Health literacy in people with venous leg ulcers: a protocol for scoping review

Introduction Chronic venous leg ulcer (VLU) healing is a complex clinical problem. It requires intervention from skilled, costly, multidisciplinary wound-care teams, working with patients to manage their care. Compression therapy has been shown to help heal venous ulcers and to reduce recurrence, with some evidence suggesting the value of exercise as well. These activities require health education and health literacy (HL) as patients must process, understand and consistently apply health information for successful self-management. Research suggests that those most vulnerable to VLUs also tend to have limited HL, but there have been no reviews examining the state of HL in patients with previous or active VLUs. This scoping review aims to examine the level of HL in VLU patients and how HL may link to self-management behaviours (particularly exercise and compression adherence), and their VLU healing generally.Methods and analysis We will use Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review guidelines and the Levac methodology framework to explore eligible papers that examine the effect of HL on their exercise and compression adherence. Electronic databases will be searched (MEDLINE, EMBASE, the Cochrane Library, PsycInfo and Health, OpenGray), examining for all papers on these subjects published between 2000 and 2020. All studies describing compression and or exercise during VLU management will be included. Study characteristics will be recorded; qualitative data will be extracted and evaluated. Quantitative data will be extracted and summarised.Ethics and dissemination We will disseminate results through peer-reviewed publications. We will use data (ie, journal articles) from publicly available platforms; so, this study does not require ethical review. The consultation step will be carried out with patients, carers and health professionals as part of an established wound consumer group

Physical activity, sleep and wound healing in adults with venous leg ulcers: A prospective observational cohort pilot study protocol

Background: Adults with venous leg ulcers (VLUs) are less likely to be physically active and show greater sleep disturbances than the general population. Limited evidence suggests these issues contribute to VLU healing delays.Objectives: The primary objective is to determine if physical activity (PA) and sleep levels are associated with VLU healing. The secondary objectives are to: 1) evaluate the feasibility and acceptability of a wrist-worn accelerometer device, wActiSleep-BT device wear (ActiGraph); 2) evaluate the utility of self-reported PA instruments to measure PA for people with VLU; and 3) determine whether PA and sleep levels are associated with i) delayed healing, ii) self-reported quality of life (QoL) and/or iii) self-reported VLU pain.Design and method: This prospective observational cohort pilot study aims to recruit 30 adults with VLUs from three hospital-based outpatient wound clinics in Melbourne, Australia. PA and sleep levels will be measured using the wActiSleep-BT device. VLU healing data will be collected from medical records. Patients? self-reported outcomes will be collected using questionnaires.Discussion: Findings will provide insight into the relationship between PA and sleep with healing, QoL and pain, and determine the feasibility and acceptability of the wActiSleep-BT device. Findings will also inform the potential utility of self-reported instruments in estimating PA level in people with VLUs.Contribution of the paper statements:What is already known about the topic?VLUs are a common and costly problem. Adults with VLUs are more likely to be inactive. Sleep disturbances are more common in adults with VLUs than the general population. Increased PA may improve wound healing outcomes for adults with VLUs. What this paper adds An objective evaluation of the level of PA and sleep by adults with VLUs. The relationship between PA, sleep, VLU healing, as well as QoL and pain. The validation of self-reported instruments for assessing PA level. A feasibility assessment of the wActiSleep-BT device to examine levels of PA and sleep in adults with VLUs. An acceptability assessment of wearing the wActiSleep-BT device by adults with VLUs.</p