The Role of Clinicians' Self-Efficacy in Exercise Promotion for Adults with Venous Leg Ulcers: A Cross-Sectional Study.

Abstract

Introduction: Physical activity is recognised for its functional, physical, and psychological benefits in managing venous leg ulcers. Despite these advantages, individuals with venous leg ulcers often remain inactive, largely due to fear of exacerbating their condition and a lack of comprehensive guidance. Clinicians play a crucial role in promoting physical activity, providing support to patients to engage in safe and beneficial exercises. This study aimed to assess clinicians' knowledge, attitudes, and practices toward physical activity in adults with venous leg ulcers to inform clinical practice and the development of targeted physical activity strategies.

Methods: An online questionnaire was developed to assess clinicians' familiarity with physical activity guidelines, their confidence in recommending physical activity, and the barriers they encountered in practice.

Results: A total of 141 clinicians, predominantly nurses (99%), completed the survey, with 83% reporting awareness of clinical guidelines for venous leg ulcer management. However, only 25% regularly recommended a general increase in physical activity, 27% recommended calf strengthening exercises, and 38% consistently recommended ankle joint mobility exercises. Key barriers; 1) insufficient training to recommend specific exercises, 2) lack of evidence-based information to provide to patients and 3) limited access to exercise specialists for referrals. Statistical modelling showed that self-efficacy significantly influenced recommendations for ankle mobility exercises; clinicians with higher confidence were 7.6 times more likely to make such recommendations (p < .001). Although attitudes toward prescribing ankle exercises to adults with venous leg ulcers in compression were not statistically significantly related to reported practice (p = .087), they demonstrated relevance to clinical decision making and warrant further investigation.

Conclusion: While clinicians recognise the importance of physical activity for adults with venous leg ulcers, gaps in knowledge, resources, and training limit their ability to provide specific exercise recommendations. Addressing these gaps through large-scale implementation of structured physical activity strategies is essential.