Physical activity in patients with venous leg ulcer – between engagement and avoidance. A patient perspective

OBJECTIVE To identify and describe the qualitative variations in how physical activity is perceived and understood by individuals with current or previous venous leg ulcer. DESIGN A qualitative study using semi-structured interviews. METHOD Twenty-two individuals aged 60-85 years were interviewed. The interviews were recorded, transcribed verbatim and analysed by three researchers using a phenomenographic research approach. A set of categories of descriptions and their internal relationships were constructed based on the essential features of the variation in patients' perceptions of physical activity. RESULTS Four categories of descriptions were identified: (i) 'self-management', (ii) 'instructions and support', (iii) 'fear of injury' and (iv) 'a wish to stay normal'. The categories could be interpreted by a two-dimensional construct: (1) perception of venous leg ulcer as a chronic or acute condition and (2) engagement or avoidance behaviour toward physical activity. Chronicity and behaviour combined together formed a 2 × 2 square housing the four qualitatively different categories. Irrespective of category, the participants reported that information given by caregivers regarding leg ulcer and physical activity was insufficient or contradictory. Written information or exercise programmes were not obtained regularly and not at all in primary care. CONCLUSION A dichotomous view emerged from participants' experiences of physical activity based on (1) perception of venous leg ulcer as a chronic or acute condition and (2) engagement or avoidance behaviour toward physical activity.