Illness trajectories in patients suffering from leg ulcers: A qualitative study

Abstract

The aim of this study was to identify illness trajectories in leg ulcers by analysing personal, social and relational dimensions related to leg ulcer onset and to the care process. Semi-structured interviews were conducted with 21 patients, one physician and four nurses. Patients' medical records were also examined. Data were analysed using the grounded theory approach. Four illness trajectories were identified: possibility, denial, focus on illness and tragedy. The findings highlighted that leg ulcers can be experienced in different ways depending on the personal characteristics of the people suffering from them and the kind of relationship that exists between patients and healthcare professionals.

The importance of relationships in treatment for chronic leg ulceration

“…As discussed, satisfaction with communication in a consultation is closely linked to overall satisfaction, recall of information and adherence (Ley, 1990; Ong et al, 1995; Zolnierek and DiMattero, 2009), and further research has suggested that a good relationship between individuals and the healthcare professionals involved in their care can lead to a greater sense of well-being, security and more confidence to self-manage their condition (Fox and Chesla, 2008). This emphasis on ‘relationships’ is also reflected in the leg ulcer literature more specifically, as a recent study examining the illness experiences of individuals with leg ulcers suggests that these experiences and patient’s illness-related beliefs may be influenced by relationships with healthcare professionals (Cipolletta and Amicucci, 2015). Another study conducted by Briggs and Flemming (2007) synthesised the qualitative literature available at that time and found that patients experience of living with a leg ulcer was influenced by the patient–professional relationship, suggesting that nurses may have therapeutic value and provide strategies for living with a chronic condition, but that individuals also reported a lack of empathy, trust and understanding in these relationships.…”

Illness trajectories in patients with amyotrophic lateral sclerosis: How illness progression is related to life narratives and interpersonal relationships

“…The theoretical framework drawn on for this study is the constructivist perspective, which assumes that each person makes sense of events in a different way (Kelly, 1955); therefore, a disease can take on multiple meanings and a person's health status may change accordingly (Cipolletta & Amicucci, 2015;Cipolletta, Beccarello, & Galan, 2012;Cipolletta, Consolaro, & Horvath, 2014). For this reason, personal meanings and the distribution of dependencies were explored.…”

“…Therefore, the question is how people distribute their dependencies when asking one person for something and another for something else. Previous research has shown that the distribution of dependency is implicated in how a person lives and copes with illness (Cipolletta & Amicucci, 2015;Cipolletta et al, 2012), and gives and receives care (Cipolletta, Marchesin, & Benini, 2015;Cipolletta, Shams, Tonello, & Pruneddu, 2013). More specifically, a higher distribution of dependencies enables patients to cope better with illness because they can reconstrue their personal role and accept help.…”

Meanings of living with a chronic wound: a meta-synthesis study

“…(n = 1), Italy (n = 1) and Sweden (n = 1), as described in Table 1. The 13 articles 7,21-23,27-35 included a total of 248 participants, most of them female (n = 145), aged between 27 and 95 years old and of different ethnicities, who experienced the condition of being affected by venous ulcers 27,29,33 , various chronic wounds 7,28 , leg ulcers 22,[30][31][32]35 , pressure injury 21 , diabetic foot 34 , as well as individuals with lower limb amputation composing the sample of the same study 23 .…”