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Psychological factors in leg ulceration: a case-control study
C J Moffatt1, P J Franks, D C Doherty
1Centre for Research & Implementation of Clinical Practice, London, UK.
The British Journal of Dermatology
|June 16, 2009
Summary
Patients with chronic leg ulcers suffer from poor psychological health, including higher depression rates and reduced social support. Improved care systems are needed to decrease social isolation and enhance support for this vulnerable population.
Area of Science:
- Medical Psychology
- Chronic Disease Management
- Wound Care
Background:
- Psychological status significantly impacts chronic disease development and outcomes.
- Limited understanding exists regarding psychological factors in chronic leg ulceration.
Purpose of the Study:
- To investigate psychological health and perceived social support in individuals with chronic leg ulceration.
- To compare psychological well-being between patients with leg ulcers and matched community controls.
Main Methods:
- A matched case-control study design was employed.
- Patients with leg ulceration were matched 1:1 with community controls based on age and gender.
- Conditional logistic regression and matched t-test analyses were utilized.
Main Results:
- Patients with leg ulcers exhibited significantly poorer health-related quality of life across all Nottingham Health Profile domains.
- Elevated depression levels (Hospital Anxiety and Depression Scale) were observed in the patient group compared to controls.
- Patients reported fewer social networks, less perceived social support (Medical Outcomes Study Social Support Survey), and utilized fewer coping strategies (COPE scale), particularly problem-focused ones.
Conclusions:
- Chronic leg ulceration is associated with adverse psychological health, including increased depression risk, diminished social support, and heightened social isolation.
- Healthcare systems should prioritize creating supportive environments that mitigate social isolation and bolster support for patients with leg ulcers.
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