Painful leg ulcers: community nurses' knowledge and beliefs, a feasibility study

Leg ulceration presents a significant health-care problem for patients and it is likely to be associated with pain. Poorly managed persistent pain may lead to insomnia, depression and suicidal ideation. To manage leg ulcer pain effectively, it is necessary first to assess pain, but there is little evidence of this activity in the literature. This study aimed to explore community nurses' knowledge and beliefs about the management of painful leg ulceration.

A feasibility study surveyed the knowledge and views of a sample of community nurses in the North of England, United Kingdom. Data were collected using a postal questionnaire.

A total of 115 completed questionnaires were returned (response rate = 32%). The majority of the respondents were female (n = 102, 91.8%). The nurses in this clinical study claimed to be aware of the pain that patients with leg ulceration may experience. Over 90% of the patients were aware of the key consequences of this pain, including insomnia, depression, social isolation and others. However, over one-third of the nurses reported that they had not received pain management training. Approximately one half reported not assessing pain appropriately. Nurses reported using pain triggers and severity to diagnose aetiology and complications of leg ulceration.

This study suggested inadequate pain management practices despite the fact that there were a significant number of the nurses who were aware of the associated pain and possible outcomes. Pain assessment was lacking, suggesting a lack of formal pain assessment procedures. They described not using effective pain management techniques and were aware of their need for education in this area.