Psychosocial Adjustment, Coping, and Quality of Life in Persons With Venous Ulcers and a History of Intravenous Drug Use

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Abstract
Objective/purpose Psychosocial adjustment, coping, and quality of life for persons with a venous ulcer and a history of intravenous drug use were examined. Design A cross-sectional design was used. Setting and subjects Data were collected in an urban outpatient clinic. All eligible persons were asked to participate. Thirty-two patients agreed to participate, providing an 89% response rate. The mean age of participants was 44.6 years (SD = 4.3); 91% were African American, and 72% were male. Instruments Subjects responded to questions about their health and substance abuse history and completed the Quality of Life With a Leg Ulcer Questionnaire, Psychosocial Adjustment to Illness Scale (PAIS), Ways of Coping Instrument, and Pain Questionnaire. Leg ulcer tracings were measured with the SigmaScan computer program. Methods Questionnaires were read to participants. Leg ulcers were traced at their borders onto plastic. Results Wound area correlated significantly with the domestic environment (r = .43) and the psychosocial distress (r = .38) scores of the PAIS. Wound area was negatively correlated to Quality of Life With a Leg Ulcer Questionnaire score (r = −.52). Pain interference was significantly related to the self-controlling coping score (r = .40), domestic environment score of the PAIS (r = .51), and Quality of Life With a Leg Ulcer Questionnaire score (r = −.65). Cox and Wermuth's multiple regression modeling approach was used to summarize the study's variables. Conclusions A larger wound area was associated with greater illness-induced difficulties in the home environment, greater psychological distress, and poor quality of life. Pain interference was associated with a greater effort to regulate one's feelings and actions, difficulties in the home, and poor quality of life.