Quality of life profile and correlated factors in chronic
               leg ulcer patients in the mid-west of São Paulo State, Brazil

This study aimed to identify the impact of leg ulcers on patient's quality of life using the Dermatology Life Quality Index and to define the main factors correlated with this perception.

METHOD:

Cross-sectional, non-probabilistic sampling study. We included patients with chronic leg ulcers being treated for at least 3 months. A sociodemographic and clinical survey was conducted to assess the profile of the ulcers. We administered a screening for depressive symptoms and the Dermatology Life Quality Index. We performed a descriptive statistical analysis, chi-square test and Mann-Whitney test for categorical data, Pearson for numeric variables, and multiple regression for categorical data.

RESULTS:

Forty-one patients were assessed. Their mean age was 61.78 years. Venous ulcers (48.8%) were the most prevalent. Seventy-three percent of the sample perceived no impact/low impact on quality of life in the past week, and 26.8% perceived moderate/high impact. A multiple regression analysis identified the causes of lesion, pain related to the ulcers, time of onset, and severity of the depressive symptoms as the variables that had an influence on quality of life.

CONCLUSIONS:

The majority of the sample perceived low or no impact of the condition on the quality of the life. The variables etiology of the lesion (p<0.001), pain related to the ulcers (p=0.001), time of onset (p=0.006), and severity of the depressive symptoms (p<0.001) had an influence on the quality of life, suggesting the need for further studies with more robust designs to confirm the causal relationship between these characteristics and quality of life.

Leg ulcer; Quality of life; Varicose ulcer

Sociedade Brasileira de Dermatologia Av. Rio Branco, 39 18. and., 20090-003 Rio de Janeiro RJ, Tel./Fax: +55 21 2253-6747 - Rio de Janeiro - RJ - Brazil
E-mail: revista@sbd.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] MAILING ADDRESS: Patrick Alexander Wachholz, Rodovia Comandante João Ribeiro de Barros, Km 225/226, Distrito Industrial (Aimorés) 17034-971 - Bauru - SP Brazil. E-mail: p_wachholz@hotmail.com

Gender	Categorical variable: Male; Female
Age	Numeric variable = year
	Categorical variable = Younger than 60 years; 60 years or older
Ethnicity	Categorical variable: White; Black;
	Brown; Yellow; Indigenous
Retired	Categorical variable: Yes; No; Sick pay
Functional capacity	Categorical variable: Walking without support; Walking with support;
	Wheelchair user; Bedridden
Weight, Height and	Numeric variables = kilograms(kg);
Body Mass Index	meters(m); BMI=weight/height²2. Callam MJ, Harper DR, Dale JJ, Ruckley CV. Chronic ulcer of the leg: clinical history. Br Med J (Clin Res Ed). 1987;294:1389-91.
	Categorical variable = categories of body mass index as recommended by the
	World Health Organization ³⁴34. Proto RS, Machado Filho CD, Rehder JR, Paixão MP, Angelucci RI. Quality of life in leprosy: a comparative analysis between patients in the Amazon region and patients in Santo André in the ABC region of São Paulo, Brazil. An Bras Dermatol. 2010;85:939-41.
Probable etiology	Categorical variable: Venous; Arterial; Mixed; Neuropathic ulcers related to Hansen's disease; Diabetic neuropathy; Other
Number of lesions	Categorical variable: One; Two; Three; Four; Five or more
Site of ulcer(s)^* * Ulcer site according to the scheme proposed by Callan et al. 2	Zone 1, Zone 2, Zone 3
Size^† † Larger diameter x smaller diameter for each lesion.	Categorical variable: < 4cm2; -16 cm2 ; 16,1-36 cm2; 36,1-80 cm2 ; > 80 cm2
Pain related to ulcer(s)	Dichotomous variable: Yes; No
Odor or breakdown related to ulcer(s)	Dichotomous variable: Yes; No
Time of ulcer(s) onset	Numeric variable: Months

Variable		All (N=41)	Men (n=24)	Women (n=17)
Mean age (SD)		61.78 years (±12.37)	59.63 years (±12.38)	64.82 years (±12.06)
Age group	Younger than 60 years	16(39%)	10(24.4%)	6(14.6%)
	60 years or older	25(61%)	14(34.1%)	11(26.8%)
Ethnicity		29(70.7%)	21(51.2%)	8(19.5%)
White		6(14.6%)	1(2.4%)	5(12.2%)
Black		6(14.6%)	2(4.9%)	4(9.8%)
Brown
Retired		30(73.2%)	20(48.8%)	10(24.4%)
Yes		7(17.1%)	2(4.9%)	5(12.2%)
No		4(9.8%)	2(4.9%)	2(4.9%)
Sick pay
Functional Capacity		36(48.8%)	20(48.8%)	16(39%)
Walking without support		4(9.8%)	4(9.8%)	0
Walking with support		1(2.4%)	0	1(2.4%)
Wheelchair user
Weight^* * Weight measured in kilograms (kg) , mean (SD)		81.02(±17.38)	81.96(±19.70)	79.70(±13.95)
Height^† † Height measured in meters (m) , mean (SD)		1.67(±0.10)	1.71(±0.11)	1.61(±0.6)
BMI^‡ ‡ Body mass index measured statistically by dividing weight by squared height. , mean (SD)		28.80(±5.59)	27.68(±5.14)	30.37(±5.97)
Normal		11(26.8%)	7(17.1%)	4(9.8%)
Overweight		12(29.3%)	9(22%)	3(7.3%)
Obese		18(43.9%)	8(19.5%)	10(24.4%)

Variable		n	%
Probable etiology	Venous	20	48.8
	Arterial	1	2.4
	Mixed	2	4.9
	Neuropathic ulcers related to Hansen's disease	12	29.3
	Diabetic neuropathy	2	4.9
	Other	4	9.8
Number of lesions	One	20	48.8
	Two	11	26.8
	Three	3	7.3
	Four	3	7.3
	Five	1	2.4
	More than five	3	7.3
Size	Less than 4 cm2	31	58.5
	4 to 16 cm2	18	33.9
	16.1 to 36cm2	3	5.6
	36.1 to 80cm2	1	1.8
Site	RLL^* * Right Lower Limb Zone 1	7	12.5
	RLL Zone 2	15	26.7
	RLL Zone 3	1	1.7
	LLL^† † Left Lower Limb Zona1	13	23.2
	LLL Zone 2	18	32.1
	LLL Zone 3	2	3.5
Pain	Yes	21	51.2
	No	20	48.8
Odor	Yes	11	26.8
	No	30	73.2

Variable
DLQI
Total score^* * Score minimum of zero and maximum score of thirty. , mean (SD)	4.46(±3.97)
Symptoms and Feelings^† † Minimum score of zero and maximum score of six.	1.22(±1.01)
Activities of Daily Living^† † Minimum score of zero and maximum score of six.	0.80(±0.87)
Leisure^† † Minimum score of zero and maximum score of six.	0.85(±1.10)
Work and Study^‡ ‡ Minimum score of zero and maximum score of three.	0.88(±1.32)
Treatment^† † Minimum score of zero and maximum score of six.	0.37(±0.79)
Interpretation of Total Score by Category	n (%)
No Impact	10(24.4%)
Low Impact	20(48.8%)
Moderate Impact	6(14.6%)
High Impact	5(12.2%)
QIDS-SR16	11.85(±3.56)
Total score, mean (SD)^§ § Minimum score of zero and maximum score of twenty-seven.
Severity of Depressive Symptoms	n(%)
Light	14(34.1%)
Moderate	18(43.9%)
Severe	9(22%)

	F	p
Age	2.859	.103
Functional capacity	1.533	.227
BMI^* * Body Mass Index	.023	.880
Probable etiology	8.732	.000
Number of lesions	.561	.461
Size	.702	.410
Pain related to ulcer	14.232	.001
Odor related to ulcer	2.552	.122
Time of onset	8.867	.006
QIDS-SR16^† † Quick Inventory of Depressive Symptomatology-Self Report	23.007	.000

Brasil

Brasil

Quality of life profile and correlated factors in chronic leg ulcer patients in the mid-west of São Paulo State, Brazil* * Study conducted at Instituto Lauro de Souza Lima (ILSL) - Bauru (SP), Brazil.

BACKGROUND:

OBJECTIVES:

METHOD:

RESULTS:

CONCLUSIONS:

Quality of life profile and correlated factors in chronic leg ulcer patients in the mid-west of São Paulo State, Brazil^* * Study conducted at Instituto Lauro de Souza Lima (ILSL) - Bauru (SP), Brazil.