Abstract: Balance Confidence in Persons With and Without Injection-Related Venous Ulcers (44th Annual Conference (June 9-13, 2012))

Barbara Pieper, PhD, RN, ACNS-BC, CWOCN, FAAN¹, Ellen DiNardo, MSN, RN, ANP-BC², Thomas N. Templin, PhD³, Allon Goldberg, PhD⁴, Darlene Ausby, RN⁵, Diane E. Featherston, MSN, ACNS-BC, WCC⁶ and M. Wells, MSN, RN², (1)Wayne State University, Professor/Nurse Practitioner, Detroit, MI, (2)Detroit Receiving Hospital/University Health Center, Nurse Practitioner, Detroit, MI, (3)Wayne State University, Professor, Detroit, MI, (4)Health Care Sciences, Wayne State University, Assistant Professor, Detroit, MI, (5)Detroit Receiving Hospital?University Health Center, Nurse, Detroit, MI, (6)College of Nursing, Wayne State University, Assistant Professor, Detroit, MI

Objectives/Purpose: Persons who injected illicit drugs are at risk for many injection-related health problems one of which is venous ulcers of the lower legs. This study examined balance confidence (i.e., confidence of not losing balance and becoming unsteady while performing activities) for persons with and without injection-related venous ulcers.

Background: Venous damage to the legs from drug use results in life-long, progressive skin changes, edema, and ulcers that are painful and slow to heal. These ulcers negatively affect mobility. If balance, a component of mobility, is impaired, the person is at higher fall risk and its consequences.

Methods and Design: This was a 2-group design that included person with (n=31) and without (n=30) injection-related venous ulcers recruited from an urban, indigent care clinic. Patients were individually assessed. Measures included demographic and health questionnaires, the 16-item Activity-Specific Balance Confidence (ABC) Scale, and the 5-Time Sit-to-Stand (STS) Test. Participants were 40 – 65 years of age (M = 54; SD = 5.53); men (57.4%) and women; African American (93%).

Results: Internal consistency reliability of the ABC was .97. The ABC score was strongly related to the STS (-.64). Groups did not differ by gender, education, marital status, number of medications, or alcohol use. Those with wounds were significantly older, rated health worse, and had more comorbidities (specifically, DVT, hepatitis C, neuropathies, and asthma). Higher ABC scores were significantly related to not having a wound (-27), higher self-rated health (.33), fewer comorbidities (-.35), and not depressed (-.34).

Conclusions: Little is known about venous ulcers affecting balance. Balance confidence was poorer in persons with injection-related venous ulcers. The high number of comorbid health conditions associated with injection drug use also contributed to poor balance confidence. Because of aging of injection users, research is needed to understand balance and its impact on gait for safety.

6401 Balance Confidence in Persons With and Without Injection-Related Venous Ulcers