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Processes underlying adherence to leg ulcer treatment: a qualitative field study
Ann Van Hecke1, Sofie Verhaeghe, Maria Grypdonck
1Faculty of Medicine and Health Sciences, Department of Public Health-Nursing Science, Ghent University, U.Z. Blok A 2°v, De Pintelaan 185, B-9000 Gent, Belgium. ann.vanhecke@ugent.be
Trust in nurses is key for leg ulcer patients to adhere to treatment. Building a trusting relationship through attentive care and communication significantly improves adherence to lifestyle advice, even when patients are initially skeptical.
Area of Science:
- Nursing
- Patient Adherence
- Chronic Wound Care
Background:
- Non-adherence to leg ulcer treatment regimens is a significant clinical challenge.
- The underlying processes influencing adherence in leg ulcer patients are not well understood.
- Limited literature exists on adherence processes for leg ulcer management.
Purpose of the Study:
- To explore the processes that underpin adherent behavior in patients with leg ulcers.
- To investigate how an intervention enhances adherence to lifestyle advice for leg ulcer management.
Main Methods:
- A qualitative field study was conducted in a home care setting in Belgium.
- Twenty-six patients with venous leg ulcers and five tissue viability nurses participated.
- Data were collected through semi-structured interviews and participant observation, with iterative analysis and researcher triangulation.
Main Results:
- Trust in the nurse was identified as central to adherence to leg ulcer treatment.
- Nurses spending meaningful time with patients and providing care beyond expectations fostered trust.
- Perceived physical improvement and reduced discomfort reinforced adherence, while physical and socio-structural impediments influenced ability to adhere.
Conclusions:
- A conceptual framework for understanding adherence to leg ulcer treatment was developed.
- Nurses must recognize the impact of nurse-related factors on patient adherence.
- Incorporating trust-building strategies into leg ulcer care is recommended.
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