Sociodemographic factors in chronic leg ulceration
Identifieur interne : 000123 ( Istex/Corpus ); précédent : 000122; suivant : 000124Sociodemographic factors in chronic leg ulceration
Auteurs : C. J. Moffatt ; P. J. Franks ; D. C. Doherty ; R. Smithdale ; R. MartinSource :
- British Journal of Dermatology [ 0007-0963 ] ; 2006-08.
Abstract
Background While there is a commonly held belief that leg ulceration is associated with social factors, the evidence to support this is mainly anecdotal.
Url:
DOI: 10.1111/j.1365-2133.2006.07265.x
Links to Exploration step
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<profileDesc><abstract xml:lang="en" style="main"><head>Summary</head>
<p><hi rend="bold">Background </hi>
While there is a commonly held belief that leg ulceration is associated with social factors, the evidence to support this is mainly anecdotal.</p>
<p><hi rend="bold">Objectives </hi>
To determine deficits in sociodemographic status in patients with chronic leg ulceration.</p>
<p><hi rend="bold">Methods </hi>
In a matched case–control study carried out in community leg ulcer clinics and participants’ homes within Wandsworth Primary Care Trust, patients with chronic leg ulceration were compared with age‐ and sex‐matched community controls drawn from general practitioner registers. Main outcome measures were the prevalence of social class, ethnicity, marital status, living status and social support. Data were analysed by conditional logistic regression.</p>
<p><hi rend="bold">Results </hi>
In all, 113 patients were identified and matched to controls. Patients had a mean age of 75 years (range 31–94), with 72 (64%) being women. The ulcer had been present for a median of 8 months (range 0·8–144), and 29% of patients had an area of ulceration >10 cm<hi rend="superscript">2</hi>
(range 0·5–171·5). Being Afro‐Caribbean increased the risk of leg ulceration eightfold (95% confidence interval, CI 1·83–34·75; <hi rend="italic">P</hi>
< 0·001) compared with the white population. There was a gradient with social class, with patients with leg ulcers being more likely to come from social class IV and V (odds ratio, OR 2·82, 95% CI 1·19–6·74; <hi rend="italic">P</hi>
= 0·015). Never having married (OR 2·98, 95% CI 1·15–7·74; <hi rend="italic">P</hi>
= 0·025), living in rented housing (<hi rend="italic">P</hi>
< 0·001) and having a mobility deficit (<hi rend="italic">P</hi>
< 0·001) more often occurred in the ulcer patients, while living with a spouse was protective (OR 0·46, 95% CI 0·21–0·99; <hi rend="italic">P</hi>
= 0·048). Patients with ulceration experienced significantly poorer social support than their controls for most subscales of the medical outcomes study social support questionnaire (all <hi rend="italic">P</hi>
< 0·05).</p>
<p><hi rend="bold">Conclusions </hi>
Chronic leg ulceration is associated with poorer socioeconomic status, and factors which relate to social isolation. At present it is not possible to determine whether these associations are causative or are a consequence of the ulceration.</p>
</abstract>
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.</title>
<title type="short">Sociodemographic factors in chronic leg ulceration</title>
</titleGroup>
<creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#aff-1-1"><personName><givenNames>C.J.</givenNames>
<familyName>Moffatt</familyName>
</personName>
</creator>
<creator creatorRole="author" xml:id="cr2" affiliationRef="#aff-1-1"><personName><givenNames>P.J.</givenNames>
<familyName>Franks</familyName>
</personName>
</creator>
<creator creatorRole="author" xml:id="cr3" affiliationRef="#aff-1-1"><personName><givenNames>D.C.</givenNames>
<familyName>Doherty</familyName>
</personName>
</creator>
<creator creatorRole="author" xml:id="cr4" affiliationRef="#aff-1-1"><personName><givenNames>R.</givenNames>
<familyName>Smithdale</familyName>
</personName>
</creator>
<creator creatorRole="author" xml:id="cr5" affiliationRef="#aff-1-1"><personName><givenNames>R.</givenNames>
<familyName>Martin</familyName>
</personName>
</creator>
</creators>
<affiliationGroup><affiliation xml:id="aff-1-1"><unparsedAffiliation>Centre for Research and Implementation of Clinical Practice, Thames Valley University, 32–38 Uxbridge Road, London W5 2BS, U.K.
*Wandsworth Community NHS Trust, St Johns Therapy Centre, 86 Garratt Lane, London SW18 4BY, U.K.</unparsedAffiliation>
</affiliation>
</affiliationGroup>
<keywordGroup xml:lang="en"><keyword xml:id="k1">case–control study</keyword>
<keyword xml:id="k2">ethnicity</keyword>
<keyword xml:id="k3">leg ulceration</keyword>
<keyword xml:id="k4">social class</keyword>
<keyword xml:id="k5">social isolation</keyword>
<keyword xml:id="k6">sociodemographics</keyword>
</keywordGroup>
<abstractGroup><abstract type="main" xml:lang="en"><title type="main">Summary</title>
<p><b>Background </b>
While there is a commonly held belief that leg ulceration is associated with social factors, the evidence to support this is mainly anecdotal.</p>
<p><b>Objectives </b>
To determine deficits in sociodemographic status in patients with chronic leg ulceration.</p>
<p><b>Methods </b>
In a matched case–control study carried out in community leg ulcer clinics and participants’ homes within Wandsworth Primary Care Trust, patients with chronic leg ulceration were compared with age‐ and sex‐matched community controls drawn from general practitioner registers. Main outcome measures were the prevalence of social class, ethnicity, marital status, living status and social support. Data were analysed by conditional logistic regression.</p>
<p><b>Results </b>
In all, 113 patients were identified and matched to controls. Patients had a mean age of 75 years (range 31–94), with 72 (64%) being women. The ulcer had been present for a median of 8 months (range 0·8–144), and 29% of patients had an area of ulceration >10 cm<sup>2</sup>
(range 0·5–171·5). Being Afro‐Caribbean increased the risk of leg ulceration eightfold (95% confidence interval, CI 1·83–34·75; <i>P</i>
< 0·001) compared with the white population. There was a gradient with social class, with patients with leg ulcers being more likely to come from social class IV and V (odds ratio, OR 2·82, 95% CI 1·19–6·74; <i>P</i>
= 0·015). Never having married (OR 2·98, 95% CI 1·15–7·74; <i>P</i>
= 0·025), living in rented housing (<i>P</i>
< 0·001) and having a mobility deficit (<i>P</i>
< 0·001) more often occurred in the ulcer patients, while living with a spouse was protective (OR 0·46, 95% CI 0·21–0·99; <i>P</i>
= 0·048). Patients with ulceration experienced significantly poorer social support than their controls for most subscales of the medical outcomes study social support questionnaire (all <i>P</i>
< 0·05).</p>
<p><b>Conclusions </b>
Chronic leg ulceration is associated with poorer socioeconomic status, and factors which relate to social isolation. At present it is not possible to determine whether these associations are causative or are a consequence of the ulceration.</p>
</abstract>
</abstractGroup>
</contentMeta>
<noteGroup><note xml:id="fn1" numbered="no"><p>Conflicts of interest
None declared.</p>
</note>
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<mods version="3.6"><titleInfo lang="en"><title>Sociodemographic factors in chronic leg ulceration</title>
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<titleInfo type="abbreviated" lang="en"><title>Sociodemographic factors in chronic leg ulceration</title>
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<titleInfo type="alternative" contentType="CDATA" lang="en"><title>Sociodemographic factors in chronic leg ulceration</title>
</titleInfo>
<name type="personal"><namePart type="given">C.J.</namePart>
<namePart type="family">Moffatt</namePart>
<affiliation>Centre for Research and Implementation of Clinical Practice, Thames Valley University, 32–38 Uxbridge Road, London W5 2BS, U.K.*Wandsworth Community NHS Trust, St Johns Therapy Centre, 86 Garratt Lane, London SW18 4BY, U.K.</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">P.J.</namePart>
<namePart type="family">Franks</namePart>
<affiliation>Centre for Research and Implementation of Clinical Practice, Thames Valley University, 32–38 Uxbridge Road, London W5 2BS, U.K.*Wandsworth Community NHS Trust, St Johns Therapy Centre, 86 Garratt Lane, London SW18 4BY, U.K.</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">D.C.</namePart>
<namePart type="family">Doherty</namePart>
<affiliation>Centre for Research and Implementation of Clinical Practice, Thames Valley University, 32–38 Uxbridge Road, London W5 2BS, U.K.*Wandsworth Community NHS Trust, St Johns Therapy Centre, 86 Garratt Lane, London SW18 4BY, U.K.</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">R.</namePart>
<namePart type="family">Smithdale</namePart>
<affiliation>Centre for Research and Implementation of Clinical Practice, Thames Valley University, 32–38 Uxbridge Road, London W5 2BS, U.K.*Wandsworth Community NHS Trust, St Johns Therapy Centre, 86 Garratt Lane, London SW18 4BY, U.K.</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">R.</namePart>
<namePart type="family">Martin</namePart>
<affiliation>Centre for Research and Implementation of Clinical Practice, Thames Valley University, 32–38 Uxbridge Road, London W5 2BS, U.K.*Wandsworth Community NHS Trust, St Johns Therapy Centre, 86 Garratt Lane, London SW18 4BY, U.K.</affiliation>
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</role>
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<typeOfResource>text</typeOfResource>
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<originInfo><publisher>Blackwell Publishing Ltd</publisher>
<place><placeTerm type="text">Oxford, UK</placeTerm>
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<dateIssued encoding="w3cdtf">2006-08</dateIssued>
<edition>Accepted for publication 15 January 2006</edition>
<copyrightDate encoding="w3cdtf">2006</copyrightDate>
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<languageTerm type="code" authority="iso639-2b">eng</languageTerm>
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<abstract>Background While there is a commonly held belief that leg ulceration is associated with social factors, the evidence to support this is mainly anecdotal.</abstract>
<abstract>Objectives To determine deficits in sociodemographic status in patients with chronic leg ulceration.</abstract>
<abstract>Methods In a matched case–control study carried out in community leg ulcer clinics and participants’ homes within Wandsworth Primary Care Trust, patients with chronic leg ulceration were compared with age‐ and sex‐matched community controls drawn from general practitioner registers. Main outcome measures were the prevalence of social class, ethnicity, marital status, living status and social support. Data were analysed by conditional logistic regression.</abstract>
<abstract>Results In all, 113 patients were identified and matched to controls. Patients had a mean age of 75 years (range 31–94), with 72 (64%) being women. The ulcer had been present for a median of 8 months (range 0·8–144), and 29% of patients had an area of ulceration >10 cm2 (range 0·5–171·5). Being Afro‐Caribbean increased the risk of leg ulceration eightfold (95% confidence interval, CI 1·83–34·75; P < 0·001) compared with the white population. There was a gradient with social class, with patients with leg ulcers being more likely to come from social class IV and V (odds ratio, OR 2·82, 95% CI 1·19–6·74; P = 0·015). Never having married (OR 2·98, 95% CI 1·15–7·74; P = 0·025), living in rented housing (P < 0·001) and having a mobility deficit (P < 0·001) more often occurred in the ulcer patients, while living with a spouse was protective (OR 0·46, 95% CI 0·21–0·99; P = 0·048). Patients with ulceration experienced significantly poorer social support than their controls for most subscales of the medical outcomes study social support questionnaire (all P < 0·05).</abstract>
<abstract>Conclusions Chronic leg ulceration is associated with poorer socioeconomic status, and factors which relate to social isolation. At present it is not possible to determine whether these associations are causative or are a consequence of the ulceration.</abstract>
<subject lang="en"><genre>keywords</genre>
<topic>case–control study</topic>
<topic>ethnicity</topic>
<topic>leg ulceration</topic>
<topic>social class</topic>
<topic>social isolation</topic>
<topic>sociodemographics</topic>
</subject>
<relatedItem type="host"><titleInfo><title>British Journal of Dermatology</title>
</titleInfo>
<genre type="journal">journal</genre>
<identifier type="ISSN">0007-0963</identifier>
<identifier type="eISSN">1365-2133</identifier>
<identifier type="DOI">10.1111/(ISSN)1365-2133</identifier>
<identifier type="PublisherID">BJD</identifier>
<part><date>2006</date>
<detail type="volume"><caption>vol.</caption>
<number>155</number>
</detail>
<detail type="issue"><caption>no.</caption>
<number>2</number>
</detail>
<extent unit="pages"><start>307</start>
<end>312</end>
<total>6</total>
</extent>
</part>
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<identifier type="DOI">10.1111/j.1365-2133.2006.07265.x</identifier>
<identifier type="ArticleID">BJD7265</identifier>
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<recordOrigin>Blackwell Publishing Ltd</recordOrigin>
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