Nursing Interventions Aimed at Persons with Venous Ulcers: an Integrative Review

Authors

DOI:

https://doi.org/10.5294/aqui.2020.20.1.7

Keywords:

Varicose ulcer, leg ulcer, nursing care, controlled before-after studies, practical nursing

Abstract

Intervenciones de enfermería dirigidas a las personas con úlceras venosas: una revisión integrativa

Intervenções de Enfermagem dirigidas às pessoas com úlceras varicosas: uma revisão integrativa

Objectives: This work sought to identify and describe the theoretical foundations, components, duration, delivery mode, and results of the nursing interventions aimed at persons with venous ulcers as available in the literature.

Materials and method: Integrative review between 2000 and 2018 in the Pubmed, Ovidnursing, and EBSCOhost electronic databases.

Results: This review includes 16 articles. Most of the interventions were of educational nature; three were developed in the community (through the Leg Club model) and the other ones were delivered by a nursing professional, face to face. The minimum time of duration for these was eight weeks, with telephone follow up. The most-common result variables were venous ulcer healing and reduction of the wound area.

Conclusions: Diversity existed in relation with the components of the interventions and the results expected. Report of the interventions must be reinforced, along with the use of nursing theories that support their design.

Para citar este artículo / To reference this article / Para citar este artigo

Cifuentes JEGuerrero S. Nursing Interventions Aimed at Persons with Venous Ulcers: an Integrative Review. Aquichan. 2020;20(1):e2017. DOI: https://doi.org/10.5294/aqui.2020.20.1.7

Recibido: 10/08/2019

Aceptado: 18/12/2019

Publicado: 13/03/2020

Downloads

Download data is not yet available.

Author Biographies

Johana Enyd Cifuentes Rodriguez, Universidad Nacional de Colombia

Candidata a Doctora en Enfermería,McS Enfermería, Enfermera.  Becaria Asistente Docente Universidad Nacional de Colombia. Bogotá, Colombia.

Miembro STTI - Capítulo Upsilon Nu. Universidad Nacional de Colombia. Comite asuntos academicos

Sandra Guerrero Gamboa, Facultad de Enfermeria. Universidad Nacional de Colombia.

Doctora en Enfermería, Magister Enfermería, Enfermera Enterostomal, Profesora Asociada Facultad Enfermería Universidad Nacional de Colombia. Miembro STTI - Capítulo Upsilon Nu. Universidad Nacional de Colombia

References

Harding K, Dowsett C, Fias L, Jelnes R, Mosti G, Oien R, et al. Simplifying venous leg ulcer management. 2015 [cited 2019 Mar. 20]. Available in: https://www.woundsinternational.com/resources/details/simplifying-venous-leg-ulcer-management-consensus-recommendations

Xie T, Ye J, Rerkasem K, Mani R. The venous ulcer continues to be a clinical challenge: An update. Burn Trauma. [Internet]. 2018;6(18):1-7. DOI: https://doi.org/10.1186/s41038-018-0119-y

Berenguer-Pérez M, López-Casanova P, Sarabia-Lavín R, González de la Torre H, Verdú-Soriano J. Epidemiology of venous leg ulcers in primary health care: Incidence and prevalence in a health centre: A time series study ( 2010-2014 ). Int Wound J. [Internet]. 2019;16(1):256-65. DOI: https://doi.org/10.1111/iwj.13026

González-Consuegra RV, Verdú J. Quality of life in people with venous leg ulcers: An integrative review. J Adv Nurs. [Internet]. 2011;67(5):926-44. DOI: https://doi.org/10.1111/j.1365-2648.2010.05568.x

Finlayson K, Wu M-L, Edwards HE. Identifying risk factors and protective factors for venous leg ulcer recurrence using a theoretical approach: A longitudinal study. Int J Nurs Stud. [Internet]. 2015;52(6):1042-51. DOI: https://doi.org/10.1016/j.ijnurstu.2015.02.016

De Araujo ICF, Yoshida WB, Abbade LPF, Deffune E. The pernicious cycle of VLUs in Brazil: Epidemiology, pathogeny and auxiliary healing methods. J Wound Care. [Internet]. 2013;22(4):186-93. DOI: https://doi.org/10.12968/jowc.2013.22.4.186

Hopkins A. Disrupted lives: Investigating coping strategies for non-healing leg ulcers. Br J Nurs. [Internet]. 2004;13(9):556-63. DOI: https://doi.org/10.12968/bjon.2004.13.9.12972

Green J, Jester R, McKinley R, Pooler A. The impact of chronic venous leg ulcers: A systematic review. J Wound Care. [Internet]. 2014;23(12):601–12. DOI: https://doi.org/10.12968/jowc.2014.23.12.601

Briggs M, Flemming K. Living with leg ulceration: A synthesis of qualitative research. J Adv Nurs. [Internet]. 2007;59(4):319-28. DOI: https://doi.org/10.1111/j.1365-2648.2007.04348.x

Marinel Lo Roura J, Verdú Soriano J. Conferencia Nacional de Consenso sobre las Úlceras de la Extremidad Inferior. 2nd ed. Madrid: Ergon; 2018. 146 p.

Alavi A, Sibbald RG, Phillips TJ, Miller OF, Margolis DJ, Marston W, et al. What’s new: Management of venous leg ulcers treating venous leg ulcers. J Am Acad Dermatol. [Internet]. 2016;74(4):643-64. DOI: https://doi.org/10.1016/j.jaad.2015.03.059

Whittemore R, Knafl K. The integrative review: Updated methodology. J Adv Nurs. [Internet]. 2005;52(5):546-53. DOI: https://doi.org/10.1111/j.1365-2648.2005.03621.x

The Joanna Briggs Institue. New JBI Levels of Evidence [Internet]. New JBI Levels of Evidence. 2013 [cited 2019 Feb. 21]. Available in: http://joannabriggs.org/assets/docs/approach/JBI-Levels-of-evidence_2014.pdf

O’Brien J, Finlayson K, Kerr G, Edwards H. Evaluating the effectiveness of a self-management exercise intervention on wound healing, functional ability and health-related quality of life outcomes in adults with venous leg ulcers: A randomised controlled trial. Int Wound J. [Internet]. 2016;14(1):1-8. DOI: https://doi.org/10.1111/iwj.12571

Brooks J, Ersser SJ, Lloyd A, Ryan TJ. Nurse-led education sets out to improve patient concordance and prevent recurrence of leg ulcers. J Wound Care. [Internet]. 2004;13(3):111-6. DOI: https://doi.org/10.12968/jowc.2004.13.3.26585

Meagher H, Ryan D, Clarke-Moloney M, O’Laighin G, Grace PA. An experimental study of prescribed walking in the management of venous leg ulcers. J Wound Care. [Internet]. 2012;21(9):421-430. DOI: https://doi.org/10.12968/jowc.2012.21.9.421

Domingues E, Oliveira U, Lima MHM. Effectiveness of the strategies of an orientation programme for the lifestyle and wound-healing process in patients with venous ulcer: A randomised controlled trial. Int Wound J. [Internet]. 2018;15(5):798-806. DOI: https://doi.org/10.1111/iwj.12930

O’Brien J, Edwards H, Stewart I, Gibbs H. A home-based progressive resistance exercise programme for patients with venous leg ulcers: A feasibility study. Int Wound J. [Internet]. 2012;10(4):389–96. DOI: https://doi.org/10.1111/j.1742-481X.2012.00995.x

Jull A, Parag V, Walker N, Maddison R, Kerse N, Johns T. The PREPARE pilot RCT of home-based progressive resistance exercises for venous leg ulcers. J Wound Care. [Internet]. 2009;18(2):497–503. DOI: https://doi.org/10.12968/jowc.2009.18.12.45606

González A. Education project to improve venous stasis self-management knowledge. J Wound Ostomy Cont Nurs. [Internet]. 2014;41(6):556-9. DOI: https://doi.org/10.1097/WON.0000000000000088

Kelechi TJ, Mueller M, Spencer C, Rinard B, Loftis G. The effect of a nurse-directed intervention to reduce pain and improve behavioral and physical outcomes in patients with critically colonized/infected chronic leg ulcers. J Wound, Ostomy Cont Nurs. [Internet]. 2014;41(2):111-21. DOI: https://doi.org/10.1097/WON.0000000000000009

Heinen M, Borm G, Van der Vleuten C, Evers A, Oostendorp R, Van Achterberg T. The Lively Legs self-management programme increased physical activity and reduced wound days in leg ulcer patients: Results from a randomized controlled trial. Int J Nurs Stud. [Internet]. 2012;49(2):151-61. DOI: https://doi.org/10.1016/j.ijnurstu.2011.09.005

Kapp S, Miller C, Sayers V, Donohue L. The Leg Ulcer Prevention Program: effectiveness of a multimedia client education package for people with venous leg ulcers. Wound Pract Res [Internet]. 2010 May [cited 2019 Mar. 20];18(2):80. Available in: https://search.informit.com.au/documentSummary;dn=174647821217129;res=IELHEA

Van Hecke A, Grypdonck M, Beele H, Vanderwee K, Defloor T. Adherence to leg ulcer lifestyle advice: Qualitative and quantitative outcomes associated with a nurse-led intervention. J Clin Nurs. [Internet]. 2011;20(3-4):429-43. DOI: https://doi.org/10.1111/j.1365-2702.2010.03546.x

Finlayson KJ, Courtney MD, Gibb MA, O’Brien JA, Parker CN, Edwards HE. The effectiveness of a four-layer compression bandage system in comparison with Class 3 compression hosiery on healing and quality of life in patients with venous leg ulcers: A randomised controlled trial. Int Wound J. [Internet]. 2012;11(1):21-7. DOI: https://doi.org/10.1111/j.1742-481X.2012.01033.x

Wong IKY, Andriessen A, Charles HE, Thompson D, Lee DTF, So WKW, et al. Randomized controlled trial comparing treatment outcome of two compression bandaging systems and standard care without compression in patients with venous leg ulcers. J Eur Acad Dermatology Venereol. [Internet]. 2012;26(1):102-10. DOI: https://doi.org/10.1111/j.1468-3083.2011.04327.x

Edwards H, Courtney M, Finlayson K, Shuter P, Lindsay E. A randomised controlled trial of a community nursing intervention: Improved quality of life and healing for clients with chronic leg ulcers. J Clin Nurs. [Internet]. 2009;18(11):1541-9. DOI: https://doi.org/10.1111/j.1365-2702.2008.02648.x

Edwards H, Courtney M, Finlayson K, Lewis C, Lindsay E, Dumble J. Improved healing rates for chronic venous leg ulcers: Pilot study results from a randomized controlled trial of a community nursing intervention. Int J Nurs Pract. [Internet]. 2005;11(4):169–76. DOI: https://doi.org/10.1111/j.1440-172X.2005.00521.x

Edwards H, Kathleen F, Lindsay E, Patricia S, Allan C. Chronic Venous leg ulcers: Effect of a community nursing intervention on pain and healing. Nurs Stand. [Internet]. 2005;19(52):47-54. DOI: https://doi.org/10.7748/ns2005.09.19.52.47.c3950

Hoffmann TC, Glasziou PP, Barbour V, Macdonald H. Better reporting of interventions: Template for intervention description and replication (TIDieR) checklist and guide. Br Med J. [Internet]. 2014 Mar.;1-12. DOI: https://doi.org/10.1136/bmj.g1687

Meleis AI. Theoretical Nursing: Development and Progress. 5th Edit. Journal of Neuroscience Nursing. Wolters Kluwer Health. Lippincott Williams & Wilkins; 2012. 690 p.

Lindsay E. Lindsay leg clubs: Clinically effective, cost effective. J Community Nurs. [Internet] 2013 [cited 2019 Feb. 18];27(1):5-8. Available in: https://www.jcn.co.uk/journal/01-2013/wound-management/1529-lindsay-leg-clubs--clinically-effective--cost-effective/

Upton D, Upton P, Alexander R. Contribution of the Leg Club model of care to the well-being of people living with chronic wounds. J Wound Care [Internet]. 2015;24(9):397-405. DOI: https://doi.org/10.12968/jowc.2015.24.9.397

Lindsay E. Leg Clubs®: a clinically and cost-effective approach to lower limb management. Br J Community Nurs. [Internet]. 2014;15(Sup4:S16-23). DOI: https://doi.org/10.12968/bjcn.2010.15.Sup4.48379

Lindsay E. The Lindsay Leg Club Model: A model for evidence-based leg ulcer management. Br J Community Nurs. [Internet]. 2014; (Supplement: S15-20). DOI: https://doi.org/10.12968/bjcn.2004.9.Sup2.13128

Zajkowski PJÃ, Draper T, Bloom JÃ, Henke PKÃ, Wakefield TWÃ. Exercise with compression stockings improves reflux in patients with mild chronic venous insufficiency. Phlebology. [Internet]. 2006;21(2):9-13. DOI: https://doi.org/10.1258/026835506777304764

Araujo D, Riberiro C, Maciel A, Bruno S, Freonezi G, FAL D. Physical exercise for the treatment of non-ulcerated chronic venous insufficiency (review). Cochrane Database Syst Rev. [Internet]. 2016;3(12):1-35. DOI: https://doi.org/10.1002/14651858.CD010637.pub2

Orr L, Klement KA, Mccrossin L, Drombolis DO, Houghton PE, Spaulding S, et al. A systematic review and meta-analysis of exercise intervention for the treatment of calf muscle pump impairment in individuals with chronic venous insufficiency. Ostomy Wound Manag. [Internet]. 2017; 63(8):30-43. DOI: https://doi.org/10.25270/owm.2017.08.3043

Partsch H. Compression therapy in leg ulcers. Rev Vasc Med [Internet]. 2013;1(1):9-14. DOI: https://doi.org/10.1016/j.rvm.2013.02.001

O’Donnell TF, Passman MA, Marston WA, Ennis WJ, Dalsing M, Kistner RL, et al. Management of venous leg ulcers: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. [Internet]. 2014;60(2):3S-59S. DOI: https://doi.org/10.1016/j.ejvs.2015.02.007

Raphael D, Waterworth S, Gott M. Telephone communication between practice nurses and older patients with long term conditions: a systematic review. J Telemed Telecare. [Internet]. 2017;23(1):142-8. DOI: https://doi.org/10.1177/1357633X15625398

Inglis SC, Clark RA, Cleland JG, McAlister F, Stewart S, Cleland J. Structured telephone support or telemonitoring programs for patients with chronic heart failure. Cochrane Database Syst Rev. [Internet]. 2010;(8):147. DOI: https://doi.org/10.1002/14651858.CD007228.pub2

Choi NG, Dinitto DM. The digital divide among low-income homebound older adults: Internet use patterns, ehealth literacy, and attitudes toward computer/internet use. J Med Internet Res. [Internet]. 2013;15(5):1-16. DOI: https://doi.org/10.2196/jmir.2645

Korda H, Itani Z. Harnessing social media for health promotion and behavior change. Health Promot Pract. 2013;14(1):15-23. DOI: https://doi.org/10.1177/1524839911405850

Segal J, Sacopulos M, Sheets V, Thurston I, Brooks K, Puccia R. Online doctor reviews: Do they track surgeon volume, a proxy for quality of care? J Med Internet Res. [Internet]. 2005;14(2):e50. DOI: https://doi.org/10.2196/jmir.2005

Skavberg Roaldsen K, Biguet G, Elfving B. Physical activity in patients with venous leg ulcer - between engagement and avoidance. A patient perspective. Clin Rehabil [Internet]. 2011;25(3):275-86. DOI: https://doi.org/10.1177/0269215510371424

Poku E, Aber A, Phillips P, Essat M, Buckley H, Palfreyman S, et al. Systematic review assessing the measurement properties of patient-reported outcomes for venous leg ulcers. BJS Open. [Internet]. 2017;1(5):138-47. DOI: https://doi.org/10.1002/bjs5.25

Walburn J, Vedhara K, Hankins M, Rixon L, Weinman J. Psychological stress and wound healing in humans: A systematic review and meta-analysis. J Psychosom Res. [Internet]. 2009;67(3):253-71. DOI: https://doi.org/10.1016/j.jpsychores.2009.04.002

Vegas O, VanBuskirk J, Richardson S, Parfitt D, Helmreich D, Rempel M, et al. Effects of psychological stress and housing conditions on the delay of wound healing. Psicothema. [Internet]. 2012;24(4):581-6. DOI: https://doi.org/10.1016/j.bbi.2008.04.043

Glaser R, Kiecolt-Glaser JK, Marucha PT, MacCallum RC, Laskowski BF, Malarkey WB. Stress-related changes in proinflammatory cytokine production in wounds. Arch Gen Psychiatry. [Internet]. 1999;56(5):450-6. DOI: https://doi.org/10.1001/archpsyc.56.5.450

Pieper B, Szczepaniak K, Templin T. Psychosocial adjustment, coping, and quality of life in persons with venous ulcers and a history of intravenous drug use. J Wound, Ostomy, Cont Nurs. [Internet]. 2000;27(4):227-37. DOI: https://doi.org/10.1067/mjw.2000.107877

Upton D, Solowiej K. Pain and stress as contributors to delayed wound healing. Wound Pract Res [Internet]. 2010 ausgust [cited 2019 Mar. 28];18(3):114-22. Available: https://search.informit.com.au/documentSummary;dn=364536431309445;res=IELHEA

Finlayson K, Miaskowski C, Alexander K, Liu W-H, Aouizerat B, Parker C, et al. Distinct wound healing and quality of life outcomes in subgroups of patients with venous leg ulcers with different symptom cluster experiences. J Pain Symptom Manage. [Internet]. 2017;53(5):871-9. DOI: https://doi.org/10.1016/j.jpainsymman.2016.12.336

Published

2020-03-13

How to Cite

Cifuentes Rodriguez, J. E., & Guerrero Gamboa, S. (2020). Nursing Interventions Aimed at Persons with Venous Ulcers: an Integrative Review. Aquichan, 20(1), e2017. https://doi.org/10.5294/aqui.2020.20.1.7

Issue

Section

Articles