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A dual realist review: Compression for leg swelling at the end of life has potential quality of life benefit

O'Brien, J. & Dingle, M. (2022). A dual realist review: Compression for leg swelling at the end of life has potential quality of life benefit. Journal of Advanced Nursing, doi: 10.1111/jan.15458

Abstract

Aims: To examine the evidence for the use of compression in the general population and determine how far it can be used to inform treatment at the end of life.

Design: In advanced illness, some patients suffer lower limb swelling and its resulting problems. In the general population, compression is used to treat lower limb swelling, but little is known about its use at the end of life. This review is designed to deeply explore the available evidence and identify what is known and areas for further research.

Data Sources: Five databases were searched; CINAHL, MEDLINE, Embase, AMED and Cochrane, in November 2021. Reference lists for included studies were hand-searched. A web search was carried out.

Review Methods: Two parallel realist reviews were performed. The first reviewed the use of compression in the general population. The second explored lower limb swelling at the end of life. Findings were screened using inclusion and exclusion criteria, quality assessed and qualitative and quantitative data extracted.

Results: The initial searches returned 1179 articles in review one and 839 articles in review two. Following the screening, 10 articles remained in each review for analysis. A programme theory was drawn for each review. The theories had sufficient similarities to allow evidence from the general population to be used to make recommendations for those at the end of life.

Impact: People with advanced illness and leg swelling suffer physically and psychologically. Compression delivers a reduction in swelling and quality of life benefit in the general population. This study found people with advanced illness may experience the same benefits. A cautious approach should be taken and stockings or adjustable Velcro compression devices (AVCDs) are likely to be the best starter interventions. Existing guidelines should also be consulted. Further research to develop the right intervention in this group is needed.

Publication Type: Article
Additional Information: This is the peer reviewed version of the following article: O'Brien, J. & Dingle, M. (2022). A dual realist review: Compression for leg swelling at the end of life has potential quality of life benefit. Journal of Advanced Nursing, which has been published in final form at doi: 10.1111/jan.15458. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
Publisher Keywords: compression, end of life, leg, lower limb, oedema, palliative, quality of life, swelling
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RT Nursing
Departments: School of Health & Psychological Sciences > Nursing
[img] Text - Accepted Version
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