Paper
Saturday, July 16, 2005
Lively Legs, the Development of a Lifestyle Program for Leg Ulcer Patients
Maud Heinen, MSc, RN1, L. Kay Bartholomew, EdD, MPH2, M. Wensing, PhD3, P. Van de Kerkhof, PhD, MD4, and Theo Van Achterberg, PhD, RN1. (1) Centre for Quality of Care Research, Nursing Science, University Medical Centre Nijmegen, Nijmegen, Gelderland, Netherlands, (2) 2 Centre for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center Houston, Houston, TX, USA, (3) Quality of Care Research, University Medical Centre Nijmegen, Nijmegen, Gelderland, Netherlands, (4) Department of Dermatology, University Medical Centre Nijmegen, Nijmegen, Gelderland, Netherlands
| Learning Objective #1: Describe the use of intervention mapping in the development of a nursing intervention |
| Learning Objective #2: Adjust this lifestyle-related intervention to another situation or to another patient group |
This presentation is about the development of the Lively Legs lifestyle program for leg ulcer patients at outpatient clinics for dermatology. Leg ulceration is often a chronic condition mostly caused by venous insufficiency. Patients can also suffer from arterial insufficiency or a disturbed microcirculation or a combination of these. The prevalence of leg ulcers in the Netherlands is estimated at 3.5 per 1000 inhabitants. The prevalence of Chronic Venous Insufficiency is estimated at 5 tot 15% in males and 15 to 30% in females. The typical patient is an elderly, low SES female. Van der Velden et al. reported a prevalence of 12 per 1000 for women over the age of 75 in the Netherlands. Patients with recurring or more severe leg ulcers are referred to outpatient clinics for dermatology. Dermatologists, nurses and practice nurses provide current care at outpatient clinics. Patients are often receiving wound care and compression therapy at the outpatient clinics for a long period of time. Patients experience several problems in relation to the leg ulceration and are not structurally informed about related lifestyle aspects. The Lively Legs program was developed according to the intervention-mapping (IM) framework for systematically developing theory and evidence based health promotion programs. A multidisciplinary project-group of health care workers and patients was involved in all five steps of IM; formulating proximal program objectives, selecting methods and strategies, producing program components, planning for adoption and implementation and planning for evaluation. Social Cognitive Theory was selected as the main theory in the development of the program and combined with elements of goal-setting theory and the precaution adoption model. The program is conducted through health counseling by dermatology nurses who received training in motivational interviewing.