An observational study protocol to explore loneliness and systemic inflammation in an older adult population with chronic venous leg ulcers
Abstract Background Chronic venous leg ulcers (CVLUs) are the most common type of lower extremity wound. Even when treated with evidenced-based care, 30–50% of CVLUs fail to heal. A specific gap exists about the association between psychosocial stressors, particularly loneliness, and biomarkers of i...
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doaj-91e97e7587d2409da7d8e5e1798e07d12021-02-14T12:10:00ZengBMCBMC Geriatrics1471-23182021-02-0121111110.1186/s12877-021-02060-wAn observational study protocol to explore loneliness and systemic inflammation in an older adult population with chronic venous leg ulcersTeresa J. Kelechi0Robin C. Muise-Helmericks1Laurie A. Theeke2Steven W. Cole3Mohan Madisetti4Martina Mueller5Margaret A. Prentice6College of Nursing, Medical University of South CarolinaDepartment of Regenerative Medicine and Cell Biology, Medical University of South CarolinaSchool of Nursing, West Virginia UniversityDepartment of Medicine, University of California Los AngelesCollege of Nursing, Medical University of South CarolinaCollege of Nursing, Medical University of South CarolinaCollege of Nursing, Medical University of South CarolinaAbstract Background Chronic venous leg ulcers (CVLUs) are the most common type of lower extremity wound. Even when treated with evidenced-based care, 30–50% of CVLUs fail to heal. A specific gap exists about the association between psychosocial stressors, particularly loneliness, and biomarkers of inflammation and immunity. Loneliness is highly prevalent in persons with CVLUs, has damaging effects on health, and contributes to the development of multiple chronic conditions, promotes aberrant inflammation, and diminishes healing. However, the confluence of loneliness, inflammation and the wound healing trajectory has not been elucidated; specifically whether loneliness substantially mediates systemic inflammation and alters healing over time. This study seeks to address whether there is a specific biomarker profile associated with loneliness, CVLUs, and wound healing that is different from non-lonely persons with CVLUs. Methods An observational prospective study will identify, characterize and explore associations among psychosocial stressors, symptoms and biomarkers between 2 CVLU groups, with loneliness+ (n = 28) and without loneliness- (n = 28) during 4 weeks of wound treatment, measured at 3 time points. We will examine psychosocial stressors and symptoms using psychometrically-sound measures include PROMIS® and other questionnaires for loneliness, social isolation, depression, anxiety, stigma, sleep, fatigue, pain, quality of life, cognition, and function. Demographics data including health history, sex, age, wound type and size, wound age, and treatment will be recorded from the electronic health record. We will characterize a biomarker panel of inflammatory genes including chemotaxic and growth factors, vascular damage, and immune regulators that express in response to loneliness to loneliness and CVLUs using well-established RNA sequence and PCR methods for whole blood samples. In an exploratory aim we will explore whether age and sex/psychological stressors and symptoms indicate potential moderation/mediation of the effect of loneliness on the biomarker profile over the study period. Discussion This study will provide insight into the influence of psychosocial stressors, symptoms, and biological mechanisms on wound healing, towards advancing a future healing prediction model and interventions to address these stressors and symptoms experienced by persons with CVLUs.https://doi.org/10.1186/s12877-021-02060-wLonelinessChronic venous leg ulcersInflammationSocial genomics |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Teresa J. Kelechi Robin C. Muise-Helmericks Laurie A. Theeke Steven W. Cole Mohan Madisetti Martina Mueller Margaret A. Prentice |
spellingShingle |
Teresa J. Kelechi Robin C. Muise-Helmericks Laurie A. Theeke Steven W. Cole Mohan Madisetti Martina Mueller Margaret A. Prentice An observational study protocol to explore loneliness and systemic inflammation in an older adult population with chronic venous leg ulcers BMC Geriatrics Loneliness Chronic venous leg ulcers Inflammation Social genomics |
author_facet |
Teresa J. Kelechi Robin C. Muise-Helmericks Laurie A. Theeke Steven W. Cole Mohan Madisetti Martina Mueller Margaret A. Prentice |
author_sort |
Teresa J. Kelechi |
title |
An observational study protocol to explore loneliness and systemic inflammation in an older adult population with chronic venous leg ulcers |
title_short |
An observational study protocol to explore loneliness and systemic inflammation in an older adult population with chronic venous leg ulcers |
title_full |
An observational study protocol to explore loneliness and systemic inflammation in an older adult population with chronic venous leg ulcers |
title_fullStr |
An observational study protocol to explore loneliness and systemic inflammation in an older adult population with chronic venous leg ulcers |
title_full_unstemmed |
An observational study protocol to explore loneliness and systemic inflammation in an older adult population with chronic venous leg ulcers |
title_sort |
observational study protocol to explore loneliness and systemic inflammation in an older adult population with chronic venous leg ulcers |
publisher |
BMC |
series |
BMC Geriatrics |
issn |
1471-2318 |
publishDate |
2021-02-01 |
description |
Abstract Background Chronic venous leg ulcers (CVLUs) are the most common type of lower extremity wound. Even when treated with evidenced-based care, 30–50% of CVLUs fail to heal. A specific gap exists about the association between psychosocial stressors, particularly loneliness, and biomarkers of inflammation and immunity. Loneliness is highly prevalent in persons with CVLUs, has damaging effects on health, and contributes to the development of multiple chronic conditions, promotes aberrant inflammation, and diminishes healing. However, the confluence of loneliness, inflammation and the wound healing trajectory has not been elucidated; specifically whether loneliness substantially mediates systemic inflammation and alters healing over time. This study seeks to address whether there is a specific biomarker profile associated with loneliness, CVLUs, and wound healing that is different from non-lonely persons with CVLUs. Methods An observational prospective study will identify, characterize and explore associations among psychosocial stressors, symptoms and biomarkers between 2 CVLU groups, with loneliness+ (n = 28) and without loneliness- (n = 28) during 4 weeks of wound treatment, measured at 3 time points. We will examine psychosocial stressors and symptoms using psychometrically-sound measures include PROMIS® and other questionnaires for loneliness, social isolation, depression, anxiety, stigma, sleep, fatigue, pain, quality of life, cognition, and function. Demographics data including health history, sex, age, wound type and size, wound age, and treatment will be recorded from the electronic health record. We will characterize a biomarker panel of inflammatory genes including chemotaxic and growth factors, vascular damage, and immune regulators that express in response to loneliness to loneliness and CVLUs using well-established RNA sequence and PCR methods for whole blood samples. In an exploratory aim we will explore whether age and sex/psychological stressors and symptoms indicate potential moderation/mediation of the effect of loneliness on the biomarker profile over the study period. Discussion This study will provide insight into the influence of psychosocial stressors, symptoms, and biological mechanisms on wound healing, towards advancing a future healing prediction model and interventions to address these stressors and symptoms experienced by persons with CVLUs. |
topic |
Loneliness Chronic venous leg ulcers Inflammation Social genomics |
url |
https://doi.org/10.1186/s12877-021-02060-w |
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