General practitioners' experiences of managing patients with chronic leg ulceration.
OBJECTIVE
To understand general practitioners' experiences of managing patients with chronic leg ulceration, thus informing future strategies to improve leg ulcer care in general practice, Australia.


METHODS
Qualitative study using phenomenology and in-depth interviewing.


METHODS
Maximum variation sample of 12 GPs working in the Perth and Hills Division of General Practice between September and December 2004.


METHODS
Themes in participants' experiences of leg ulcer care.


RESULTS
Participants regarded leg ulcer management as an integral part of general practice. They expressed a desire to maintain their involvement, yet relied on nursing assistance. They perceived that ulcer care was usually straightforward and successful. Approaches to management appeared to differ significantly from that outlined in current guidelines. Instead, participants valued accessibility of care for the patient, awareness of patient context and regular review. Occasional problems with non-healing ulcers were experienced, and, in these situations, specialist opinion was appreciated.


CONCLUSIONS
This study highlights fundamental differences between GP and specialist conceptualisation of leg ulcer care. For GPs, it identifies key areas of ulcer management that could be improved. For specialists, it suggests that widespread implementation of traditional guidelines may not be appropriate or acceptable. New approaches to leg ulcer management in general practice are likely to need a combination of education, human resources and practical support.
Sadler
Genevieve M
GM
Department of Dermatology, Royal Perth Hospital, Perth, WA, Australia. gen_sadler@xcitelogic.com.au
Russell
Grant M
GM
Boldy
Duncan P
DP
Stacey
Michael C
MC
D001291:Attitude of Health Personnel; D001315:Australia; D002908:Chronic Disease; D005194:Family Practice; D006801:Humans; D007407:Interviews as Topic; D007871:Leg Ulcer / Q000628:therapy*; D010818:Practice Patterns, Physicians'