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The impact of psychosocial factors on adherence to compression therapy to prevent recurrence of venous leg ulcers

Finlayson, Kathleen J., Edwards, Helen E., & Courtney, Mary D. (2010) The impact of psychosocial factors on adherence to compression therapy to prevent recurrence of venous leg ulcers. Journal of Clinical Nursing, 19(9-10), pp. 1289-1297.

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    Abstract

    Aims To identify self-care activities undertaken and determine relationships between self-efficacy, depression, quality of life, social support and adherence to compression therapy in a sample of patients with chronic venous insufficiency. Background Up to 70% of venous leg ulcers recur after healing. Compression hosiery is a primary strategy to prevent recurrence, however, problems with adherence to this strategy are well documented and an improved understanding of how psychosocial factors influence patients with chronic venous insufficiency will help guide effective preventive strategies. Design Cross-sectional survey and retrospective medical record review. Method All patients previously diagnosed with a venous leg ulcer which healed between 12–36 months prior to the study were invited to participate. Data on health, psychosocial variables and self-care activities were obtained from a self-report survey and data on medical and previous ulcer history were obtained from medical records. Multiple linear regression modelling was used to determine the independent influences of psychosocial factors on adherence to compression therapy. Results In a sample of 122 participants, the most frequently identified self-care activities were application of topical skin treatments, wearing compression hosiery and covering legs to prevent trauma. Compression hosiery was worn for a median of 4 days/week (range 0–7). After adjustment for all variables and potential confounders in a multivariable regression model, wearing compression hosiery was found to be significantly positively associated with participants’ knowledge of the cause of their condition (p=0.002), higher self-efficacy scores (p=0.026) and lower depression scores (p=0.009). Conclusion In this sample, depression, self-efficacy and knowledge were found to be significantly related to adherence to compression therapy. Relevance to clinical practice These findings support the need to screen for and treat depression in this population. In addition, strategies to improve patient knowledge and self-efficacy may positively influence adherence to compression therapy.

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    18 citations in Scopus
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    14 citations in Web of Science®

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    ID Code: 34361
    Item Type: Journal Article
    Keywords: venous leg ulcers, compression , adherence, psychosocial
    DOI: 10.1111/j.1365-2702.2009.03151.x
    ISSN: 1365-2702
    Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Clinical Nursing - Primary (Preventative) (111002)
    Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > OTHER MEDICAL AND HEALTH SCIENCES (119900) > Medical and Health Sciences not elsewhere classified (119999)
    Divisions: Current > Research Centres > Centre for Health Research
    Current > QUT Faculties and Divisions > Faculty of Health
    Current > Institutes > Institute of Health and Biomedical Innovation
    Current > Schools > School of Nursing
    Copyright Owner: Copyright 2010 Blackwell Publishing Ltd
    Deposited On: 08 Sep 2010 08:03
    Last Modified: 01 Mar 2012 00:20

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