Psychological factors in leg ulceration: a case–control study

Moffatt, C.J., Franks, P.J., Doherty, D.C., Smithdale, R. and Steptoe, A. (2009) Psychological factors in leg ulceration: a case–control study. British Journal of Dermatology, 161(4), pp. 750-756. (doi: 10.1111/j.1365-2133.2009.09211.x)

Abstract

<p><b>Summary Background:</b>  There is increasing recognition of the role that psychological status plays in the development and outcomes of chronic disease, but little understanding of its importance in chronic leg ulceration.</p> <p><b>Objectives:</b>  To examine psychological health and perceived social support in patients with chronic leg ulceration.</p> <p><b>Methods:</b>  Patients with leg ulceration within a defined population were matched for age and gender (1 : 1) with community controls in a matched case–control study. Analysis was by conditional logistic regression and matched t-test analysis.</p> <p><b>Results:</b>  Ninety-five patients (60 women and 35 men; 59% aged over 75 years) were identified and matched to the same number of controls. Cases had significantly poorer health-related quality of life in all domains of the Nottingham Health Profile (all P ≤ 0·001), compared with controls. Levels of depression (Hospital Anxiety and Depression Scale) were significantly greater in the patient group (mean 5·3 vs. 3·6, P < 0·001). Social support (Medical Outcomes Study Social Support Survey scale) showed significantly fewer social networks and less perceived social support in patients than controls (P = 0·008). Patients used significantly fewer coping strategies (COPE scale) than controls, particularly with regard to problem-focused coping strategies.</p> <p><b>Conclusions:</b>  Patients with leg ulceration experience poor psychological health with a greater risk of depression, less perceived social support and greater social isolation. Systems of care should offer an environment that reduces social isolation and increases support to this patient group.</p>

• Item Type: Articles
• Keywords: Case–control, coping, depression, leg ulcer, social support
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Franks, Professor Peter
• Authors: Moffatt, C.J., Franks, P.J., Doherty, D.C., Smithdale, R., and Steptoe, A.
• Subjects: R Medicine > RL Dermatology
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Nursing and Health Care
• Journal Name: British Journal of Dermatology
• Publisher: Wiley-Blackwell
• ISSN: 0007-0963
• ISSN (Online): 1365-2133
• Published Online: 10 April 2009