For our Wound Research Voices feature in March, we are pleased to share a short summary of a PhD thesis by Paul Bobbink, Faculty of Biology and Medicine, University Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland and lecturer at  Geneva School of Health Sciences, HES-SO, University of Applied Sciences and Arts, Western Switzerland, Geneva. The title of the thesis is Conscientiously Engaging in Self-Management” Making decisions in Venous Leg Ulcer Self-Management Strategies Following Nurse-Led Patient Education: A Constructivist Grounded Theory.

Abstract

Venous leg ulcers (VLUs) are chronic wounds of the lower limb that often require prolonged healing and frequently recur. They can cause pain, limit mobility, and profoundly impact quality of life. Although compression therapy and other clinical treatments are strongly supported by evidence, less is known about how individuals understand and engage with self-management advice following a tailored nurse-led patient education program.

This doctoral research explored how adults living with VLUs experience a nurse-led education program and make decisions regarding self-management. This qualitative study included 26 participants with an open VLU, who were enrolled in the tailored nurse-led patient education program within a multisite randomized controlled trial (RCT) in French speaking Switzerland. The RCT was conducted across outpatient wound care clinics in several cantons, involving individuals receiving community and outpatient-care.

Based on their experience, rather than passively adhering to instructions, participants actively interpreted and adapted recommendations based on their personal beliefs, prior health experiences, and everyday life context. The study highlights that effective self-management is not limited to “compliance,” but involves meaningful engagement tailored to individuals. Nurses should prioritize the development of trusting relationships, collaboratively exploring patients’ beliefs and goals, and co-designing self-management plans that fit patients’ daily context. Such approaches can enhance patient engagement and support the uptake of evidence-based behaviors such as wearing compression therapy and engaging in recommended physical activity, thereby potentially improving clinical outcomes. Accordingly, researchers and clinicians should critically reflect on the use of “compliance” in research projects or clinical practice.

List of publications for clinical practice:

Bobbink, P., Pugliese, M.-T., Larkin, P., & Probst, S. (2020). Nurse-led patient education for persons suffering from a venous leg ulcer in outpatient’s clinics and homecare settings : A scoping review. Journal of Tissue Viability, 29(4), 297‑309. https://doi.org/10.1016/j.jtv.2020.08.006

Bobbink, P., Gschwind, G., Larkin, P., & Probst, S. (2025). Making conscientious decisions : Engaging in venous leg ulcer self-management following nurse-led patient education. Qualitative Health Research, 35(8), 901‑915. https://doi.org/10.1177/10497323241285692

Probst, S., Schobinger, E., Saini, C., Larkin, P., & Bobbink, P. (2025). Unveiling the hidden pain and daily struggles of individuals with a venous leg ulcer : A thematic analysis. Journal of Tissue Viability, 34(3), 100906. https://doi.org/10.1016/j.jtv.2025.100906

Probst, S., Saini, C., Bobbink, P., Frei, A., Dudley‐Martin, F., Gafner, S., Stern, F., & Gethin, G. (2025). The impact of a multidisciplinary patient education program on venous leg ulcer healing : A randomised controlled trial. Wound Repair and Regeneration, 33(5), e70084. https://doi.org/10.1111/wrr.70084

List of publications for methodological aspects of the PhD thesis:

Bobbink, P., Larkin, P. J., & Probst, S. (2020). Experiences of Venous Leg Ulcer persons following an individualised nurse-led education : Protocol for a qualitative study using a constructivist grounded theory approach. BMJ Open, 10(11), e042605. https://doi.org/10.1136/bmjopen-2020-042605

Bobbink, P., Larkin, P., & Probst, S. (2024). Application and challenges of using a Constructivist Grounded Theory methodology to address an undertheorized clinical challenge : A discussion paper. International Journal of Nursing Studies Advances, 6, 100199. https://doi.org/10.1016/j.ijnsa.2024.100199

Bobbink, P., Larkin, P., & Probst, S. (2026). Reflecting on reporting guidelines in qualitative inquiry : Advocating for openness or methodological specificity in constructivist grounded theory. Global Qualitative Nursing Research, 13, 23333936251413205. https://doi.org/10.1177/23333936251413205