Living with leg ulceration: a synthesis of qualitative research

Aim. This paper is a report of a study to identify and synthesize all published qualitative research studies exploring patients' experiences of living with a leg ulcer. Background. Leg ulceration is a common chronic condition with over 40% of patients having open ulceration for over a year. Leg ulceration can have a significant and detrimental effect on a persons' life. Data sources. Electronic searches of Ovid MEDLINE (R) (1966-2005), CINAHL (1982-2005), EMBASE (1980-2005), British Nursing Index (1985-2005), ASSIA, Social Science Citation Index (SSCI) and PsychINFO (1985-2005) were carried out in June 2005. Review methods. Studies were included if: they described experience of living with a leg ulcer, e.g. phenomenological studies, grounded theory, descriptive, focus groups or interview studies; included adults with chronic leg ulceration (venous, mixed or arterial); published in English. Analysis was undertaken using the Qualitative Assessment and Review Instrument software for synthesis of qualitative research. Results. Twelve studies met the inclusion criteria. There were eight phenomenological studies, two using grounded theory and two 'descriptive studies'. The location of the research was United Kingdom (7), United States of America (2), Sweden (1), Australia (1). Five common themes related to the experience of living with leg ulceration were identified: Physical effects of leg ulceration; Describing the leg ulcer journey; Patient-professional relationships; Cost of a leg ulcer; Psychological impact. Conclusion. Leg ulceration should be viewed as a chronic, debilitating condition. The clinical focus of care should be symptom management through the 'leg ulcer journey'.