care activities. All variables clinically or statistically significantly associated with recurrence at the bivariate level were entered into a logistic regression model to determine their independent influences on recurrence. RESULTS: Median follow-up time was 24 months (range 12-40 months). Sixty-eight percent of participants had recurred. Bivariate analysis found recurrence was positively associated with ulcer duration, cardiac disease, a body mass index< or =20, scoring as at risk of malnutrition and depression; and negatively associated with increased physical activity, leg elevation, wearing Class 2 (20-25 mmHg) or Class 3 (30-40 mmHg) compression hosiery, and higher self-efficacy scores. After adjusting for all variables, an h/day of leg elevation (OR=0.04, 95% CI=0.01-0.17), days/week in Class 2 or 3 compression hosiery (OR=0.53, 95% CI=0.34-0.81), Yale Physical Activity Survey score (OR=0.95, 95% CI=0.92-0.98), cardiac disease (OR=5.03, 95% CI=1.01-24.93) and General Self-efficacy scores (OR=0.83, 95% CI=0.72-0.94) remained significantly associated (p<0.05) with recurrence. CONCLUSIONS: Results indicate a history of cardiac disease is a risk factor for recurrence; while leg elevation, physical activity, compression hosiery and strategies to improve self-efficacy are likely to prevent recurrence.
BACKGROUND:Chronic venous leg ulcers have a significant impact on older individuals' well-being and health care resources. Unfortunately after healing, up to 70% recur. OBJECTIVE: To examine the relationships between leg ulcer recurrence and physical activity, compression, nutrition, health, psychosocial indicators and self-care activities in order to provide information for preventive strategies. DESIGN: Survey and retrospective chart review. SETTINGS: Two metropolitan hospital and three community-based leg ulcer clinics. SUBJECTS: A sample of 122 community living patients with leg ulcer of venous aetiology which had healed between 12 and 36 months prior to the survey. METHODS: Data were collected from medical records on demographics, medical history and previous ulcer history and treatments; and from self-report questionnaires on physical activity, nutrition, psychosocial measures, ulcer recurrences and history, compression and other self-care activities. All variables clinically or statistically significantly associated with recurrence at the bivariate level were entered into a logistic regression model to determine their independent influences on recurrence. RESULTS: Median follow-up time was 24 months (range 12-40 months). Sixty-eight percent of participants had recurred. Bivariate analysis found recurrence was positively associated with ulcer duration, cardiac disease, a body mass index< or =20, scoring as at risk of malnutrition and depression; and negatively associated with increased physical activity, leg elevation, wearing Class 2 (20-25 mmHg) or Class 3 (30-40 mmHg) compression hosiery, and higher self-efficacy scores. After adjusting for all variables, an h/day of leg elevation (OR=0.04, 95% CI=0.01-0.17), days/week in Class 2 or 3 compression hosiery (OR=0.53, 95% CI=0.34-0.81), Yale Physical Activity Survey score (OR=0.95, 95% CI=0.92-0.98), cardiac disease (OR=5.03, 95% CI=1.01-24.93) and General Self-efficacy scores (OR=0.83, 95% CI=0.72-0.94) remained significantly associated (p<0.05) with recurrence. CONCLUSIONS: Results indicate a history of cardiac disease is a risk factor for recurrence; while leg elevation, physical activity, compression hosiery and strategies to improve self-efficacy are likely to prevent recurrence.
Authors: Carolina D Weller; Elizabeth E Gardiner; Jane F Arthur; Melissa Southey; Robert K Andrews Journal: Int Wound J Date: 2019-03-12 Impact factor: 3.315
Authors: Sue Kesterton; Helen J Crank; Garry A Tew; Jonathan Michaels; Anil Gumber; Emma McIntosh; Brenda King; Markos Klonizakis Journal: Int Wound J Date: 2019-10-13 Impact factor: 3.315