A systematic review of qualitative research into people's experiences of living with venous leg ulcers

J Adv Nurs. 2018 Mar;74(3):550-563. doi: 10.1111/jan.13465. Epub 2017 Oct 24.


Aim: To systematically identify, evaluate and synthesize qualitative research that examined the symptoms and health-related quality of life themes that are important from the perspective of patients with venous leg ulceration.

Background: Venous leg ulceration is a common chronic condition; the symptoms and associated treatments have a negative effect on health-related quality of life. Qualitative research methods can provide insight into the personal experiences of patients with venous leg ulceration.

Design: Qualitative evidence synthesis (using framework synthesis).

Data sources: Multiple electronic databases including MEDLINE, EMBASE, PsycINFO and CINAHL were comprehensively searched from inception to November 2015.

Review methods: Systematic identification, quality assessment and synthesis of existing qualitative research were performed; framework synthesis was conducted on included studies. An inductive approach was used and emergent themes were identified. The final stage in the synthesis involved the development of new interpretations.

Results: Thirteen studies met the inclusion criteria; the overall quality of the included studies was good. Four overarching themes were identified; physical impact, psychological impact, social impact and treatment and, in these, further subthemes were identified. Ulcer and treatment-related pain, as well as odour and exudate appeared to have significant and direct negative effects on quality of life, with additional and cumulative effects on sleep, mobility and mood.

Conclusion: The themes identified in this review should be considered by professionals providing services, care and treatment for venous leg ulcer patients and in the selection, or development, of patient-reported outcome measures for use with this population.

Keywords: framework synthesis; literature review; nursing; patient experience; qualitative; quality of life; systematic review; venous leg ulcer.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Humans
  • Leg Ulcer / nursing
  • Leg Ulcer / physiopathology
  • Leg Ulcer / psychology*
  • Nurse-Patient Relations
  • Patient Reported Outcome Measures*
  • Qualitative Research
  • Quality of Life
  • Reproducibility of Results
  • Social Behavior
  • Varicose Ulcer / nursing
  • Varicose Ulcer / physiopathology
  • Varicose Ulcer / psychology*