Bakgrund: Venösa bensår är ingen sjukdom utan ett symtom som orsakas av bakomliggande faktorer. Det är framförallt äldre personer som har en ökad risk för sårbildning. Sjuksköterskan är ansvarig för att utföra en bedömning av såret inför val av behandling. Syfte: Att beskriva sjuksköterskors bedömning av venösa bensår hos patienter inom hemsjukvården. Metod: Studien är en kvalitativ intervjustudie med induktiv ansats. Data samlades in genom sex semistrukturerade intervjuer. Materialet analyserades med kvalitativ innehållsanalys. Resultat: Analysen resulterade i tre kategorier: Sjuksköterskans tillvägagångssätt vid bedömning, sjuksköterskan och patienten tillsammans i en bedömning, sjuksköterskans behov av erfarenhet, stöd och utveckling i bedömning. Sårets egenskaper och fastställande av bakomliggande orsak var av stor betydelse. Likaså poängterades vikten av att göra en helhetsbedömning av patienten, vilket visade sig både ha positiva och negativa sidor relaterat till patientens hemmiljö. Kontinuerlig utbildning och stöd från kollegor ansågs vara till stor hjälp vid bedömning av patienter med venösa bensår. Slutsats: Det konstaterades att bedömningen av venösa bensår upplevs svår, innehåller flera moment samt att praktiken inte alltid stämmer överens med teorin. För att försäkra att patienten får de bästa förutsättningarna till en god sårläkning bör sjuksköterskan se till hela människan och varje patients enskilda behov. / Titel: Nurse's assessment of venous leg ulcers in home based care Background: Venous leg ulcers is not an illness, but a symptom caused by underlying factors. It is mostly elderly people which have an increased risk for ulceration. The nurse is responsible for making the assessment of the ulcer, before choice of treatment. Aim: To describe nurse's assessment of venous leg ulcers in patients within home based care. Method: The study is qualitative interview study with an inductive approach. Data was collected through six semi- structured interviews. The material was analysed with qualitative content analysis. Results: The analysis resulted in three categories: Nurses approach to assessment, the nurse and the patient together in an assessment, nurses needs for experience, support and development in assessment. The ulcer's characteristics and determination of underlying cause were of great importance. Similarly, the importance of making a comprehensive assessment of the patient was emphasized, which proved to have both positive and negative sides related to the patient's home environment. Continuous education and support from colleagues were of great help in assessing patients with venous ulcers. Conclusion: It was confirmed that the assessment of venous leg ulcers is experienced complex, containing several moments, and that practice and theory are not always consistent. To ensure that the patient gets the best prerequisites for good wound healing, the nurse should look after the entire person and patient's individual needs.

This study attempted to investigate the impact of new technology, specifically tele-advice on community nurses' care of leg ulcers. Firstly, a stratified randomised controlled study was designed to measure the impact of using this technology on their levels of wound knowledge and confidence. An individual self-test questionnaire and an attitudinal scale measured nurses' knowledge and confidence respectively both pre and post-intervention. Secondly, a new visual wound assessment tool was designed to represent the state of the wound by a single numerical value; the State of the Wound Index (SWI). Thirdly, the impact of nurses' knowledge, confidence and patient variables was explored to assess their impact on the state of the wound as represented by SWI. The sample consisted of thirty-eight registered primary care nurses from two local NHS trusts in South Wales and their corresponding 38 patients with venous leg ulcers. Nurses were stratified according to their qualifications into experimental or control groups. Both groups were shown to have comparable levels of knowledge and confidence pre-intervention. Nurses in the experimental group received expert tele-advice by a Clinical Nurse Specialist (CNS) over a 12 week period regarding the care of their patient's leg ulcer, whilst those in the control group continued to care for their leg ulcer patients in the traditional way. hi the experimental group, nurses' level of knowledge increased significantly (p=0.02) whilst no improvement was observed for the control group. In terms of confidence, the experimental group reached near significance when extremely positive statements were excluded with no improvement observed for the control group. Results show that the intervention had a positively significant impact on nurses' wound care knowledge and level of confidence. A set of 18 tele-transmittable wound factors was identified by a panel of wound experts. These factors were ranked by another independent panel of leg ulcer experts and no significance could be established in their order of importance. These factors were then examined for their highest and lowest possible estimates for every wound in the sample both pre and post intervention using a Visual Analogue Scale (VAS). These estimated values formed the basis for 95% confidence interval estimates from which 100 virtual nurse assessed values were generated. These values were then used to generate SWI. This new index ranged from 0 (best possible state) to 100 (worse possible) and was seen to reliably increase when the wound deteriorated and decrease as the wound improved. Linear regression models were built to establish the relationship between SWI, patient variables and nurses' knowledge and confidence levels pre and post-intervention. These indicated that knowledge and confidence can have a positive impact on the healing process. This study has shown that there is great potential for the use of tele-advice in community nurses' care of leg ulcers. For this to succeed, it is recommended that further pre and post registration nurse training is provided to enhance their knowledge in wound care, especially in the areas of physiology and wound assessment.

Background: Most patients with leg-ulcers are managed within primary- and community care and a main part of district nurses' duties is to provide leg-ulcer care. Leg-ulcers have an impact on patients' quality of life, health services and society. Previous studies have shown that district nurses have a poor knowledge and fail to work evidence-based within this field. It is therefore of great interest to explore the district nurses' experiences of this matter, as an evidence-based approach is essential to optimize wound-healing and prevent re-occurrence. Aim/ objective: The aim of this study was to explore district nurses' experiences of working evidence-based whilst caring for patients with venous leg-ulcers. Method: The study has a qualitative design with an inductive approach. Data has been collected from members in a closed web-site group on social media, containing nurses countrywide, with experience of leg-ulcer care. A questionnaire with open and closed questions was used. Data from the 55 responses received were analysed using qualitative content analysis, which resulted in two main areas related to Competence and Working environment. Results: The main findings concerned the lack of co-operation with other professional groups, shortage of continuous training, unavailability of time, continuity and other resources, inability of patients to comply, and a need for improved management support. Discussions with more experienced nursing colleagues for advice was regarded as highly important and useful. Conclusions: The result shows that organizational structures hindered the district nurses to work evidence-based. This study can contribute to inspiration and increase the awareness in the different levels within the working organization regarding the importance of working evidence-based on this topic.

Submitted by Fabiana Gonçalves Pinto (benf@ndc.uff.br) on 2017-03-07T18:26:02Z No. of bitstreams: 1 Isabelle Andrade Silveira.pdf: 1744842 bytes, checksum: 517b4f56d05e86c90f2f3978129e864a (MD5) / Made available in DSpace on 2017-03-07T18:26:02Z (GMT). No. of bitstreams: 1 Isabelle Andrade Silveira.pdf: 1744842 bytes, checksum: 517b4f56d05e86c90f2f3978129e864a (MD5) Previous issue date: 2016 / Mestrado Acadêmico em Ciências do Cuidado em Saúde / Introdução: O Leg Ulcer Measurement Tool é um instrumento desenvolvido no Canadá especificamente para avaliar úlceras de perna. Composto por 14 itens classificados como domínios avaliados clinicamente e 3 domínios avaliados pelo paciente. A primeira parte do instrumento avalia as características da lesão e a segunda parte avalia a intensidade e frequência da dor e a qualidade de vida. Objetivos: Traduzir e adaptar transculturamente o LUMT para língua portuguesa do Brasil; Validar o conteúdo do instrumento traduzido através do Comitê de Juízes; Avaliar a praticabilidade da versão final do instrumento em pacientes com úlceras de perna. Método: Pesquisa metodológica que seguiu as etapas de tradução e adaptação transcultural recomendadas por Guillemin, Bombardier e Beaton (1993), as quais incluem: tradução inicial; síntese das traduções; retrotradução; avaliação das versões por um comitê de juízes e a realização do pré-teste. O protocolo de pesquisa foi submetido ao Comitê de Ética em Pesquisa da Faculdade de Medicina da Universidade Federal Fluminense e aprovado sob o número 1.585.542, CAAE 56252216.2.0000.5243. Resultados: Na primeira etapa, foram realizadas duas traduções do instrumento e das instruções; na segunda etapa em uma reunião consensual com as duas tradutoras e as autoras desse estudo as discrepâncias entre as traduções iniciais foram resolvidas e gerada uma versão síntese; na terceira etapa, a versão síntese do instrumento e das instruções foram retrotraduzidas para o inglês por duas tradutoras independentes a fim de verificar a equivalência com a versão original e nenhuma destas apresentou discrepâncias importantes em relação ao instrumento original; na quarta etapa, um comitê de juízes analisou a versão síntese e as retrotraduções com relação à equivalência semântica e idiomática e julgou adequada a versão do instrumento em língua portuguesa; na quinta e última etapa o LUMT na língua portuguesa foi aplicado por enfermeiros em pacientes com úlceras de perna e avaliada sua praticabilidade na prática clínica, e o mesmo foi considerado apropriado e aplicável. Conclusão: Atingiu-se o objetivo proposto de realizar a tradução e adaptação transcultural do LUMT para a língua portuguesa do Brasil. Durante as etapas percorridas foi viável perceber a viabilidade da utilização do mesmo na realidade brasileira. Este estudo metodológico contribui para a área da saúde na disponibilização de um instrumento específico para avaliação de úlceras de perna e para a comparação de resultados internacionalmente de forma mais acurada e fidedigna, fortalecendo a homogeneidade dos dados coletados / Introduction: The Leg Ulcer Measurement Tool is a tool developed in Canada specifically to evaluate leg ulcers. Composed of 14 items classified as domains assessed clinically and 3 domains assessed by the patient. The first part of the instrument evaluates the characteristics of the lesion and the second part evaluates the intensity and frequency of pain and quality of life. Objectives: To translate and adapt culturally the LUMT into Portuguese of Brazil; Validate the instrument content translated through the Judges Committee; To evaluate the feasibility of the final version of the instrument in patients with leg ulcers. Method: Methodology research that followed the steps of translation and cultural adaptation recommended by Guillemin, Bombardier and Beaton (1993), which include: initial translation; synthesis of translations; back translation; evaluation of versions by a panel of judges and the pretest. The research protocol was submitted to the Ethics Committee of the Medical School of the Universidade Federal Fluminense and approved under number 1585542, CAAE 56252216.2.0000.5243. Results: In the first stage, there were two translations of the instrument and instructions; in the second stage in a consensus meeting with the two translators and the authors of this study the discrepancies between the initial translations were resolved and generated a summary version; the third step, the synthesis version of the instrument and instructions were back-translated into English by two independent translators to verify the equivalence with the original version and none of them was important discrepancies in the original instrument; the fourth stage, a committee of judges examined the synthesis version and back translations regarding the semantic and idiomatic equivalence and deemed appropriate instrument version in Portuguese; in the fifth and final stage, the LUMT in Portuguese was applied by nurses in patients with leg ulcers and assessed its feasibility in clinical practice, and it was considered appropriate and applicable. Conclusion: It was reached the proposed objective of performing the translation and cultural adaptation of LUMT into Portuguese of Brazil. During the covered steps it was possible to realize the feasibility of using the same in the Brazilian reality. This methodological study contributes to the health sector in the provision of a specific instrument for evaluating leg ulcers and to compare results internationally more accurately and reliably, strengthening the homogeneity of the data collected

Bakgrund: Kroniska venösa bensår är ett bensår som inte läker inom sex veckor. Bensår kan förekomma på grund av olika omständigheter som underliggande sjukdom eller från yttre skada som leder till en cirkulationsstörning i benet och uppkommer då hudlagren bryts ner vilket kan påverka djupare vävnader. Vanlig behandling är kompressionsbehandling vilket kan behövas även efter läkning för att förebygga återkommande av bensår. Behandlingstiden är ofta lång vilket leder till kontakt med vården under en längre tid. Syfte: Syftet med litteraturstudien var att beskriva personer med kroniska venösa bensårs erfarenheter av kroniska venösa bensår. Metod: En beskrivande litteraturstudie som sammanställt 13 vetenskapliga artiklar med kvalitativ ansats. Huvudresultat: I resultatet framkom det att flera av deltagarna i studierna fått en negativ påverkan i vardagen på grund av de symtom och behandling bensåren medförde. Kompressionsbehandling och sårvård visade sig vara påfrestande och kunde utföras både i deltagarnas egna hem och på mottagningar. Begränsningar i vardagen medförde att ångest och depression utvecklades och flera valde att självisolera sig. Information och stöd var en avgörande faktor som bidrog till att deltagarna hade bristande förståelse för behandlingen, vilket påverkade förtroendet för vårdpersonalen. Eget ansvar för rörelse och näringsrik kost visade sig ha en positiv effekt för hälsan och sårens läkningsprocess. Slutsats: Personers erfarenheter av kroniska venösa bensår innefattade flera negativa upplevelser som påverkade livskvaliteten. Information, kunskap och förståelse visade sig vara en betydande faktor i förhållandet mellan de utsatta personerna och sjuksköterskan. Mer kunskap och utbildning behövs inom området. / Background: Chronic venous leg ulcers are leg ulcers that do not heal within six weeks. Leg ulcers can occur due to various circumstances such as underlying disease or from external damage that leads to a circulatory disorder in the leg. Leg ulcers occur when the skin layers break down, which can affect deeper tissues. Common treatment is compression treatment which may be needed even after healing to prevent the recurrence of leg ulcers. The treatment time is often long, which leads to contact with healthcare personnel for a longer period of time. Aim: The purpose of the literature study was to describe people with chronic venous leg ulcers' experiences of chronic venous leg ulcers. Method: A descriptive literature study that compiled 13 scientific articles with a qualitative approach. Main results: The results showed that several of the participants in the studies had a negative impact on everyday life due to the symptoms and treatment caused by the leg ulcers. Compression therapy and wound care proved to be frustrating for the participants and could be performed both in their own homes and at clinics. Limitations in everyday life led to anxiety and depression developed and many chose to self-isolate. Information and support was a decisive factor that contributed to the participants in the result having a lack of understanding of the treatment, which affected the confidence of the care staff. Own responsibility for exercise and a nutritious diet proved to have a positive effect on health and the wound healing process. Conclusion: People's experiences of chronic venous leg ulcers include several negative experiences that affect the quality of life. Information, knowledge and understanding have proven to be a significant factor in the relationship between the vulnerable people and the nurse. More knowledge and education is needed in the area.

SAMMANFATTNING    Bakgrund: Venösa bensår är ett globalt vanligt förekommande fenomen, 1–2 % av jordens befolkning anses vara drabbade. Bensår skapar stort lidande för patientens fysiska och psykiska hälsa. Två vanliga förekommande problem är smärta och isolering. Det finns flera metoder för att läka venösa bensår där flerlagers-kompressionslinda anses vara en av det bästa metoderna. Att läka bensår skulle kunna minska patientlidandet.    Syfte: Att sammanställa och jämföra läkningseffekten av två- och fyra-lagerskompressionslindning hos patienter med venösa bensår.   Metod: En deskriptiv design med litteraturöversikt användes som metod där tio vetenskapliga kvantitativa originalartiklar inkluderades. Artikelsökning gjordes i databaserna PubMed och CINAHL.   Resultat: Litteraturöversikten kunde inte påvisa en skillnad mellan 2LB- och 4LB-kompressiongrupperna för förbättrad och fullständig läkningsförmåga. Båda lindorna bekräftades ha en sårläkande effekt. Effekten av kompressionslindorna gav en mer påskyndad sårläkning, än hos patienter utan kompressionsbehandling. Majoriteten av de inkluderade studierna visade på ett liknande resultat i fullständig procentuell läkning mellan två-lagerkompressionslindning (2LB) och fyra-lagerkompressionslindning (4LB).   Slutsats: Litteraturöversikten visar att kompressionsbehandling med 2LB och 4LB har en likvärdig och god sårläkande effekt för patienter. Både 2LB och 4LB är mer gynnsam för sårläkning och välmående än utan kompressionsbehandling för patienter som lever med venösa bensår. / ABSTRACT Background: Venous leg ulcers is a globally common phenomenon, 1-2 % of the world’s population is believed to be affected. Leg ulcers causes great suffering for the patient's physical and mental health. Two common complications are pain and isolation. There are several methods to heal venous leg ulcers, multilayer-compression-therapy is considered one of the best methods. Healing leg ulcers could reduce patient suffering. Purpose: To compile and compare the healing effects of two- and four-layer compression therapy in patients with venous leg ulcers.   Method: A descriptive design with a literature review as method, with ten scientific quantitative original articles were included. Article searches was done in databases PubMed and CINAHL.   Results: The results did not show a difference between the 2LB and 4LB-groups regarding complete and improved healing. However, both methods had a healing effect. The bandages were more effective in accelerating healing in patients, than in patients without compression therapy. Most of the included studies showed a similar result in the percentage of complete healing effect between the two-layer compression therapy (2LB) and four-layer compression therapy (4LB).   Conclusion: This literature review demonstrated that compression therapy with 2LB and 4LB has an equally as well as good healing effect for patients. Both 2LB and 4LB are significantly more beneficial for wound healing and well-being than without compression therapy for patients living with venous leg ulcers.

Bakgrund: I takt med att Sveriges befolkning blir äldre ökar behovet av vård och kompressionsbehandling. För att kunna ge en optimal sårvård behöver distriktssköterskan ha kompetens inom venös insufficiens, sårläkningsprocessen, sårläkningshämmande faktorer, cirkulationsbedömning och kompressionsbehandling. Vid behandling av venösa bensår ska distriktssköterskor arbeta patientsäkert och ta ansvar för sina handlingar. Syfte: Beskriva hur distriktssköterskor erfar sin kompetens och behovet av kompetensutveckling gällande kompressionsbehandling av venösa bensår. Metod: En kvalitativ metod med induktiv ansats tillämpades i studien. Datainsamlingen genomfördes med semistrukturerade intervjuer med tio distriktssköterskor inom primärvården. Det insamlade materialet analyserades utifrån en kvalitativ innehållsanalys. Resultat: Analysen resulterade i tre huvudkategorier. Kategorierna beskrev distriktssköterskors erfarenhet av sin kompetens samt resurser och strategier för kompetensutveckling. Distriktssköterskor som ofta utförde kompressionsbehandling ansåg sig ha kompetens inom området och hade förmågan att utföra en korrekt bedömning samt behandling. Distriktssköterskor som istället erfor sin kompetens som bristfällig uttryckte ofta utmaningar i arbetsmomentet. Utmaningar beskrevs vara att motivera patienter till att använda kompressionsbehandling samt att förmedla information om behandlingens fördelar. Slutsats: Kunskap inom kompressionsbehandling är en förutsättning för att vårda patienter med venösa bensår Kompetensutveckling samt stöd och kunskapsutbyte med medarbetare har fördelaktig inverkan på distriktssköterskans individuella kompetens. Hinder i kompetensutveckling var tidsbrist samt att utbildning inte prioriterades. / Background: As the population of Sweden grows older, the need for care and compression treatment increases. In order to provide optimal wound care, the district nurse needs to have expertise in venous insufficiency, the wounds healing process, inhibiting factors in wound healing, circulation assessment and compression treatment. When treating venous leg ulcers, the district nurses must work patient-safe and take responsibility for their actions. Aim: Describe how district nurses experience their competence and the need for competence development regarding compression treatment for venous leg ulcers. Method: A qualitative method with an inductive approach was applied in the study. The data collection was conducted with semi-structured interviews with ten district nurses in primary care. The collected material was analyzed on the basis of a qualitative content analysis.  Findings: The categories described district nurses' experience of their competence as well as resources and strategies for competence development. District nurses who often performed compression treatment considered themselves to have competence in the area and had the ability to perform a correct assessment and treatment. District nurses who experienced their skills as deficient often expressed challenges in the work step. Challenges were described as motivating patients to use compression therapy and providing information about the benefits of the treatment. Conclusion: Knowledge in compression treatment is a prerequisite for caring for patients with venous leg ulcers. Competence development and support and knowledge exchange with employees have a beneficial effect on the district nurse's individual competence. Lack of time and low prioritized education were described as obstacles in skills development.

Bakgrund: Svårläkta sår, vilket inkluderar venösa bensår, är idag vanligtförekommande. Förekomsten ökar med stigande ålder och kvinnor drabbas oftareän män. Kompressionslindning, såromläggning och information är viktiga faktoreri behandlingen. Att leva med venösa bensår är både fysiskt och psykisktutmanande och det sociala livet kan påverkas negativt. Hälso- och sjukvårdenskompetensnivå är central i omvårdnaden där en hög kvalitet på vården förbättrarpatientens livssituation.Syfte: Att beskriva sjuksköterskans upplevelser av omvårdnad vid venösa bensår.Metod: Examensarbetet utfördes som en litteraturöversikt där 14 vetenskapligaartiklar av både kvalitativ- och kvantitativ ansats inkluderades. De utvaldaartiklarna inhämtades ur databaserna PubMed och CINAHL och var publicerademellan åren 2008-2021.Resultat: Sjuksköterskor upplever både ett stort ansvar för patienterna men ocksåett lågt självförtroende i omvårdnaden vilket resulterar i att många sjuksköterskorupplever sig vara otillräckliga. Att visa öppenhet och respekt för patienten iomvårdnaden är av stor vikt, men förutsättningarna för att ge den omvårdnadpatienterna behöver upplevs som bristande. Av den anledningen uttryckersjuksköterskorna ett behov av ökad kompetens och utbildning.Slutsats: Omvårdnaden vid venösa bensår upplevs av sjuksköterskor världenöver som både givande och påfrestande. En tung arbetsbelastning, bristandekompetens, känslan av otillfredsställelse, skam och stort ansvar leder till enohållbar arbetssituation. Konsekvenserna av de bristfälliga förutsättningarnapåverkar patienternas omvårdnad och därigenom även kvaliteten på vården.Sjuksköterskornas upplevelse av omvårdnad vid venösa bensår behöver belysas änmer för att möjliggöra förändringar, här spelar forskningen en viktig roll.Nyckelord: Litteraturöversikt, omvårdnad, sjuksköterskor, upplevelser, venösa / Background: Hard-to-heal wounds, which include venous leg ulcers, arecommon today. The incidence increases with rising age and women suffer moreoften than men. Compression bandage, wound dressing and information areimportant factors in the treatment. Living with venous leg ulcers is both physicallyand mentally challenging and social life can be negatively affected. The level ofhealth care competence is central to nursing, where a high quality of care improvesthe patient's life situation.Aim: To describe nurse’s experiences of nursing care for venous leg ulcers.Methods: The thesis was conducted as a literature review where 14 scientificarticles of both qualitative- and quantitative approach were included. The selectedarticles were obtained from the databases PubMed and CINAHL and werepublished between the years 2008-2021.Results: Nurses experience both a great responsibility for the patients but also alow self-confidence in nursing care which results in many nurses feelinginadequate. To show openness and respect to the patient in the nursing care is ofgreat importance, but the conditions for providing the care that patients need areperceived as deficient. For this reason, the nurses express a need for increasedcompetence and education.Conclusion: Nurses worldwide experience the nursing care of venous leg ulcersas both rewarding and trying. A burdensome workload, lack of skills and thefeeling of dissatisfaction, shame and great responsibility lead to an unsustainablework situation. The consequences of the insufficient conditions affect the nursingcare of the patient and thereby also the quality of care. Nurses' experiences of thenursing care of venous leg ulcers needs to be highlighted furthermore to createpossibilities for changes at both the individual and societal level, research plays animportant part here.

Bakgrund: Åldrandet orsakar hudförändringar vilket resulterar i att huden blir tunnare och skörare. Det blir en ökad risk för hudskador hos äldre, däribland svårläkta bensår. Såren är komplexa att behandla och kräver omfattande resurser och de kan dessutom orsaka lidande och påverka patientens upplevelse av hälsa negativt. Cirka 1 procent av befolkningen drabbas av svårläkta bensår, där över 90 procent är förknippade till venösa, arteriella, trycksår och diabetessår. Syfte: Att beskriva patienters upplevelse av att leva med svårläkta bensår. Metod: Studien är skriven som en litteraturöversikt där både kvantitativa och kvalitativa artiklar har inkluderats Resultat: I resultaten framkom fyra teman som belyser hur svårläkta bensår påverkar patienternas liv. De inkluderar smärta, social isolering, minskad livskvalitet, kommunikationsproblem med sjuksköterskor, begränsningar i vardagen och vårdrelationers betydelse. Svårläkta bensår medför en negativ påverkan på både fysisk och psykisk hälsa vilket begränsar patienterna från att utföra dagliga aktiviteter. Studien pointerar betydelsen av en bättre kommunikation med sjuksköterskor och en tryggare vårdrelation. Konklusion: Studien klargör vilka utmaningar patienter med svårläkta bensår möter, samt psykologiska, fysiska och sociala hinder. Smärta och sömnproblem är vanligt förekommande samt en oro för negativ social respons, vilket resulterar i social isolering. För att öka patienternas förtroende och välbefinnande är kommunikation med sjuksköterska avgörande. / Background: Aging leads to changes in the skin, resulting in it becoming thinner and more fragile. This increases the risk of skin damage among the elderly, including the development of non-healing leg ulcers. Treating these ulcers is complex and requires substantial resources. Approximately 1 percent of the population suffers from non-healingleg ulcers, with over 90 percent being associated with diabetes, pressure sores, or arterialor venous leg ulcers. Aim: To describe patients' experiences of living with non-healing leg ulcers. Method: This study is conducted as a literature review, including both quantitative and qualitative articles. Findings: Four central themes were defined in the study, illuminating how non-healing leg ulcers impact patients' lives. These include pain, social isolation, reduced quality of life, communication issues with nurses, daily life limitations, and the significance of healthcare relationships. Non-healing leg ulcers have a negative impact on both physical and mental health, limiting patients in performing daily activities. The study underscores the importance of improved communication with nurses and a secure healthcare relationship. Conclusion: The study clarifies the challenges faced by patients with non-healing legulcers, as well as psychological, physical, and social barriers. Pain and sleep problems are common, as well as concerns about negative social responses, leading to social isolation.To enhance patients' trust and well-being, communication with nurses is crucial.

Gostovic, M & Grube, R. Livet med venösa bensår. En litteraturstudie. Examensarbete i omvårdnad 15 högskolepoäng. Malmö Universitet: Fakulteten för Hälsa och Samhälle, Institutionen för Vårdvetenskap, 2022.   Bakgrund: Venösa bensår beror på venös insufficiens som är en kronisk sjukdom som orsakar cirkulatorisk svikt i de nedre extremiteterna och drabbar främst den äldre befolkningen. De venösa bensåren uppkommer ofta på grund av trombos, yttre trauma, fysisk inaktivitet eller hereditet. Det är vanligt med samsjuklighet vid venös insufficiens. Behandlingen består främst av omläggning och livslång kompressionsbehandling. Syfte: Syftet med litteraturstudien var att undersöka patienters upplevelser av att leva med venösa bensår. Metod: En litteraturstudie som är baserad på resultat från 13 empiriska studier med kvalitativ ansats från Cinahl, PubMed och PsycInfo. Studierna har granskats med hjälp av Kvalitetsgranskningsmall för studier med kvalitativ forskningsmetodik och de inkluderade studierna har bedömts vara av hög samt medelhög kvalitet. De inkluderade studiernas resultat analyserades med hjälp av integrerad sammanställning av kvalitativ forskning inspirerad av metasyntes. Resultat: Sex teman identifierades: Egenvårdens betydelse för välbefinnandet, Svårigheter i egenvården, Vården som en del av vardagen, Upplevelsen av smärta, Upplevd självbild och skam samt Social och psykisk påverkan. Konklusion: Litteraturstudien gav en ökad förståelse för vad det innebär att leva med venösa bensår och gav en insikt i vilka kunskapsluckor som vården behöver fylla för att kunna förse patienterna med en adekvat omvårdnad. / Gostovic, M & Grube, R. Life with venous leg ulcers. A Literature Review. Degree project in nursing 15 credit points. Malmö University: Faculty of Health and Society, Department of Care Science, 2022.   Background: Venous leg ulcers is caused by venous insufficiency which is a chronic disease caused by circulatory deficiency in the lower extremities and affects primarily the elderly population. The venous leg ulcers most commonly originates from thrombosis, external trauma, physical inactivity or heredity. Comorbidity is common among the patients with venous leg ulcers.  The treatment plan primarily consists of wound dressing and lifelong compression treatment. Aim: The aim of the study was to investigate the patients’ experiences of living with venous leg ulcers. Method: A literature review based on results from 13 empirical studies with qualitative design from Cinahl, PubMed and PsycInfo. The studies have been reviewed by using a review template intended for qualitative studies and the included studies were valued as high and medium high quality. The included studies results were analyzed with the help of an integrated compilation of qualitative research inspired by meta synthesis. Results: Six themes were identified: Self-care had an impact of the well-being, Health care as a part of the daily life, The experience of pain, Perceived self-image and shame and Social and psychological influence. Conclusion: The literature review increased the understanding of what it’s like to live with venous leg ulcers and gave an insight into which knowledge-gaps the health care needs to fill to provide the patients with adequate care.