Venous leg ulcer distress – the silent unknown

While depression and anxiety have been widely studied across chronic health conditions, the literature supports that distress symptoms, while sometimes correlated with depressive and anxiety symptoms, is different and has not been well investigated. Health care literature has attempted to define distress as related to patient signs and symptoms of chronic illness that can be displayed in both physical and psychological symptoms and this has been identified and researched in some chronic conditions including diabetes, Inflammatory Bowel Disease (IBD), asthma, cancer and multiple sclerosis. While distress symptoms have been noted in people with Venous Leg Ulcers (VLUs), this has not been investigated further (a systematic review currently being finalised for publication). Leg ulcers are known to be slow to heal and cause prolonged ill-health, affecting 1-3% of adults, increasing prevalence with age and lasting often for many years. These ulcers can be debilitating, having a major impact on a person’s life, often with obvious disease distress symptoms including evidence of pain, decreased physical functioning, immobility, sleep disturbance, lack of energy, limitations in leisure activities, worries and frustrations, lack of self-esteem and a substantial negative impact on health-related quality of life8. Studies in VLUs have often reported depression and anxiety and have indicated that depressive symptoms can be linked to delayed healing. The higher prevalence of symptoms of anxiety and depression in people with VLUs, when compared with the general population, is well established, however the presence and impact of distress in this population of people has not been explored. Due to a lack of tools to assess distress, specifically in VLUs, this is currently poorly identified and therefore is not recognised as part of the interventions for patient-centred care. This presentation discusses phase II of this study that was conducted with a grant from Wounds Australia.