A randomised controlled trial of a community nursing intervention: improved quality of life and healing for clients with chronic leg ulcers

Abstract

Aims and objective.  The negative impact of chronic leg ulcers on quality of life is well documented. The aim of this study was to determine the effectiveness of a new community nursing model of care on quality of life, morale, depression, self-esteem, social support, healing, pain and functional ability of clients with chronic venous leg ulcers. Background.  Venous leg ulcers are slow to heal, frequently recur and are associated with pain, restricted mobility and decreased quality of life. Although chronic wound care consumes a large proportion of community nursing time and health care resources, there is little evidence available on the effectiveness of differing models of community care for this population. Design.  Randomised controlled trial. Methods.  We recruited a sample of 67 participants with venous leg ulcers referred for care to a community nursing organisation in Queensland, Australia after obtaining informed consent. Participants were randomised to either the Lindsay Leg Club® model of care (n = 34), emphasising socialisation and peer support; or the traditional community nursing model (n = 33) consisting of individual home visits by a registered nurse. Participants in both groups were treated by a core team of nurses using identical research protocols based on short-stretch compression bandage treatment. Data were collected at baseline, 12 and 24 weeks from commencement. Results.  Participants who received care under the Leg Club model demonstrated significantly improved outcomes in quality of life (p = 0·014), morale (p < 0·001), self-esteem (p = 0·006), healing (p = 0·004), pain (p = 0·003) and functional ability (p = 0·044). Conclusion.  In this sample, the evaluation of the Leg Club model of care shows potential to improve the health and well-being of clients who have chronic leg ulcers. Relevance to clinical practice.  These results suggest further evaluation and implementation of this model is warranted by community health organisations involved in the care of this population