"I was surprised that the veins were the cause" - The illness trajectory of people with venous leg ulcers: A qualitative study.

Abstract

Background: Patients with venous leg ulcers (VLUs) often carry out inadequate self-care. Person-centered care is recommended as effective support. Understanding the illness trajectory from the patient's perspective could be a way to better understand patients' needs.

Aim: The aim was to describe the illness trajectory experienced by patients with venous leg ulcers.

Methods: Using a qualitative approach, we conducted individual interviews with a purposive sample of 12 patients with venous leg ulcers in the wound outpatient department of a university hospital. Thematic analysis was carried out utilizing the Illness Trajectory Model as the theoretical framework.

Results: 8 women and 4 men with an average age of 74 years had different wound durations, recurrence rates and comorbidities. We identified six illness trajectory-relevant phases: (1) "Accident" or "mosquito bite"; (2) Experiential knowledge reaches its limits; (3) Seeking professional help; (4) Help from the wound clinic; (5) Saying goodbye to normality; (6) Managing VLU in everyday life. VLUs were often caused by accidents and initially treated by patients themselves, with medical help sought later. Over time, patients adapted to treatments like compression therapy, gained self-management (SM) skills to cope with daily life challenges.

Conclusion: All participants performed SM to varying degrees, but not always adequately. Insufficient awareness of the wound as a symptom and complication of a causative disease caused inadequate and ineffective wound management in many cases. Adequate SM developed primarily through learning from experience. The promotion of empirical knowledge and needs-oriented education can improve the SM of affected persons.