The Effect of a Patient Education Intervention on Knowledge and Venous Ulcer Recurrence: Results of a Prospective Intervention and Retrospective Analysis

Ostomy Wound Manage. 2017 Jun;63(6):16-28.

Abstract

Patient education may help reduce the recurrence of venous ulcers. To examine the effectiveness of a home-based patient education program on disease and self-care knowledge and ulcer recurrence rates, a prospective study and retrospective analysis of patient outcomes was conducted among 3 groups of patients. Group A (n = 28) had received the education intervention and assessments as part of an earlier study and were recruited to participate in a 36-week follow-up.Group B patients (n = 22) participated in the prospective component of this study and were assessed after 2, 9, and 36 weeks. Data from control group patients (group C, n = 45) were abstracted following a retrospective chart review. Group A and B participants had a healing venous ulcer for at least 5 weeks before the education intervention. Group C patients had been treated for 41 weeks, had a positive wound healing trajectory until week 5, and did not receive additional education. Demographic data for each group were abstracted from the patients' charts. The educational intervention consisted of a 45-minute, one-on-one presentation in the patient's home that included visual aids, a brochure, and a handout addressing important aspects of care and activity. Pre- and post-intervention knowledge was assessed using the Checklist for Patient Learning, which includes 2 subscales to measure knowledge of disease process (6 items, range 0-6) and knowledge of self-care activities to prevent recurrence (7 items, range 0-7), with higher scores indicating more knowledge. Wound healing and recurrence, as observed by the patient's wound care provider and reported by the patient, was noted as Yes or No. Descriptive statistics and unpaired t-tests were used to analyze the data. In all 3 groups, >50% of patients were female and 65 to 74 years of age. In group A and B, knowledge scores at the 36-week assessment were higher than those at baseline (4.13 ± 0.437 and 10.7 ± 0.421, respectively, for group A and 4.22 ± 0.231 and 10.9 ± 0.871, respectively, for group B). The 36-week scores did not differ significantly between groups A and B (P = .687). Recurrence rates were lower in group A and B (50% and 45%, respectively) than in the control group (69%). The results of this study confirm patient education improves disease and self-care knowledge scores and may reduce venous ulcer recurrence rates. Studies including larger patient cohorts and longer follow-up times are warranted.

MeSH terms

  • Aged
  • Female
  • Humans
  • Knowledge*
  • Male
  • Middle Aged
  • Patient Education as Topic / methods
  • Patient Education as Topic / standards*
  • Prospective Studies
  • Recurrence*
  • Retrospective Studies
  • Time Factors
  • Varicose Ulcer / prevention & control
  • Varicose Ulcer / therapy*
  • Wound Healing