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Dhar A, Needham J, Gibb M, Coyne E. The client and family experience of attending a nurse-led clinic for chronic wounds. Aust J Prim Health 2024; 30:NULL. [PMID: 37925745 DOI: 10.1071/py23081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 10/10/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND The quality of life for individuals with chronic wounds is diminished due to poor health-related outcomes and the financial burden of wound care. The literature has shown nurse-led wound care to have a positive impact on wound healing and psychosocial wellbeing. However, there is minimal research investigating the lived experience of attending a nurse-led clinic for chronic wounds. The purpose of this study was to explore the client and family experience of attending a nurse-led clinic for chronic wounds. METHODS Qualitative descriptive study. Semi-structured telephone interviews were transcribed verbatim and thematic analysis was undertaken. RESULTS Twelve clients and two family members participated, and the average length of interviews was 20min. Three main themes emerged: (1) expecting and managing pain; (2) receiving expert advice and reflecting on previous care; and (3) managing the cost of care. There was an emphasis on the impact of chronic wounds on pain and the ability to complete the activities of daily living. Expert advice, client satisfaction and physical accessibility were highlighted as benefits of the clinic. Cost and minimal client education were identified as challenges of the clinic. CONCLUSIONS The findings demonstrated that chronic wounds have a significant impact on the client and family attending the nurse-led clinic. Comprehensive pain assessment, improved social support, better client education and cost-effective care is required to optimise the experience for people attending the nurse-led clinic.
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Affiliation(s)
- Anusuya Dhar
- Griffith University, School of Nursing and Midwifery, Logan campus, Meadowbrook, Qld 4131, Australia
| | - Judith Needham
- Griffith University, School of Nursing and Midwifery, Logan campus, Meadowbrook, Qld 4131, Australia
| | - Michelle Gibb
- Wound Specialist Services Pty Ltd, Brisbane, Qld 4000, Australia
| | - Elisabeth Coyne
- Griffith University, School of Nursing and Midwifery, Logan campus, Meadowbrook, Qld 4131, Australia
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Social networks and their impact on access to health care: insights from older widows living alone in Kottayam, South India. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21001100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
The feminisation of ageing observed across the world is a significant challenge in many societies. Women's greater longevity is associated with the increased likelihood of age-related disability and morbidity. Furthermore, gendered disadvantage and poverty can make access to health care increasingly problematic in later years. Among the Indian states, Kerala has the highest number of residents above the age of 60 and many are older widows. Given this context, this paper explores what promotes access to health care for older widows living alone in the south Indian state of Kerala. Thirty-two in-depth interviews, eight focus group discussions and eight units of participant observation were carried out among widows, health-care providers and key informants. Applying a reflexive inductive approach to our analysis, the main barriers to access that emerged were altered family structures and loneliness, whilst enablers included good social networks and access to neighbourhood clinics. Our participants’ social networks were drawn from three levels: family, neighbourhood and the wider community. The ability to form a personal community from their social networks and the quality of relationships within this community strongly predicted the capacity to access health care. Efforts to improve access to health care for older widows requires a response that is rooted in the socio-cultural context of the community. Comprehensive social protection policies that promote initiatives to engender social capital among the older population, decentralised primary health-care services, and the training and sensitisation of health service staff would be key to promote equitable access for older widows.
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Klein TM, Andrees V, Kirsten N, Protz K, Augustin M, Blome C. Social participation of people with chronic wounds: A systematic review. Int Wound J 2021; 18:287-311. [PMID: 33314686 PMCID: PMC8244007 DOI: 10.1111/iwj.13533] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/18/2020] [Accepted: 11/24/2020] [Indexed: 12/16/2022] Open
Abstract
Living with chronic ulcers can be burdensome and restrictive, with regard to not only physical and psychological but also social well-being. This review aims to analyse social participation in patients with chronic wounds and to compare results across different wound types. A search string was applied in several electronic databases. Results were screened according to predefined inclusion and exclusion criteria. Data of eligible articles were extracted and synthesised narratively. The search revealed 42 eligible publications. Only minor differences across different ulcer types could be detected. Overall, family members were the main social contacts for patients; they often provided wound care and emotional support. Patients had few non-family relations, but those existing were often very close. Patients felt guilty as their condition imposed burden on family and friends, as well. A close relationship with nurses was described. Restrictions were caused by direct and indirect consequences of the wound. Overall, social support and social connections were reduced in wound patients. Inconsistent results were found regarding social isolation. In summary, people with chronic wounds experience impairments in all aspects of social participation. Therefore, social participation deserves increased attention in routine care both as a trigger of burden and as an outcome of therapy.
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Affiliation(s)
- Toni Maria Klein
- Institute for Health Services Research in Dermatology and Nursing (IVDP)University Medical Center Hamburg‐EppendorfHamburgGermany
| | - Valerie Andrees
- Institute for Health Services Research in Dermatology and Nursing (IVDP)University Medical Center Hamburg‐EppendorfHamburgGermany
| | - Natalia Kirsten
- Institute for Health Services Research in Dermatology and Nursing (IVDP)University Medical Center Hamburg‐EppendorfHamburgGermany
| | - Kerstin Protz
- Institute for Health Services Research in Dermatology and Nursing (IVDP)University Medical Center Hamburg‐EppendorfHamburgGermany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP)University Medical Center Hamburg‐EppendorfHamburgGermany
| | - Christine Blome
- Institute for Health Services Research in Dermatology and Nursing (IVDP)University Medical Center Hamburg‐EppendorfHamburgGermany
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McIntyre N, Galazka AM, Lindsay E, Bawden R, Renyi R. A relational database within the Leg Club Network: an audit. Int Wound J 2021; 18:233-241. [PMID: 33236851 PMCID: PMC8244080 DOI: 10.1111/iwj.13522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 01/11/2023] Open
Abstract
The growing prevalence of venous leg ulcers in an ageing population presents challenges for wound care and management. The Lindsay Leg Club model is an alternative approach to the management of leg health that can improve patient outcomes. This article reports on an audit of a relational database located within the Leg Club Network, containing records of more than 17 000 patients (known as members) who attended a Leg Club in a 5-year period (2014-2019). Overall, over 266 000 member leg assessments and treatments were entered into the database. The average nurse-member attendance time was 28 min, with a skill mix of 23% senior nurses, 70% qualified and associate nurses, and 7% nurses in supervisory roles. Healing rates averaged 62% after 12 weeks. Recurrence rates were 20% after 12 weeks. Annual clinical and volunteer hours averaged 821 and 800 h, respectively. Staffing costs were £28 per wound treatment or leg assessment with a typical duration of 27 min; 71% of members were aged 70 to 94 years old, which indicates the need for a service that caters to the specific requirements of this age group. However, no data on psychosocial and well-being outcomes were recorded. Their inclusion in further developments of this database is recommended.
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Affiliation(s)
| | - Anna Milena Galazka
- Post‐doctoral research consultant, Welsh Wound Innovation CentrePontyclun in collaboration with Cardiff Business School, Cardiff UniversityCardiffUK
- Cardiff Business SchoolCardiff UniversityCardiffUK
- Independent Specialist PractitionerThe Lindsay Leg Club FoundationIpswichUK
- Present address:
Senior Lecturer in Leadership/Organisational Behaviour, Liverpool Business SchoolLiverpool John Moores UniversityLiverpoolUK
| | - Ellie Lindsay
- Independent Specialist PractitionerThe Lindsay Leg Club FoundationIpswichUK
- Visiting FellowQueensland University of TechnologyBrisbaneQueenslandAustralia
- Associate LecturerCRICPLondonUK
| | | | - Roland Renyi
- Retired chairmanThe Lindsay Leg Club FoundationIpswichUK
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Cifuentes Rodriguez JE, Guerrero Gamboa S. Nursing Interventions Aimed at Persons with Venous Ulcers: an Integrative Review. AQUICHAN 2020. [DOI: 10.5294/aqui.2020.20.1.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
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.
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Isoherranen K, O'Brien JJ, Barker J, Dissemond J, Hafner J, Jemec GBE, Kamarachev J, Läuchli S, Montero EC, Nobbe S, Sunderkötter C, Velasco ML. Atypical wounds. Best clinical practice and challenges. J Wound Care 2019; 28:S1-S92. [DOI: 10.12968/jowc.2019.28.sup6.s1] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Kirsi Isoherranen
- Helsinki University Central Hospital and Helsinki University, Wound Healing Centre and Dermatology Clinic, Helsinki, Finland
| | | | - Judith Barker
- Nurse Practitioner - Wound Management, Rehabilitation, Aged and Community Care., Adjunct Associate Professor, University of Canberra, Canberra, Australia
| | - Joachim Dissemond
- University Hospital of Essen, Department of Dermatology, Venerology and Allergology, Hufelandstraße 55, Essen, Germany
| | - Jürg Hafner
- Department of Dermatology, University Hospital of Zurich, Gloriastrasse 31, Zurich, Switzerland
| | - Gregor B. E. Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | - Jivko Kamarachev
- Department of Dermatology, University Hospital of Zurich, Gloriastrasse 31, Zurich, Switzerland
| | - Severin Läuchli
- Department of Dermatology, University Hospital of Zurich, Gloriastrasse 31, Zurich, Switzerland
| | | | - Stephan Nobbe
- Department of Dermatology, University Hospital of Zurich, Gloriastrasse 31, Zurich, Switzerland Department of Dermatology, Cantonal Hospital of Frauenfeld, Switzerland
| | - Cord Sunderkötter
- Chair, Department of Dermatology and Venerology, University and University Hospital of Halle, Ernst-Grube-Strasse 40, Halle, Germany
| | - Mar Llamas Velasco
- Department of Dermatology, Hospital Universitario De La Princesa, Madrid, Spain
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Abstract
The Lindsay Leg Club network is a research-based initiative that provides treatment, health guidance, education and ongoing care for people of all age groups who are experiencing lower limb-related problems. Leg Club clinicians work in a unique partnership with patients (known as 'members') and the local community. Working to current best-practice guidelines, they provide a high standard of care in a social and friendly setting that promotes understanding, peer support and informed choice. This article presents the findings of a member satisfaction survey, through which we aimed to identify additional services we could provide or areas of improvement.
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Affiliation(s)
- Ellie Lindsay
- OBE FQNI Life President, Lindsay Leg Club Foundation
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Palaya J, Pearson S, Nash T. Perception of social support in individuals living with a diabetic foot: A qualitative study. Diabetes Res Clin Pract 2018; 146:267-277. [PMID: 30389622 DOI: 10.1016/j.diabres.2018.10.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 10/13/2018] [Accepted: 10/23/2018] [Indexed: 12/21/2022]
Abstract
AIM To explore the perception of social support in individuals living with a diabetic foot in order to influence future service delivery in management of similar individuals. METHOD A purposive sample of eight participants with a diabetic foot were recruited from a public podiatry service in Tasmania, Australia. A hermeneutic phenomenology qualitative approach was used with individual semi-structured interviews conducted using an interview guide designed to gain insight into five pre-determined measures of social support. Hybrid thematic analysis was used to produce the final results. RESULTS Five clusters of themes emerged; emotional self-efficacy, isolation and stress; transport needs linked to physical or social functioning; perception of social support from health professionals; reciprocal support including health professionals facilitating support and financial support. CONCLUSION The findings have major implications for three broad areas; recognition and management of psychosocial well-being, the need for patient centred care approaches and inclusion and equity in health care and society. Adopting measures that are informed by these findings in current day management practices will complement the existing body of evidence on addressing factors for developing and treating ulceration.
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Affiliation(s)
- Joshua Palaya
- College of Health and Medicine, University of Tasmania, Private Bag 34, Hobart, Tasmania 7000, Australia; Tasmanian Health Service - South, Podiatry Department, GPO Box 1061, Hobart, Tasmania 7001, Australia.
| | - Sue Pearson
- College of Health and Medicine, University of Tasmania, Private Bag 34, Hobart, Tasmania 7000, Australia.
| | - Toni Nash
- Tasmanian Health Service - South, Podiatry Department, GPO Box 1061, Hobart, Tasmania 7001, Australia.
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Abstract
Aim Appraise the evidence on the outcomes of Leg Clubs on ulcer healing, psychosocial outcomes, patient safety, cost and experiences of Leg Club members. Background The Leg Club is a community-based social model of care in 30 UK locations and nine overseas for treating patients with chronic leg wounds. However, its cumulative effectiveness has not been reviewed to-date. Methods Systematic review of primary research relating to the impact and quality of care of Leg Clubs treating patients with leg ulcers. Six electronic databases were systematically searched using the MeSH term ‘leg ulcer’, including other representative terms, in combination with ‘Leg Club’. The quality of individual studies was assessed using appraisal tools. The confidence in the quantitative evidence was evaluated using Grading of Recommendations Assessment, Development and Evaluation (GRADE); and the Confidence in the Evidence from Reviews of Qualitative Research (CERQual) assessed the quality of qualitative findings. Findings A total of 17 relevant publications were identified. Out of the 17 articles, four publications represent findings from randomised controlled trial (RCT). Thus, evidence from 14 independent studies involving at least 532 participants were included in the synthesis of this review. The quality of the evidence varied across the different outcomes and were mostly low or of very low quality. Findings from one underpowered RCT from Australia reporting on clinical, patient-reported outcomes and economic outcomes were evaluated as moderate quality. Studies indicate that the Leg Club model has a positive impact on ulcer healing and recurrence, mood, sleep, quality of life and pain. Moreover, only three studies assessed wound infections and reported no infections had occurred during treatment at the Leg Clubs. Economic evaluations find Leg Clubs to be probably more cost-effective than usual care. Both patients and nurses projected positive views about the Leg Clubs, with particular emphasis on improved social interactions and delivery of patient-centred care.
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Lindsay E. The Wellbeing Project, awards, and more. Br J Community Nurs 2015; 20 Suppl 12:S40. [PMID: 26639072 DOI: 10.12968/bjcn.2015.20.sup12.s40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Renyi R, Hampton S. The Leg Club® model: improving the care and wellbeing of patients. Br J Community Nurs 2015; Suppl Wound Care:S40-S41. [PMID: 26322404 DOI: 10.12968/bjcn.2015.20.sup9.s40] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Roland Renyi
- Trustee and Chair, The Lindsay Leg Club Foundation
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