Leg ulcers are a hard-to-heal wound that can have a profound impact on the lives of those that they affect. While a significant body of evidence has explored the efficacy of various treatments for leg ulcers, little research has addressed the patient experience of such treatment. A total of 21 participants were recruited for this qualitative interview study, exploring patient’s experiences of non-surgical treatment for leg ulcers. Thematic analysis identified two major themes, ‘Failure’ and ‘Powerlessness’, as well as the overarching theme of ‘Relationships’. These findings are discussed in relation to concepts of acceptance and in the broader context of patient-centred care.
BraunVClarkeV (2006) Using thematic analysis in psychology. Qualitative Research in Psychology3: 77–101.
2.
BriggsMFlemmingK (2007) Living with leg ulceration: A synthesis of qualitative research. Journal of Advanced Nursing59(4): 319–328.
3.
CasesADempsterMDaviesM, et al. (2011) The experience of individuals with renal failure participating in home haemodialysis: An interpretative phenomenological analysis. Journal of Health Psychology16(6): 884–894.
4.
ChaseSKMelloniMSavageA (1997) A forever healing: The lived experience of venous ulcer disease. Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing15(2): 73–78.
5.
CipollettaSAmicucciL (2015) Illness trajectories in patients suffering from leg ulcers: A qualitative study. Journal of Health Psychology. Available at: http://doi.org/10.1177/1359105315619224
6.
EpsteinRMFiscellaKLesserCS, et al. (2010) Why the nation needs a policy push on patient-centered health care. Health Affairs29(8): 1489–1495.
7.
FoxSCheslaC (2008) Living with chronic illness: A phenomenological study of the health effects of the patient–provider relationship. Journal of the American Academy of Nurse Practitioners20: 109–117.
8.
GaleaHolmes MNWeinmanJABearneLM (2015) ‘You can’t walk with cramp!’ A qualitative exploration of individuals’ beliefs and experiences of walking as treatment for intermittent claudication. Journal of Health Psychology, http://doi.org/10.1177/1359105315600238
9.
GohelMSBarwellJRTaylorM, et al. (2007) Long term results of compression therapy alone versus compression plus surgery in chronic venous ulceration (ESCHAR): Randomised controlled trial. BMJ335(7610): 83.
10.
GuestJFGerrishAAyoubN, et al. (2015) Clinical outcomes and cost-effectiveness of three alternative compression systems used in the management of venous leg ulcers. Journal of Wound Care24(7), 300, 302–305, 307–308, passim.
11.
HorvathAOSymondsBD (1991) Relation between working alliance and outcome in psychotherapy: A meta-analysis. Journal of Counseling Psychology38(2): 139–149.
12.
HowieEBambroughJKarabatsouK, et al. (2016) Patient experiences of awake craniotomy: An Interpretative Phenomenological Analysis. Journal of Health Psychology21(11): 2612–2623. DOI: 10.1177/1359105315581513.
13.
HuntingtonBKuhnN (2003) Communication gaffes: A root cause of malpractice claims. Bayl University Medical Centre Proceedings16(2): 157–161.
14.
KaplanSHGreenfieldSWareJE (1989) Assessing the effects of physician-patient interactions on the outcomes of chronic disease. Medical Care27(3 Suppl.): S110–S127.
15.
KrupnickJLSotskySMSimmensS, et al. (1996) The role of the therapeutic alliance in psychotherapy and pharmacotherapy outcome: Findings in the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Journal of Consulting and Clinical Psychology64(3): 532–539.
16.
LambertMJBarleyDE (2001) Research summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy: Theory, Research, Practice, Training38(4): 357–361.
17.
LeyP (1990) Improving patients’ understanding, recall, satisfaction and compliance. In: BroomeAK (ed.) Health Psychology: Processes and Applications. London: Chapman & Hall, pp. 74–102.
18.
MathiasBParry-JonesBHuwsJC (2014) Individual experiences of an acceptance-based pain management programme: An interpretative phenomenological analysis. Psychology & Health29(3): 279–296.
19.
MoffattCJFranksPJDohertyDC, et al. (2009) Psychological factors in leg ulceration: A case-control study. British Journal of Dermatology161(4): 750–756.
20.
MoorePJSickelAEMalatJ, et al. (2004) Psychosocial factors in medical and treatment avoidance: The role of the doctor-patient relationship. Journal of Health Psychology9(3): 421–433.
21.
NakamuraYMOrthU (2005) Acceptance as a coping reaction: Adaptive or not?Swiss Journal of Psychology64(4): 281–292.
22.
OngLMOngLMde HaesJC, et al. (1995) Doctor-patient communication: A review of the literature. Social Science & Medicine40(7): 903–918.
23.
PearceGThøgersen-NtoumaniCDudaJL (2013) The development of synchronous text-based instant messaging as an online interviewing tool. International Journal of Social Research Methodology17(6): 677–692.
SimonDDixFMcCollumC (2004) Management of venous leg ulcers. BMJ328: 1358–1362.
26.
TelfordKKralikDKochT (2006) Acceptance and denial: Implications for people adapting to chronic illness: Literature review. Journal of Advanced Nursing55(4): 457–464.
27.
TollowPOgdenJ (2016) Surgical management for venous leg ulcers: The role of hope, investment and agency. Journal of Health Psychology. Available at: http://doi.org/10.1177/1359105316643380
28.
WissingUEkA-CUnossonM (2002) Life situation and function in elderly people with and without leg ulcers. Scandinavian Journal of Caring Sciences16(1): 59–65.
29.
ZolnierekKHDiMatteroMR (2009) Physician communication and patient adherence to treatment: A meta-analysis. Medical Care47(8): 826–834.
