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venous ulcer, self-concept, body image, quality of life



  1. Salome, Geraldo Magela PhD, RN
  2. de Almeida, Sergio Aguinaldo RN
  3. de Jesus Pereira, Maria Teresa MSN, RN
  4. Massahud, Marcelo Renato Jr RN
  5. de Oliveira Moreira, Carmelita Naira
  6. de Brito, Maria Jose Azevedo PhD
  7. Ferreira, Lydia Masako MD, PhD


OBJECTIVE: To evaluate self-esteem and body image in patients with venous leg ulcers (VLUs).


DESIGN: A multicenter, prospective, descriptive, analytical, clinical study.


SETTINGS: A nursing care and education center of a university hospital, a health center, and an outpatient wound care clinic in Brazil.


PATIENTS: Fifty-nine consecutive adult patients with VLUs and Doppler ankle-brachial index ranging from 0.8 to 1.0 were recruited for the study. Exclusion criteria were mixed ulcers, arterial ulcers, and diabetic foot ulcers.


MAIN OUTCOME MEASURES: A questionnaire assessing sociodemographic and clinical characteristics of patients, the Brazilian version of the Body Investment Scale, and the Rosenberg Self-esteem (RSE)/UNIFESP-EPM (Sao Paulo da Universidade Federal de Sao Paulo-Escola Paulista de Medicina) scale were administered to all patients.


MAIN RESULTS: Most participants were women, aged between 60 and 70 years, and smokers; 33 (56%) were divorced, widowed, or single, and 26 (44%) were married. The patients had the ulcer for a mean of 5.42 years. Exudate and foul odor were present in most cases. Twenty-one ulcers (36%) measured 29 cm2 or less in surface area, and 17 (29%) ulcers measured between 30 and 49 cm2 (mean, 3.39 cm2). The mean RSE score was 22.66, indicating low self-esteem. The mean Body Investment Scale total score was 27.49, and the scores on the body image and body touch subscales were also low, indicating negative feelings about the body.


CONCLUSION: Patients with VLUs had low self-esteem and negative feelings about their bodies.