Elderly persons’ experiences of living with venous leg ulcer: living in a dialectal relationship between freedom and imprisonment

Abstract

The aim was to illuminate elderly persons' experiences of living with venous leg ulcer. Fifteen persons 74-89 years of age with active leg ulcer were interviewed. Data were analysed utilizing a phenomenological-hermeneutic approach inspired by Ricoeur. The analysis includes dialectic movement between understanding and explanation of the text as a whole and its parts. In the structural analysis four themes were identified: emotional consequences of altered body image, living a restricted life, achievement of well-being in connection with a painful wound and bandage, and struggle between hope and despair with regard to a lengthy healing process. The comprehensive understanding indicated that the meaning of living with venous leg ulcer can be understood as a dialectal relationship between, on the one hand the feeling of being imprisoned in the body, the bandage and the home, and on the other hand, hope of freedom from a burdensome body. The results indicate that the concept, body of image, is vitally relevant to the caring of elderly people with venous leg ulcer. The study shows the importance of recognizing the persons' perceptions of their leg ulcers and the impact of these perceptions on well-being. Nurses can thereby anticipate problems and provide more sensitive care.

VenUS I: a randomised controlled trial of two types of bandage for treating venous leg ulcers

“…[12][13][14] Living with chronic pain is a theme that consistently emerges from these studies and yet venous leg ulcers were traditionally not regarded as painful. 12,14,15 Other themes which recur are the restrictions on social, leisure and work activities, [12][13][14] the hope and despair experienced throughout the long healing trajectory 13,14 and the restrictions that ulceration places on clothing and footwear that can be worn.…”

‘When Can I be Free from My Miserable Leg?’ A Qualitative Study of Patients’ Experiences of Chronic Leg Ulceration in Primary Healthcare

“…The recurrence rates are up to 70% within 12 months of healing and a patient may suffer 3-4 recurrent ulcers during their lifetime [2]. Chronic leg ulcer induces both physical and emotional distress, and poses a pervasive and profound effect to patient's Quality of Life (QoL), [3][4][5] predominantly in the elderly [6,7]. It also places a significant economic burden on patients and families, healthcare providers and society.…”

“…Pain associated with chronic leg ulcer has been reported as chronic [12] and portrayed as 'continuous' and 'unbearable', overwhelmingly dominating the lives of participants [13]. Patients with persistent pain experience sleep disturbance, limited mobility and other negative consequences in relation to poor psychosocial wellbeing such as low mood, insomnia, depression, and suicidal ideation [6,12,13]. In addition, the unpredictable nature of exudate and malodor, bulky bandage and altered body image are associated with frustration and social isolation affecting patients' psychological wellbeing [11,[13][14][15][16] and causing distress, embarrassment, shame and anxiety [13,14,17].…”

District nurses’ experiences of caring for leg ulcers in accordance with clinical guidelines: a grounded theory study

“…Ebbeskog and Ekman (2001) found a dialectical process of hope and despair in patients with leg ulcers whose healing process was lengthy (Ebbeskog & Ekman, 2001). On the one hand, the patients felt imprisoned; on the other, they hoped for healing and freedom from the burden of a sick body.…”

“…Motivating strategies DNs in the current study used to help patients overcome feelings of hopelessness included creating trust. Trust is an important element in all nurse-patient relationships, particularly in work with older patients who have complex needs (Ebbeskog & Ekman, 2001; Upton et al, 2014). Evoking hope was another motivating strategy used by DNs.…”