practice JOURNAL OF WOUND CARE VOL 24, NO 1, JANUARY 2015 140 © 2015 MA H EALTHCARE LTD A new quality of life consultation template for patients with venous leg ulceration chronic venous leg ulceration; quality of life; wound care; template; consultation C hronic venous leg ulcers (CVLUs) impact signiicantly on every area of patient functioning (Fig 1); 1 and yet, despite these wide-ranging effects, patients are reluctant to disclose the extent of their dificulties to their district nurse (DN). 2 Theories relating to the personal characteris- tics of patients attempt to explain their responses to chronic conditions which include a reluctance to disclose key factors, an unwillingness to relinquish control to the nurse and, for some, a lack of coping with the perceived consequences of the condition. 3–5 Research that explores patient-centred care (PCC), although limited, purports positive beneits for patients who engage with care including opti- mised participation, enhanced satisfaction, posi- tive clinical outcomes and improvements in quali- ty of life (QoL). 6–9 Health-care professionals (HCPs) are also shown to beneit from a PCC approach to care with reports of enhanced personal empower- ment and increased job satisfaction. 10,11 Despite such beneits, research suggests that practitioners continue to fail to elicit patients’ main concerns during consultations and many patients remain reluctant to disclose key factors relating to their condition and/or care. 2,9–11 Thorne 12 highlights that HCP and patient communication is an important opportunity within the consultation, with effec- tive dialogue having the potential to optimise autonomy and maintain independence. 13,14 In the light of such research and in order to ensure such key QoL issues for people with CVLUs receive appropriate attention during future consultations, a new, evidence-based and patient-focused template has been developed using a nominal group (NG) approach. The intention of this template is to encourage the consulting nurse to explore appropri- ate themes, 1,2 to encourage the patient to engage in their care, 6 to make sense of their condition 4,15 and to build a concordant relationship with their HCP. 3,5,16 In this paper we report on the develop- ment, in conjunction with experts and patients, of a template to focus consultations on these patient- disclosed themes. Background This study has four overall phases, with phases 1 and 2 reported in earlier articles. 1,2 In phase 1 factors of importance to people with CVLUs were system- atically identiied during unstructured interviews (n=9; Fig 1). 1 During phase 2, 2 the wound care consultations of the same study participants (n=5) were observed on 20 occasions and a checklist based on the phase 1 indings was completed to identify the extent to which experienced nurses addressed the factors raised during the patient interviews. Data from these observations was analysed descriptively 2 and revealed that 38% of patient concerns were not raised, a further 38% were either overlooked by the nurse or discussed without any change in care and only 24% of patients’ were offered a partial or com- plete solution to their problems. 2 These phases con- stituted preparatory work for the development of this consultation template and full details have formed the basis of earlier publications. 1,2 l Objective: Chronic venous leg ulcers (CVLUs) are common and recurrent, however, care for patients predominantly has a focus which overlooks the impact of the condition on quality of life.The aim of this study was to develop a simple, evidence-based consultation template, with patients and practitioners, which focuses consultations on quality of life themes. l  Method: A nominal group was undertaken to develop a new consultation template for patients with CVLUs based on the indings of earlier qualitative study phases. l  Results: A user-friendly two-sided A4 template was designed to focus nurse-patient consultations on the quality of life challenges posed by CVLUs. l  Conclusion: CVLUs impact negatively on the quality of life of the patient but this receives inadequate attention during current consultations.This new template will help to ensure that key concerns are effectively raised, explored and addressed during each consultation. l  Declaration of interest: The NHS West Midlands Strategic Health Authority funded this study.The authors have no conlicts of interest to declare. J. Green, 1 PhD, Lecturer; R. Jester, 2 PhD, Professor; R. McKinley, 3 PhD, Professor of Education in General Practice; A. Pooler, 1 PhD, Lecturer; S. Mason, 4 Clinical Lead Tissue Viability; S. Redsell, 5 Professor of Public Health; 1 School of Nursing and Midwifery, Keele University, Staffordshire, ST4 6QG 2 Faculty of Health and Social Care, London South Bank University, London, SE1 0AA. 3 Keele University Medical School, Staffordshire, ST5 5BG. 4 Staffordshire and Stoke on Trent Partnership Trust, Bradwell Hospital, Chesterton, Newcastle- under-Lyme, ST5 7NJ 5 Faculty of Health, Social Care & Education, Anglia Ruskin University, Cambridge Email: j.green@keele. ac.uk Journal of Wound Care.Downloaded from magonlinelibrary.com by 160.005.174.079 on March 13, 2015. For personal use only. No other uses without permission. . All rights reserved.