Carrying on despite the pain: Living with painful venous ulcers. A Heideggerian hermeneutic analysis

Abstract

Venous ulcers can have profound effects on the everyday lives of the estimated two and one half million Americans who suffer with ulcerations of the lower extremities at some point in their lives. The purpose of this phenomenological study was to describe, to understand, and to interpret the meaning of the lived experience of people who live with painful venous ulcers. Fourteen patients at an outpatient wound center who experienced venous ulcer pain and who met the screening criteria and six staff members of the wound center were engaged in dialogue with the researcher. Interviews and observations were undertaken over a twenty month period, with ongoing analysis. A Heideggerian hermeneutic approach was used to uncover themes, including responses, practical knowledge, common experiences and shared meanings. Interviews were tape recorded, transcribed, and analyzed using Martin Qualitative Analysis Software (version 2.0). The themes, exemplars, and a paradigm case that emerged from this research were analyzed. The constitutive pattern "Carrying On Despite The Pain" emerged as the major finding of this research. While numerous themes related to the painful venous ulcer experience were identified, this study focused on eight key themes: expecting pain with the ulcer; feeling frustrated; swelling = pain; not standing; interfering with the job; starting the pain all over again: painful debridements; making significant life changes; and finding satisfaction in new activities. An exemplar story entitled "We Have a Handle on It Now" told by one of the wound center staffers was presented. It was suggested that caring relationships and caring contexts become antidotes for the frustration, pain and suffering that patients with painful venous ulcers experience. Implications for nursing practice, education and research were presented. The fresco entitled "The Sufferings of Weak Humanity" by Gustav Klimt was proposed as a metaphor for the findings of this research study.