Adherence to leg ulcer lifestyle advice: qualitative and quantitative outcomes associated with a nurse‐led intervention

Hecke, Ann Van; Grypdonck, Maria; Beele, Hilde; Vanderwee, Katrien; Defloor, Tom

doi:10.1111/j.1365-2702.2010.03546.x

Cited by 53 publications

(107 citation statements)

References 61 publications

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“…As patients in community care often have the same nurse attending to them over time, the NPR develops and patients seem to share more personal experiences. In these relationships, patients also seek personal information about the nurse, leading to their feeling a connection on a deeper level (Turpin, McWilliam, & Ward‐Griffin, ; Tyrrell et al., ; Van Hecke et al., ; Wilkes, Cioffi, Warne, Harrison, & Vonu‐boriceanu, ).…”

Section: The Studymentioning

confidence: 99%

The nurse–patient relationship as a story of health enhancement in community care: A meta‐ethnography

Strandås

Bondas

2017

Journal of Advanced Nursing

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Section: The Studymentioning

confidence: 99%

The nurse–patient relationship as a story of health enhancement in community care: A meta‐ethnography

Strandås

Bondas

2017

Journal of Advanced Nursing

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“…Finally, in Germany, researchers recently developed a nurse-led educational intervention to enhance self-care in patients with chronic ulcers [22]. Thus, similar initiatives in other countries have been reported [19-24], underlining the need for health promotion in this population. However, implementation of such preventive interventions in routine healthcare is a major challenge [25-28].…”

Section: Introductionmentioning

confidence: 96%

“…For example, Van Hecke et al . (2011) reported an increase in the number of patients that performed exercises after a nurse-led intervention comparable to Lively Legs [19]. The Leg Club model, developed in the United Kingdom [20], is a community care model that makes use of peer support, assistance with goal setting, and social interaction.…”

Section: Introductionmentioning

confidence: 99%

Factors influencing the implementation of a lifestyle counseling program in patients with venous leg ulcers: a multiple case study

et al. 2012

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BackgroundImplementation of lifestyle interventions in patient care is a major challenge. Understanding factors that influence implementation is a first step in programs to enhance uptake of these interventions. A lifestyle-counseling intervention, Lively Legs, delivered by trained nurses, can effectively improve the lifestyle in patients with venous leg ulcers. The aim of this study was to identify factors that hindered or facilitated implementation of this intervention in outpatient dermatology clinics and in home care.MethodsA mixed-methods multiple case study in five purposefully selected healthcare settings in the Netherlands was conducted. Measurements to identify influencing factors before and after implementation of Lively Legs included interviews, focus groups, questionnaires, and nurses’ registration. Analyses focused on qualitative data as the main data source. All data were compared across multiple cases to draw conclusions from the study as a whole.ResultsA total of 53 patients enrolled in the Lively Legs program, which was delivered by 12 trained nurses. Barriers for implementation were mainly organizational. It was difficult to effectively organize reaching and recruiting patients for the program, especially in home care. Main barriers were a lack of a standardized healthcare delivery process, insufficient nursing time, and a lack of motivated nurses to deliver the program. Facilitating factors were nurse-driven coordination of care and a standardized care process to tie Lively Legs into, as this resulted in better patient recruitment and better program implementation.ConclusionsThis study identified a range of factors influencing the implementation of a lifestyle-counseling program, mainly related to the organization of healthcare. Using a case study method proved valuable in obtaining insight into influencing factors for implementation. This study also shed light on a more general issue, which is that leg ulcer care is often fragmented, indicating that quality improvement is needed.

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“…Information about education and self‐management programs for people with an existing or healed venous leg ulcer is limited within the published literature. Of the programs and service delivery models described (4–9), effectiveness has been showed with respect to increased knowledge (7,9), the conduct of exercises (7,9), improved skin care (7), increased use of four‐layer compression bandaging (7), improved treatment concordance and reduced ulcer recurrence (4). These programs have been shown to have high acceptability among clients (5,7,9) and nurses (10).…”

Section: Introductionmentioning

confidence: 99%

“…Of the programs and service delivery models described (4–9), effectiveness has been showed with respect to increased knowledge (7,9), the conduct of exercises (7,9), improved skin care (7), increased use of four‐layer compression bandaging (7), improved treatment concordance and reduced ulcer recurrence (4). These programs have been shown to have high acceptability among clients (5,7,9) and nurses (10). None of the studies, however, revealed significant improvements on all outcome measures, a finding that is consistent with a review of multi‐component educational programs addressing a range of aetiologies (11).…”

Section: Introductionmentioning

confidence: 99%

Examining factors that influence the adoption of health‐promoting behaviours among people with venous disease

Miller¹,

Kapp²,

Donohue³

2012

International Wound Journal

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People living with venous disease are encouraged to make a number of behaviour modifications to facilitate healing and to prevent a recurrence of a venous leg ulcer. This investigation sought to examine factors described in the literature that shape the effectiveness of multi-component education programs and conduct a secondary analysis of data to examine relationships between various health behaviours for people with a venous leg ulcer who participated in a standardised e-learning education program. This study found few statistically significant and typically minor relationships between health behaviours after participants had completed the education program. No significant differences were identified by participant gender, age or need for a carer, for either the number of health behaviours performed after the education or the number of behaviour changes made during the education. Participants performing few of the recommended health-promoting behaviours prior to the education achieved more behaviour change than those already engaged in the sought after activities [F(2,154) = 16·038, P = 0·000]. The notable lack of associations between the performance of the health-promoting behaviours places emphasis on the need for comprehensive investigation of the moderators and mediators of multi-faceted behaviour change to promote wound healing and chronic disease management.

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Adherence to leg ulcer lifestyle advice: qualitative and quantitative outcomes associated with a nurse‐led intervention

Abstract: Education about leg ulcer advice should be incorporated in nursing practice. Further testing of the intervention is recommended.

Cited by 53 publications

References 61 publications

The nurse–patient relationship as a story of health enhancement in community care: A meta‐ethnography

The nurse–patient relationship as a story of health enhancement in community care: A meta‐ethnography

Factors influencing the implementation of a lifestyle counseling program in patients with venous leg ulcers: a multiple case study

Examining factors that influence the adoption of health‐promoting behaviours among people with venous disease

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