published_or_final_version / Nursing Studies / Master / Master of Nursing

A total of 180 patients participated in the study, with 30 withdrawn due to various reasons. At 12 weeks, 76% patients treated with SSB, 78% patients treated with 4LB, and 31% patients treated with usual care alone had completed ulcer healing. The hazard ratios for healing for 4LB and SSB relative to the control group were 3.14 (95% CI = 1.74-5.67) and 2.72 (95% CI = 1.53-4.86), respectively. The key findings indicated the significant effects of compression bandaging resulted in a higher proportion of complete ulcer healing; reduction in ulcer size, pain severity, and pain interference; and improvement in quality of life and lifestyle activity. Across the 12-week study period, the present study also highlighted the significant improvement of the psychosocial composite outcome among the three study groups. Furthermore, the reduction in pain severity and pain interference accounted for the major contribution to the total effect of the psychosocial composite outcome. Therefore, effective pain control and minimizing the effect of pain on daily life is essential in promoting ulcer healing. It is evident that the application of compression bandaging with either 4LB or SSB is feasible and more effective than the current usual care with no compression. This study add new knowledge to the psychosocial benefit of compression bandaging for venous ulcer patients living in the community; and support incorporating compression bandaging in the routine venous ulcer care. Further studies are therefore suggested to focus on the assessment of the cost-effectiveness of and the satisfaction and experience of both patients and nurses with compression bandaging using different high compression bandage systems. / The study was a randomized controlled trial. Those patients who participated in the experimental groups received compression bandaging with either the 4LB or SSB along with a local usual care. In contrast, the control group participants received usual care. A 12-week study intervention was given individually to the study participants. The research outcome of this study was the proportion of complete ulcer healing, ulcer size, pain severity, pain interference, disease-specific and generic health-related quality of life measures, and lifestyle activity. The instruments used include VeV MD stereophotogrammetry, Brief pain Inventory, The SF-12 Health Survey, Charing Cross Venous Ulcer Questionnaire, and the Frenchay Activity Index. Data analysis involved the use of descriptive statistics and inferential statistics such as survival analysis, one way analysis of variance (ANOVA), multivariate analysis variance (MANOVA), doubly multivariate analysis of variance (Doubly MANOVA), and Roy-Bargman stepdown analysis were used. / Venous ulcer is the most serious clinical consequence of chronic venous insufficiency. It is a chronic health problem that afflicts older people as well as health care professions. Its chronicity, together with its high recurrent rate, creates not only a big challenge to nurses' workload and health cost, but it also has a direct impact on patients' physiological and psychosocial well-being. Compression bandaging has been identified as the mainstream form of treatment for venous ulcer in previous literature, although this is not very well known by the nurses in Hong Kong. Previous studies have confirmed that the proportion of complete ulcer healing is improved with high compression as compared to no compression. However, a definite conclusion on the effectiveness of different high compression systems, such as the four-layer compression system (4LB) and short-stretch compression system (SSB), was not found. Most importantly the treatment impacts on proportion of complete ulcer healing, ulcer size, pain severity and pain interference, health-related quality of life, and lifestyle activities are essential influences on patients' participation in venous ulcer care and treatment choice. These limited data leave a gap in today's knowledge on venous ulcer management in relation to both patients and health care providers. Therefore, the aim of this study is to examine the effect of two compression bandage systems, the 4LB and SSB, in promoting ulcer healing in terms of the proportion of complete ulcer healing and ulcer size, as well as the psychosocial well-being including pain, heath-related quality of life, and lifestyle activity for older people in the community. / Wong, Kit Yee Irene. / "December 2007." / Adviser: Diana T. F. Lee. / Source: Dissertation Abstracts International, Volume: 69-08, Section: B, page: 4672. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2007. / Includes bibliographical references (p. 248-268). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract in English and Chinese. / School code: 1307.