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.