title: A pilot study of the development and implementation of a 'best practice' patient information booklet for patients with chronic venous insufficiency.
abstract: OBJECTIVE
  Chronic venous insufficiency (CVI) is a chronic condition that has a significant impact on the individual. For the effective, long-term management of CVI, it is important that patients are educated on the patho-physiology of the condition and strategies that can minimize the related complications. Therefore, the aim of this study was to develop and pilot a 'best practice' information booklet for CVI and to assess the impact of this booklet on CVI-related knowledge and quality of life (QOL).
  
  
  METHODS
  A 'best practice' CVI booklet was developed based on the best available evidence from the literature. Participants with a formal diagnosis of CVI with a clinical, aetiological, anatomical and pathological elements (CEAP) classification of 3-6 were recruited from vascular outpatient clinics at a tertiary hospital. Each participant was given and explained the CVI booklet and asked to undertake the recommended activities at home over the next six-month period. Measurements were taken at baseline, one month and six months postbooklet implementation via the previously validated Health Education Impact and the CVI Questionnaires.
  
  
  RESULTS
  Twenty-six participants, aged 38-90 years (mean 71.8 ± 12.9 years) initially participated in the study, with 20 participants remaining at the six-month time point (77% completion rate). At the end of one month, there had been a significant improvement in doing at least one activity to improve CVI (P = 0.010), monitoring CVI (P = 0.045), having effective ways to prevent CVI symptoms (P = 0.045), knowing CVI triggers (P = 0.005), ability to travel by car and bus (P = 0.05), undertaking social activities (P = 0.030) and feeling less embarrassed about the legs (P = 0.025). At trial end (6 months), there was a significant improvement in doing at least one activity to improve CVI (P = 0.003), knowing CVI triggers (P = 0.016), having effective ways of preventing CVI symptoms (P = 0.008), worrying about the CVI (P = 0.030), feeling hopeless because of CVI problems (P = 0.007), leg and ankle pain (P = 0.038), ability to do domestic duties (P = 0.017), feeling nervous and tense (P = 0.026), and feeling less embarrassed about the legs (P = 0.008). Although other domains improved in the study, none of these improvements were statistically significant.
  
  
  CONCLUSIONS
  Although a small pilot study, the outcomes demonstrate that the implementation of a 'best practice' CVI information booklet into a patients management routine can improve both CVI-related knowledge and QOL.
authors.affiliation: School of Nursing, Flinders University, Bedford Park, South Australia, Australia. amanda.bobridge@flinders.edu.au
authors.forename: A
authors.initials: A
authors.lastname: Bobridge
authors.forename: S
authors.initials: S
authors.lastname: Sandison
authors.forename: J
authors.initials: J
authors.lastname: Paterson
authors.forename: P
authors.initials: P
authors.lastname: Puckridge
authors.forename: M
authors.initials: M
authors.lastname: Esplin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010174:Pamphlets; D010353:Patient Education as Topic / Q000379:methods* / Q000458:organization & administration / Q000592:standards; D010865:Pilot Projects; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014689:Venous Insufficiency / Q000523:psychology* / Q000628:therapy