title: A systematic review on the impact of leg ulceration on patients' quality of life.
abstract: BACKGROUND
  A systematic review was conducted to analyse journal articles that describe or measure the impact of leg ulceration on patients' quality of life (QoL) in order to improve the content of an educational programme that aims to enhance self-care agency in leg ulcer patients.
  
  
  METHODS
  Original articles published in English and German between 1990 and 2006 were included if the findings were analysed at the level of patients. Articles were excluded if (1) they investigated the impact of specific treatments or settings on QoL or (2) focused mainly on arterial ulcers or diabetic foot ulcers.
  
  
  RESULTS
  Twenty-four original research articles met the inclusion criteria; 11 studies used a quantitative, 11 studies a qualitative, and 2 used a mixed method approach. The findings were collapsed into 5 core domains. Quantitative studies commonly investigated the parameters of pain, sleep, social isolation, and physical mobility. Patients had significantly more pain, more restrictions regarding social functioning, less vitality, and limitations with respect to emotional roles compared to the respective controls. Other problem areas identified were restrictions in work capacity, recreation, social interaction, psychological well-being, as well as problems caused by treatment regimes. Inconclusive results were obtained regarding pain intensity, physical restrictions, and gender effects.
  
  
  CONCLUSIONS
  Numerous original studies neither undertook a differentiation of participants by ulcer aetiology nor did they analyse the results according to gender differences.
  
  
  CONCLUSIONS
  As leg ulceration has an impact on QoL, national guidelines on the treatment of leg ulceration need to more specifically address these far-ranging effects identified in this review.
authors.affiliation: Competence Centre for General Medicine and Outpatients' Care & Institute of Nursing Science, University of Witten/Herdecke, Witten, North-Rhine Westphalia, Germany. Oliver.Herber@uni-wh.de
authors.forename: Oliver R
authors.initials: OR
authors.lastname: Herber
authors.forename: Wilfried
authors.initials: W
authors.lastname: Schnepp
authors.forename: Monika A
authors.initials: MA
authors.lastname: Rieger
mesh_terms: D006801:Humans; D007871:Leg Ulcer / Q000150:complications / Q000523:psychology* / Q000628:therapy; D009043:Motor Activity; D010147:Pain Measurement; D010809:Physical Fitness; D011788:Quality of Life; D018434:Sickness Impact Profile; D012890:Sleep; D012934:Social Isolation