Limits and possibilities experienced by nurses in the treatment of women with chronic venous ulcers

Abstract

Limits and possibilities experienced by nurses in the treatment of women with chronic venous ulcers INTRODUCTIONChronic venous ulceration (CVU) is the largest therapeutic problem involving lesions of the lower limb (1) , being more prevalent in women over 65 years of age (2) . The occurrence of this disease can trigger several changes in women's routines, requiring that they change their habits and lifestyle. In addition to pain and inability to perform certain tasks, a deficit in self-esteem occurs, compounded by female vanity and standards of beauty set by society (3) . These considerations show that the gender issue should be considered when providing care to people with CVU, with women deserving a particular type of attention from professionals who attend to them. It is in this context that nurses are inserted; their training emphasizes the care of people with wounds, placing them in situation different from that of other healthcare professionals (4) .Primary health care (PHC) is a scenario in which the care of chronic wounds is part of the daily lives of nurses, with a considerable amount of time allocated towards assisting people with CVU (5) . Studies in Sweden showed nurses' experiences in the treatment of wounds in the context of PHC and emphasize the challenges of providing care for these lesions, considering the complicating factors that overlap with this care (6)(7) .A study of health professionals in the United Kingdom and the United States revealed that care for people with CVU is often accompanied by frustration and dissatisfaction because of the uncertain outcomes of treatment. The professionals in that study attributed nonadherence to treatment by people with CVU to factors such as non-cooperation and lack of motivation to follow through with the therapy. Furthermore, there was evidence of limitations of time and/or knowledge on the part of nurses, which prevents them from elaborating on effective strategies for adherence to treatment (8) .Adherence to the lifestyle required for people with CVU can be influenced by the trusting relationship established between patients and nurses (9)(10) . Therefore, it is assumed that the relationship of care, mediated by trust between the individuals involved, constitutes an important instrument of adherence of women to treatment proposed by nurses.From these considerations, the following questions guided this study: How do nurses provide care to women with chronic venous ulcers? What are the expectations of nurses when providing care to women with CVU? Therefore, we established as the objective, to understand the experiences and expectations of nurses when providing care to women with CVU in the PHC context.The reflection on the reality experienced by nurses in caring for women with CVU may contribute to nursing knowledge in relation to the work performed by the profession, with the objective being to improve the quality of care for these patients. METHODThis qualitative study was based on the theoretical and methodological framework of social phenomenology o...

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

“…In the present study, DNs compensated for such aspects by working to achieve care continuity. Another aspect of unsupportive wound treatment organizations also noted by other researchers is a lack of nurses trained and experienced in leg ulcer treatment (Brown, 2014; Silva et al, 2014; Ylönen, Stolt, Leino-Kilpi, &Suhonen, 2014). Such a lack may lead to care that is not in accordance with guidelines.…”

“…Others have reported a lack of support from the management of health care centres, a lack of management interest in developing nurses’ wound-management skills and a lack of interdisciplinary work in wound care (Friman et al, 2014; Silva et al, 2014). In the present study, DNs compensated for such aspects by working to achieve care continuity.…”

“…Others have also reported that nurses feel professional frustration if leg ulcers worsen or come back (Silva et al, 2014). In this study, DNs used self-motivating strategies to overcome their feelings of hopelessness.…”

“…Reasons may include insufficiencies in the collaboration between DNs and GPs (Friman et al, 2010; Öien & Forssell, 2013) such as poor communication and poor coordination (Silva, Jesus, Merighi, & Oliveira, 2014); lack of support for best practice from the management of primary health care centres (Friman et al, 2010); and incomplete/inconsistent documentation (Khalil, Cullen, Chambers, Steers, & Walker, 2014). …”

O cotidiano de pacientes com úlcera venosa: uma revisão integrativa

“…É importante destacar que um trabalho interdisciplinar, quando envolve a participação e comunicação efetiva de todos os profissionais, diminui a possibilidade de que sejam tomadas condutas diferenciadas em uma mesma situação de cuidado. Sobre isso, um estudo mostrou que o trabalho multidisciplinar, com comunicação efetiva entre os membros da equipe, aumentou a possibilidade de cicatrização e reduziu a severidade dos desconfortos relacionados à presença das lesões (SILVA et al, 2014).…”