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Itch: Association With Chronic Venous Disease, Pain, and Quality of Life

Paul, Julia C.; Pieper, Barbara; Templin, Thomas N.

Journal of Wound, Ostomy and Continence Nursing: January/February 2011 - Volume 38 - Issue 1 - p 46–54
doi: 10.1097/WON.0b013e318202c47a
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PURPOSE: The purpose of the study was to examine the symptom of itch and its relationship with chronic venous disease, pain, and quality of life.

DESIGN: The study used an exploratory, cross-sectional design.

METHODS: One hundred and sixty-one participants completed demographic, health, substance abuse, itch, and pain questionnaires and the SF-12v2 Health Survey to measure health related quality of life.

RESULTS: Participants were mostly men (n = 95, 59%), African American (113, 70.2%), and had a mean age of 44.19 years. A history of injection drug use was reported by 91.4%. Using the clinical score of the Clinical-Etiology-Anatomy-Pathophysiology (CEAP) Classification of the worst leg, the most common classification was Class 3, edema without skin changes (45.9%); 18.6% had severe venous disease (Classes 5 and 6). Eighty-eight participants (54.7%) reported itch somewhere on their body with 74 of them (45.9%) reporting itch on the legs/feet. Fourteen participants who reported itch of their legs or feet had wounds on the legs or feet. A positive correlation between magnitude of reported itch and CEAP clinical classification was noted (0.26, P = .025). This relationship was not strictly linear with itch increasing at a faster rate at higher levels of the CEAP classification. Persons with leg or feet itch had poorer health related quality of life, more comorbidities, and higher leg pain than those without itch. Because the SF-12v2 Health Survey is norm based, persons with itch were more than 1 standard deviation below the mean for the United States for their mental and physical health scores.

CONCLUSIONS: Itch on the legs or feet is a clinically relevant problem that is related to the level of venous disease. Persons with lower extremity itch have higher pain ratings and lower quality of life.

Julia Claire Paul, PhDc, RN, ACNS-BC, CWS, CCRN, Doctoral Student, College of Nursing, Wayne State University.

Barbara Pieper, PhD, RN, ACNS-BC, CWOCN, FAAN, Professor/Nurse Practitioner, College of Nursing, Wayne State University.

Thomas N. Templin, PhD, Professor, Center for Health Research, College of Nursing, Wayne State University.

Correspondence: Barbara Pieper, PhD, RN, ACNS-BC, CWOCN, FAAN, Professor(Nurse Practitioner, College of Nursing, Wayne State University, 5557 Cass Avenue, Detroit, MI 48202 (bpieper@wayne.edu).

Copyright © 2011 by the Wound, Ostomy and Continence Nurses Society