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Title: The management and experience of pain associated with chronic painful leg ulceration
Author: Taverner, Tarnia
ISNI:       0000 0004 2745 7000
Awarding Body: University of Leeds
Current Institution: University of Leeds
Date of Award: 2010
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Aim: To explore the experience and management of pain associated with chronic leg ulceration in older people. Two studies were designed, to address patient and professional perspectives. Study 1. Method: A qualitative study using grounded theory methodology, which explored the experience of pain from leg ulcers. Results: Eleven patients aged 65 years and over described their pain as chronic, producing negative consequences such as depression and insomnia, in part due to inadequate pain management. A three phase theory was developed to illustrate patients' leg ulcer journey. In phase 1, leg ulcer pain has predominantly acute nociceptive properties. If this is not managed effectively, or ulcers do not heal, or they recur, the patient may develop chronic pain with both nociceptive and neuropathic properties (phase 2). If this pain is not managed effectively, patients may develop refractory chronic neuropathic pain (phase 3). Study 2. Method: A feasibility study which surveyed the knowledge and views of a sample of community nurses in the North of England. Data were collected using a postal questionnaire. Results: 115 (32%) completed questionnaires were returned. The majority of respondents were female (n=102, 91.8%). Over one-third of the nurses had received no pain management training. Approximately half reported not assessing pain appropriately. A significant majority indicated they were using preconceived ideas rather than patient pain report as a basis for pain management decisions. Overall conclusion: The results suggested that older patients had painful leg ulceration which produced negative consequences and they were not receiving appropriate pain management. Nurses had limited understanding of the nature, assessment and management of leg ulcer pain, particularly its neuropathic elements. The emphasis on healing appeared to impede effective pain management. Only when· healthcare professionals understand and acknowledge the nature of the pain in this patient group, can the pain be managed effectively.
Supervisor: Briggs, Michelle ; Closs, José Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available