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How evidence-based is venous leg ulcer care ? A survey in community settings.

Ann Van Hecke (UGent), Maria Grypdonck (UGent), Hilde Beele (UGent), Dirk De Bacquer (UGent) and Tom Defloor (UGent)
(2009) Journal of Advanced Nursing. 65(2). p.337-347
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Abstract
Incongruence between evidence and practice in leg ulcer care has been reported. Little is known about predictive factors related to the provision of lifestyle advice. Two focus interviews and a Delphi procedure were used to develop a self-administered questionnaire based on the Graham questionnaire. Nurses employed by community healthcare organizations and independent nurses in private practices participated (n = 789). The data were collected in 2006. Compression was applied in 58.7% of patients with venous ulcers. Pain was present in 82.9%. A third of patients with pain received analgesics, but half of these patients (52.1%) took analgesics as prescribed. Half of the nurses (50.8%) gave lifestyle advice related to the leg ulcer. It was mainly instructions about leg elevation (68.3%), promoting physical activity (39.8%) and optimizing nutrition (16.7%) that were provided. Nurses who perceived themselves to have adequate leg ulcer knowledge and skills were 3.75 times more likely to provide lifestyle advice compared with those lacking such knowledge and skills. Nurses who found leg ulcer care not rewarding, rarely successful or difficult gave statistically significantly less lifestyle advice than those who found it rather rewarding, successful and not difficult. Patients with leg ulcers receive less than optimum care and patient education. A particular challenge lies in leg ulcer education programmes and pain management.
Keywords
nursing, patient education, leg ulcers, community, evidence-base, questionnaire, survey

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Chicago
Van Hecke, Ann, Maria Grypdonck, Hilde Beele, Dirk De Bacquer, and Tom Defloor. 2009. “How Evidence-based Is Venous Leg Ulcer Care ? A Survey in Community Settings.” Journal of Advanced Nursing 65 (2): 337–347.
APA
Van Hecke, A., Grypdonck, M., Beele, H., De Bacquer, D., & Defloor, T. (2009). How evidence-based is venous leg ulcer care ? A survey in community settings. Journal of Advanced Nursing, 65(2), 337–347.
Vancouver
1.
Van Hecke A, Grypdonck M, Beele H, De Bacquer D, Defloor T. How evidence-based is venous leg ulcer care ? A survey in community settings. Journal of Advanced Nursing. Oxford: Blackwell; 2009;65(2):337–47.
MLA
Van Hecke, Ann, Maria Grypdonck, Hilde Beele, et al. “How Evidence-based Is Venous Leg Ulcer Care ? A Survey in Community Settings.” Journal of Advanced Nursing 65.2 (2009): 337–347. Print.
@article{624449,
  abstract     = {Incongruence between evidence and practice in leg ulcer care has been reported. Little is known about predictive factors related to the provision of lifestyle advice.

Two focus interviews and a Delphi procedure were used to develop a self-administered questionnaire based on the Graham questionnaire. Nurses employed by community healthcare organizations and independent nurses in private practices participated (n = 789). The data were collected in 2006.

Compression was applied in 58.7\% of patients with venous ulcers. Pain was present in 82.9\%. A third of patients with pain received analgesics, but half of these patients (52.1\%) took analgesics as prescribed. Half of the nurses (50.8\%) gave lifestyle advice related to the leg ulcer. It was mainly instructions about leg elevation (68.3\%), promoting physical activity (39.8\%) and optimizing nutrition (16.7\%) that were provided. Nurses who perceived themselves to have adequate leg ulcer knowledge and skills were 3.75 times more likely to provide lifestyle advice compared with those lacking such knowledge and skills. Nurses who found leg ulcer care not rewarding, rarely successful or difficult gave statistically significantly less lifestyle advice than those who found it rather rewarding, successful and not difficult.

Patients with leg ulcers receive less than optimum care and patient education. A particular challenge lies in leg ulcer education programmes and pain management.},
  author       = {Van Hecke, Ann and Grypdonck, Maria and Beele, Hilde and De Bacquer, Dirk and Defloor, Tom},
  issn         = {0309-2402},
  journal      = {Journal of Advanced Nursing},
  keyword      = {nursing,patient education,leg ulcers,community,evidence-base,questionnaire,survey},
  language     = {eng},
  number       = {2},
  pages        = {337--347},
  publisher    = {Blackwell},
  title        = {How evidence-based is venous leg ulcer care ? A survey in community settings.},
  url          = {http://dx.doi.org/10.1111/j.1365-2648.2008.04871.x},
  volume       = {65},
  year         = {2009},
}

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