title: Adherence to leg ulcer lifestyle advice: qualitative and quantitative outcomes associated with a nurse-led intervention.
abstract: OBJECTIVE
  Examining the (experienced) changes associated with a nursing intervention to enhance adherence to leg ulcer lifestyle advice.
  
  
  BACKGROUND
  Few interventions to enhance adherence to leg ulcer treatment are developed and tested.
  
  
  METHODS
  Qualitative evaluation approach and pre-post-test design were used.
  
  
  METHODS
  Twenty-six patients with venous ulcers in a community care setting participated. Data were collected by means of interviews and participant observation. Frequency and duration of wearing compression, leg exercising and leg elevation, activity level, pain and ulcer size were registered at baseline, after the end of the intervention and three months later. Inductive content analysis and Wilcoxon signed-rank test were used.
  
  
  RESULTS
  Knowledge about leg ulcer advice increased. The education contributed to more consciously following of the advice. The rationale of the advice and its association with healing or recurrence remained often unclear. More patients performed exercises after the intervention and at follow-up. Patients often looked out onto a 'new' perspective where enhancement of quality of life and even healing might be attainable. Some patients regained independence after learning how to apply and remove compression garments themselves. The frequency of exercising and the duration of exercises increased significantly. Step counts had not altered significantly. Patients not elevating the legs at baseline elevated the legs more and for a longer period of time after the intervention. This effect on leg elevation decreased after three months. No significant changes were reported on hours wearing compression.
  
  
  CONCLUSIONS
  The perceived changes suggest that the intervention holds a promise for current home care. Combining qualitative and quantitative research assisted to determine the possible effects of the intervention, increasing the potential for a meaningful randomised trial in the future.
  
  
  CONCLUSIONS
  Education about leg ulcer advice should be incorporated in nursing practice. Further testing of the intervention is recommended.
authors.affiliation: Faculty of Medicine and Health Sciences, Department of Public Health - Nursing Science, Ghent University, Ghent, Belgium. Ann.VanHecke@ugent.be
authors.forename: Ann
authors.initials: A
authors.lastname: Van Hecke
authors.forename: Maria
authors.initials: M
authors.lastname: Grypdonck
authors.forename: Hilde
authors.initials: H
authors.lastname: Beele
authors.forename: Katrien
authors.initials: K
authors.lastname: Vanderwee
authors.forename: Tom
authors.initials: T
authors.lastname: Defloor
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007871:Leg Ulcer / Q000451:nursing / Q000523:psychology / Q000628:therapy*; D008019:Life Style; D008297:Male; D010147:Pain Measurement; D010349:Patient Compliance; D012648:Self Care; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014945:Wound Healing