Older patients' experience of dressing changes on venous leg ulcers: more than just a docile patient.

摘要

Aim and objective. The aim of this paper was to describe the lived experiences of older patients with venous leg ulcers, during dressing changes as out patients with a focus of their concerns about care interventions. Research on wound care management has focused on treatment of venous leg ulcer, wound assessments and the choice of dressing material. Few studies have focused on the patients' experience of dressing changes. Design. Fifteen older people with verified venous leg ulcers were recruited in a metropolitan area of Sweden. Data were collected with research interviews in the form of dialogue. Method. Data were analysed with an interpretative phenomenological method developed by Benner. Results. Twelve women and three men participated. The themes were: 'being cared for with a skilful touch', 'feelings of belonging, continuity and affinity', and 'being suppressed into a state where one loses control, leading to feelings of discomfort'. The participants' experiences varied. Some were satisfied and felt that there was a mutual understanding between caregivers and patients, while others were dissatisfied and felt objectified. Understanding the patients as human beings and considering illness as lived experience helped the care providers to perform skilful wound care, in an atmosphere of mutual understanding. Conclusion. The patients suffering from venous leg ulcers wanted to feel worthy of wound treatment and to meet skilful, confident and gentle nurses in a sharing atmosphere. Nurses must be perceptive to the individual's bodily experience of the leg ulcer. Relevance to clinical practice. Wound care requires a multidimensional clinical approach that involves not only medical and technical care strategies of dressings and bandages, but also aspects that concern the situated-based illness experience that persons suffering from leg ulcers may face.