Intervención educativa para promover la terapia compresiva en personas con úlcera venosa: protocolo de estudio

Alide Salazar Molina; Ingrid Briones Luengo; Rafael Zapata Lamana

doi:10.53732/rccsalud/e8997

Authors

Alide Salazar Molina Universidad de Concepción, Facultad de Enfermería. Concepción, Chile https://orcid.org/0000-0002-6427-0515
Ingrid Briones Luengo Universidad de Concepción, Facultad de Enfermería. Concepción, Chile https://orcid.org/0000-0003-1766-4455
Rafael Zapata Lamana Universidad de Concepción, Escuela de Educación. Los Ángeles, Chile https://orcid.org/0000-0002-4729-1680

DOI:

https://doi.org/10.53732/rccsalud/e8997

Keywords:

venous leg ulcer, leg ulcer, compression bandages, compression therapy, treatment adherence and compliance, patient education, acceptability of health care

Abstract

Introduction. Venous ulcers are one of the complications of chronic venous disease. The gold standard treatment is compression therapy; however, adherence is variable, associated with physical and aesthetic factors, as well as a lack of education about compression therapy. Objective. To evaluate the feasibility and preliminary effect of an educational intervention on adherence to compression therapy, pain, and ulceration area in patients with venous ulcers in a municipality in south-central Chile. Materials and Methods. A pre- and post-test feasibility study was conducted. The sample consisted of 22 adults attending health centers in a municipality in south-central Chile who presented with stage 2 or higher venous ulcers, indicated for compression therapy, and who met eligibility criteria. The educational intervention was delivered over an 8-week period as a complement to advanced wound care and compression treatment. Measurements were taken at baseline and at week 12. Outcome variables included ulceration area, adherence to compression therapy, pain intensity, and acceptability. Ethical considerations were safeguarded according to the principles of Ezekiel Emmanuel. It is hoped that the educational intervention will be acceptable and that people will adhere to compression therapy, experience less pain, and reduce the area of ulceration.

References

Harding K, Dowsett C, Fias L, Jelnes R, Mosti G, Öien R, et al. Simplifying venous leg ulcer management. Consensus recommendations. Wounds International 2015. https://www.woundsinternational.com/resources/details/simplifying-venous-leg-ulcer-management-consensus-recommendations.

Raffetto JD, Ligi D, Maniscalco R, Khalil RA, Mannello F. Why Venous Leg Ulcers Have Difficulty Healing: Overview on Pathophysiology, Clinical Consequences, and Treatment. J Clin Med. 2020;10(1):29. https://dx.doi.org/10.3390/jcm10010029

Probst S, Saini C, Gschwind G, Stefanelli A, Bobbink P, Pugliese MT, et al. Prevalence and incidence of venous leg ulcers: a systematic review and meta-analysis. Int Wound J. 2023;20(9):3906–21. https://dx.doi.org/10.1111/iwj.14272

Green J, Jester R, McKinley R, Pooler A. The impact of chronic venous leg ulcers: a systematic review. JWC. 2014;23(12):601-12. https://dx.doi.org/10.12968/jowc.2014.23.12.601.

Phillips P, Lumley E, Duncan R, Aber A, Woods HB, Jones GL, et al. A systematic review of qualitative research into people’s experiences of living with venous leg ulcers. Journal of Advanced Nursing. 2017;74(3):550–63. https://dx.doi.org/10.1111/jan.13465

Mościcka P, Szewczyk M, Cwajda-Białasik J, Jawień A. The role of compression therapy in the treatment of venous leg ulcers. Adv Clin Exp Med. 2018 Aug 7;28(6):847–52. https://dx.doi.org/10.17219/acem/78768

O'Meara S, Cullum N, Nelson EA, Dumville JC. Compression for venous leg ulcers. Cochrane Database of Systematic Reviews 2012;11(11):CD000265. https://doi.org/10.1002/14651858.CD000265.pub3

Probst S, Saini C, Buehrer Skinner M. Development and feasibility of a multidisciplinary education program on adherence to treatment in persons with venous leg ulcers in the clinical setting: a pilot study. J Adv Nurs. 2020;76(10):2733–6. https://doi.org/10.1111/jan.14502.

Weller CD, Buchbinder R, Johnston RV. Interventions for helping people adhere to compression treatments for venous leg ulceration. Cochrane Database of Systematic Reviews 2016;3:CD008378 https://dx.doi.org/10.1002/14651858.cd008378.pub3

Sidani S, Braden C. Nursing and Health Interventions: Design, Evaluation, and Implementation 2nd. ed. ‎ Ames: Wiley-Blackwell; 2011. 304 p.

Teresi JA, Yu X, Stewart AL, Hays RD. Guidelines for Designing and Evaluating Feasibility Pilot Studies. Medical Care. 2021;60(1):95–103. https://dx.doi.org/10.1097/MLR.0000000000001664

Riegel B, De Maria M, Barbaranelli C, Matarese M, Ausili D, Stromberg A, et al. Symptom Recognition as a Mediator in the Self-Care of Chronic Illness. Front. Public Health. 2022; 10:883299. https://dx.doi.org/10.3389/fpubh.2022.883299

Vowden P, Kerr A, Mosti. Demystifying mild, moderate and high compression systems – when and how to introduce “lighter” compression. Wounds International, London. 2020. www.woundsinternational.com

Heinen M, Borm G, van der Vleuten C, Evers A, Oostendorp R, van AchterbergT. The Lively Legs self-management programme increased physical activity and reduced wound days in leg ulcer patients: Results from a randomized controlled trial. Int J Nurs Stud. 2012;49(2):151-161. https://dx.doi.org/10.1016/j.ijnurstu.2011.09.005

McKleroy VS, Galbraith JS, Cummings B, Jones P, Harshbarger C, Collins C, et al. Adapting evidence-based behavioral interventions for new settings and target populations. AIDS Educ Prev. 2006;18(4 Suppl A):59-73. https://dx.doi.org/10.1521/aeap.2006.18.supp.59

Agurto I, Salas C, Morgado P. Guía clínica Tratamiento integral avanzado de la úlcera venosa. Segunda edición. Santiago de Chile: FINH; 2018.

Cederholm T, Bosaeus I, Barazzoni R, Bauer J, Van Gossum A, Klek S, et al. Diagnostic criteria for malnutrition – An ESPEN Consensus Statement. Clinical Nutrition. 2015;34(3):335–40. https://doi.org/10.1016/j.clnu.2015.03.001.

Asociación Médica Mundial. Declaración de Helsinki de la Asociación Médica Mundial - Principios éticos para las investigaciones médicas en seres humanos. https://www.wma.net/es/policies-post/declaracion-de-helsinki-de-la-amm-principios-eticos-para-las-investigaciones-medicas-en-seres-humanos/

Díez F, Marcos J, Baticón P, Montes A, Bermejo JC, Merino M. Concordancia entre la escala verbal numérica y la escala visual analógica en el seguimiento del dolor agudo postoperatorio. Rev Esp Anestesiol Reanim 2011;58(5):279-82. https://doi.org/10.1016/S0034-9356(11)70062-7

Sidani S, Epstein DR, Fox M, Miranda J. Psychometric Properties of the Treatment Perception and Preferences Measure. Clinical Nursing Research. 2018;27(6):743-761. https://doi.org/10.1177/1054773816654137

Herrera N. Intervención telefónica de apoyo al automanejo en el área de ulceración y hemoglobina glicosilada en adultos diabéticos con úlcera de pie: estudio de aceptabilidad [Tesis de Magíster]. [Concepción]: Universidad de Concepción; 2023. 215 p. https://repositorio.udec.cl/handle/11594/11197

Rodríguez E. Comités de evaluación ética y científica para la investigación en seres humanos y las pautas CIOMS 2002. Acta Bioeth. 2004;10(1):37–48. https://doi.org/10.4067/S1726-569X2004000100005