Sedentary patients with venous or mixed leg ulcers

determinants of physical activity

Heinen, M. M.
Evers, A. W.M.
Van Uden, C. J.T.
Van der Vleuten, C. J.M.
van de Kerkhof, P. C.M.
Van Achterberg, T.

M.M. Heinen PhD RN Scientific Researcher Centre for Quality of Care Research, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
A.W.M. Evers PhD Psychologist Department of Medical Psychology, Radboud University Nijmegen Medical Centre. Nijmegen, The Netherlands
C.J.T. Van Uden PhD Scientific Researcher Department of Surgery, University Hospital Maastricht, The Netherlands
C.J.M. Van der Vleuten PhD MD Dermatologist Department of Dermatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
P.C.M. van de Kerkhof PhD MD Professor Department of Dermatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
T. Van Achterberg PhD RN Professor Centre for Quality of Care Research, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

Correspondence to M.M. Heinen: e-mail: [email protected]

Accepted for publication 25 May 2007

Journal of Advanced Nursing 60(1):p 50-57, October 2007.

Title

Sedentary patients with venous or mixed leg ulcers: determinants of physical activity

Aim

This paper is a report of a study to identify the determinants of physical activity (PA) in patients with venous leg ulcers to develop recommendations for behavioural interventions aimed at enhancing physical activity.

Background

Physical activity promotes wound healing and prevents the recurrence of wounds in venous patients with leg ulcers. Many patients with leg ulcers, however, have a sedentary lifestyle.

Method

A random sample of 25 patients from two clinics were interviewed in 2003 using a combination of prestructured and open-ended questions. All these patients were being treated at an outpatient dermatology clinic and had a leg ulcer with venous or mixed aetiology at the time of the interview or in the month prior to the interview.

Findings

Only nine of the 25 patients (36%) reported sufficient levels of moderate strenuous physical activity, defined as 30 minutes a day on at least 5 days a week. The results show limited knowledge about the relationship between physical activity and leg ulceration, and low self-efficacy for increasing physical activity. In addition, multi-morbidity, pain and social support were identified as main determinants of physical activity.

Conclusion

Suggestions for improving physical activity levels include influencing knowledge, beliefs and self-efficacy. Patient's individual physical limitations, pain, adequate footwear and social support should be taken into account. Programmes offered by specialized dermatology nurses to stimulate physical activity might fulfil patient needs and help enhance physical activity levels.