Explanatory model of chronic venous disease in the rural Midwest—a factor analysis

Advanced practice nurses caring for patients with venous disease may not be aware of the patient's understanding of illness, including the disease process, treatment, or outcomes. The advanced practice nurse uses his or her interpretation of illness to teach patients. Greater congruence between the nurse's and patient's understanding may result in enhanced communication, learning, and adherence. Exploration of the patient's reality may provide insight into a unique view of illness that may or may not be congruent with the biomedical model of disease. The current investigation attempts to identify an explanatory model of illness for chronic venous disease, by using the researcher-developed Diseases of Veins Explanation Survey. Data from a nonprobability sample of 114 primarily white, rural Midwestern, well-educated patients with medically confirmed and patient-acknowledged venous disease was collected at 7 sites. Twelve (10.5%) patients were men and 102 (89.5%) were women. Age range was 18 to 81 years. The factor analysis is presented. Elements of illness according to Kleinman (factors) did not fit within Kleinman's explanatory model of illness categories identified a priori in the instrument.