A qualitative study on the patient’s narrative in the progression of chronic venous disease into a first venous leg ulcer

Authors A.M. Meulendijks, M. Welbie, E.P.M. Tjin, L. Schoonhoven
Published in British Journal of Dermatology
Publication date August 2020
Research groups Innovation in Healthcare Processes in Pharmacology, Research Competence
Type Article


Background: A venous leg ulcer (VLU) has a significant negative impact on quality of life. Prevention of a VLU is not yet imbedded in clinical practice because risk factors for developing a first VLU are not well known. Objectives: To explore further the progression of chronic venous disease (CVD) into a first VLU from the patient’s perspective. Methods: A qualitative study using semistructured interviews was conducted among male and female patients with a VLU. Patients from primary and secondary care,under and over 50 years of age, and with first and recurrent VLUs were included. The interviews were transcribed and analysed using a narrative approach to a thematic analysis. Transcripts were organized in chronological order and an iterative process was used to code the transcripts. Results: Four key themes and the connections made between them emerged from the 11 narratives on the progression of CVD towards a first VLU: ‘comorbidity’, ‘mobility’, ‘work and lifestyle’ and ‘acknowledgment of CVD’. Comorbidity was linked to reduced mobility and late acknowledgment of CVD. Comorbidity also affected work and lifestyle and vice versa. Work and lifestyle affected mobility and was linked to the acknowledgment of CVD. Conclusions: A reduction in mobility as a result of comorbidity and work and lifestyle occurred before the VLU developed. Patients did not recognize symptoms of CVD and did not acknowledge the chronicity of CVD. Healthcare professionals should be aware of reductions in mobility and the knowledge deficit in patients with CVD.

On this publication contributed

  • Marlies Welbie | Researcher | Methodology of Practice-Based Research
    M. Welbie
    • Researcher
    • Research group: Research Competence
  • Esther Tjin | Researcher | Research group Innovation in Healthcare Processes in Pharmacology
    E.P.M. Tjin
    • Researcher
    • Research group: Innovation in Healthcare Processes in Pharmacology

Language English
Published in British Journal of Dermatology
Year and volume 183 2
Key words venous leg ulcer, chronic venous disease
Digital Object Identifier https://doi.org/10.1111/bjd.18640
Page range 332-339

Audrey Meulendijks