A mixed methods study of patient centred care in people with chronic venous leg ulceration

Aims: To explore the lived experience of patients with chronic venous leg ulceration and to establish whether themes that impact on quality of life are addressed during wound care consultations. To develop a consultation template based on these themes and to evaluate the feasibility of a future randomised controlled trial to evaluate template utility.\ud \ud Methods: Three phases were undertaken. The first comprised qualitative interviews with 9 patients to identify how themes impacted on the daily lives of those with chronic venous leg ulceration. The second phase used non-participant observation for 5 of the 9 patients to establish whether these themes were disclosed and addressed during consultations. A nominal group meeting of experts was undertaken to construct a new consultation template, which was verified by patient participants. The template was piloted with 9 new patient participants during the final phase to ascertain if a future randomised controlled trial to evaluate efficacy would be feasible.\ud \ud Results: Phase 1 established a range of themes and subthemes that served to diminish the quality of life of participants. Phases 2 revealed that many of these themes were either not disclosed by patient participants or, when raised, were often not fully addressed by the nurse during wound care consultations. The new consensus consultation template was developed and piloted during phase 3.\ud iii\ud \ud Conclusion: Chronic venous leg ulceration impacts on every area of the patient’s life but often such concerns were not disclosed or effectively addressed during wound care consultations. Although the pilot of the consultation template demonstrated that a future randomised controlled trial would not be feasible, valuable information was provided to inform potential future study design