Identifying risk factors and protective factors for XXXX using a theoretical approach: A longitudinal study.

@entity1 @entity1150 @entity1066 @entity3179
BACKGROUND: The high recurrence rate of chronic @entity3179 has a significant impact on an individual's quality of life and healthcare costs. OBJECTIVES: This study aimed to identify risk and protective factors for recurrence of @entity3179 using a theoretical approach by applying a framework of self and family management of chronic conditions to underpin the study. DESIGN: Secondary analysis of combined data collected from three previous prospective longitudinal studies. SETTING: The contributing studies' @entity1 were recruited from two metropolitan hospital outpatient wound clinics and three community-based wound clinics. @entity1 : Data were available on a sample of 250 adults, with a leg @entity1066 of primarily venous aetiology, who were followed after @entity1066 for a median follow-up time of 17 months after healing (range: 3-36 months). METHODS: Data from the three studies were combined. The original @entity1 data were collected through medical records and self-reported questionnaires upon healing and every 3 months thereafter. A Cox proportion-hazards regression analysis was undertaken to determine the influential factors on leg @entity1066 recurrence based on the proposed conceptual framework. RESULTS: The median time to recurrence was 42 weeks (95% CI 31.9-52.0), with an incidence of 22% (54 of 250 @entity1 ) recurrence within three months of healing, 39% (91 of 235 @entity1 ) for those who were followed for six months, 57% (111 of 193) by 12 months, 73% (53 of 72) by two years and 78% (41 of 52) of those who were followed up for three years. A Cox proportional-hazards regression model revealed that the risk factors for recurrence included a history of @entity1150 (HR 1.7, 95% CI 1.07-2.67, p=0.024), history of multiple previous leg ulcers (HR 4.4, 95% CI 1.84-10.5, p=0.001), and longer duration (in weeks) of previous @entity1066 (HR 1.01, 95% CI 1.003-1.01, p<0.001); while the protective factors were elevating legs for at least 30min per day (HR 0.33, 95% CI 0.19-0.56, p<0.001), higher levels of self-efficacy (HR 0.95, 95% CI 0.92-0.99, p=0.016), and walking around for at least 3h/day (HR 0.66, 95% CI 0.44-0.98, p=0.040). CONCLUSIONS: Results from this study provide a comprehensive examination of risk and protective factors associated with leg @entity1066 recurrence based on the chronic disease self and family management framework. These results in turn provide essential steps towards developing and testing interventions to promote optimal prevention strategies for @entity3179 .
