Experiences of Living With Varicose Veins: A Systematic Review of Qualitative Research

Abstract

Introduction: Varicose veins are common in the UK and though relatively few people develop serious complications they are a chronic condition with implications for quality of life. Treatment is predominantly conservative and, in this context, varicose veins and their effect on quality of life is important to inform the provision of clinical care.One method of understanding the issues faced by these patients is through the use of patientreported outcome measures (PROMs) which should be validated and relevant to the experience of the patient group. The identification and synthesis of existing qualitative research describing the impact of varicose veins can also be used to ensure the relevance of new and existing PROMs. Aim:The primary aim of this qualitative evidence synthesis was to examine the symptoms and quality of life domains that are important from the perspective of patients with varicose veins.Methods: Multiple electronic databases were searched including MEDLINE and CINAHL to identify reports of qualitative research of the experience of adults with varicose veins. Following study selection, data extraction and quality assessment a thematic analysis was conducted based on initial themes identified from PROMs used in this population. An inductive approach was used and emergent themes were identified. The final stage in the thematic analysis involved the development of new interpretations.Results: Three studies met the inclusion criteria for the review; the quality of the studies was high. T s of living with varicose veins were varied. Five overarching themes were identified; physical impact of varicose veins, psychological impact, social impact, adapting to VV and reasons for seeking treatment. Within these main themes further sub-themes were identified. The key theme to emerge was adaptation, as there was evidence that patients attempted to adapt to the physical, psychological and social impact of varicose veins. Conclusion:The use of PROMS to gather information about HRQoL and symptoms is well established, but PROMs currently used with patients with VV may not capture the full extent of the VV Q L The findings of this review can be used in the development of new PROMs and also in facilitating the interpretation of the results of existing PROMs in current clinical practice and future research.

Mixed methods study to develop the content validity and the conceptual framework of the electronic patient-reported outcome measure for vascular conditions

“…3 Items were developed based on themes extracted from primary qualitative data, systematic qualitative evidence synthesis and clinicians' consensus exercise. [9][10][11][12][13] We have made efforts through purposive sampling to ensure that we have included diverse demographic groupings in the primary research, and this is augmented by the inclusion of systematic reviews that include evidence gathered in national and international studies. Another strength of this study is that the qualitative evidence in the review and the primary study included patients at different stages of their disease.…”

“…4-8 3. Developing the items within each section of ePAQ-VAS based on qualitative systematic reviews [9][10][11][12] and a primary qualitative study. 13…”

Global guidelines trends and controversies in lower limb venous and lymphatic disease

“…VAD categories represents a major confounding factor in itself, considering that drugs with significantly different pharmacokinetics and pharmacodynamics are included in the same group, making the vast majority of international guidelines currently inaccurate for any meaningful comparisons. Future investigations should also address the potential bias of the patient psychological component together with the wide range in symptoms and quality of life report: the lack of proper description tool in this context has been recently published both related to varicose veins 274 and ulcer conditions. 275 Last but not least, clear correlations among hemodynamics changes and VAD use are missing in the literature, while they should be planned for a better understanding of the venous bio-signalling and the related clinical impact.…”

Electronic personal assessment questionnaire for vascular conditions (ePAQ-VAS): development and validity

“…The conceptual framework for the ePAQ‐VAS questionnaire was developed from three distinct sources to identify the key issues, symptoms and impact of AAA, PAD, CAD, VLU and VV on patients with these conditions. First, systematic literature reviews of existing outcome measures and qualitative evidence were conducted. Second, clinicians involved in the care of vascular patients were invited to list the key issues, symptoms and impact of these conditions.…”