title: Impact of intravenous drug use on quality of life for patients with venous ulcers.
abstract: OBJECTIVE
  This paper is a report of a study to examine, from the perspective of patients, the impact of venous leg ulcers on health-related quality of life in current and former intravenous drug users and the general population.
  
  
  BACKGROUND
  Venous ulceration can be caused by intravenous drug use. There has been little examination on how this affects the quality of life of this group of patients and how they compare with other patients who have venous ulcers.
  
  
  METHODS
  A qualitative approach was adopted, using framework analysis. Semi-structured interviews with 19 participants who had a venous leg ulcer were conducted between August 2005 and February 2006. Interview audiotapes were analysed to identify recurring themes relating to the impact of venous leg ulcers on overall quality of life.
  
  
  RESULTS
  A complex interaction between symptoms, social restriction and attribution of illness influenced the impact of venous leg ulcers. Smell and pain were the symptoms that had the most profound impacts. In addition to the physical and psychological consequences, participants' activities and social interactions were restricted. Intravenous drug users experienced more social isolation and difficulties in accessing treatment for their venous ulcers.
  
  
  CONCLUSIONS
  While leg ulcer services remain focused on the needs of older people, services for young intravenous drug users are unlikely to improve. A more coherent and earlier intervention, when the ulcers are not as difficult to treat, would decrease time and costs to the health service. The challenge is to find new ways of providing effective and accessible care to this growing population.
authors.affiliation: Academic Vascular Unit, Coleridge House, Northern General Hospital, Sheffield, UK. simon.palfreyman@sth.nhs.uk
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Palfreyman
authors.forename: Angela M
authors.initials: AM
authors.lastname: Tod
authors.forename: Brenda
authors.initials: B
authors.lastname: King
authors.forename: Darlene
authors.initials: D
authors.lastname: Tomlinson
authors.forename: John E
authors.initials: JE
authors.lastname: Brazier
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Michaels
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D004739:England; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009812:Odorants; D010146:Pain / Q000209:etiology; D036301:Qualitative Research; D011788:Quality of Life; D012919:Social Behavior; D015819:Substance Abuse, Intravenous / Q000150:complications*; D014647:Varicose Ulcer / Q000150:complications / Q000523:psychology*