Healthcare delivery
compression systems were generally small and uncertain, although four-layer bandaging and two-layer hosiery emerged as the most cost- effective options in the UK.17 These findings support the continued use
of evidence based strong compression, while emphasising that the specific system should be selected according to the individual’s clinical needs, physical capabilities, preferences and ability to use it correctly and consistently. Importantly, curiosity does not mean abandoning clinical expertise or standards of care. Rather, it allows clinicians to use their expertise more effectively by understanding the context in which treatment is delivered. When clinicians approach patient behaviour with curiosity rather than judgement, conversations become more collaborative and solutions more achievable. In this way, curiosity becomes an important clinical skill for supporting patients to develop greater confidence and participation in their own care.
Supporting patients to step into self-care Encouraging patients to take a more active role in lower limb management requires more than simply providing information. For many individuals, self-care represents a significant change from the traditional model of nurse led treatment. Patients who have become accustomed
to regular professional care may initially feel uncertain about their ability to undertake elements of treatment independently. Supporting this transition therefore requires a gradual and structured approach. Education plays a central role in helping patients participate confidently in their care. Patients require clear explanations not only of what to do, but also why the treatment is important. Understanding venous disease and the role of compression in improving venous return can help patients recognise how their actions contribute to healing.18 Demonstrations, visual aids and written information can reinforce this learning and provide a practical reference outside the clinical consultation. Structured resources such as illustrated guides, instructional videos, patient diaries and application aids can extend this support beyond clinical contact. They can help patients understand treatment routines, monitor symptoms and recognise when to seek clinical advice. Medical device companies can contribute expertise in product usability and visual communication; however, resources should be developed collaboratively with clinicians and informed by patient feedback to ensure that they are accurate, accessible and relevant. As discussed earlier in this series, the Lower
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Fig 2: The Lower Limb Passport: A patient facing resource designed to support education, shared understanding and participation in lower-limb care. Reproduced with permission from L&R UK
Limb Passport and My Leg Diary provide examples of resources designed to support understanding and encourage active participation in day-to-day care.2,3
(Fig 2). Used appropriately, such resources
can strengthen patient confidence and support more consistent engagement with treatment. Confidence often develops through practice.
Encouraging patients to participate in small elements of their care during consultations, such as assisting with the application of compression hosiery or participating in dressing changes can help build familiarity with the process. Over time, these incremental steps allow patients to develop the skills required to undertake aspects of treatment independently. Practical support may also be required to
address physical or environmental barriers. Compression application aids, adjustable wraps or the involvement of family members and carers can make treatment more manageable for patients with limited dexterity or mobility. In some cases, minor adjustments to routines or equipment can significantly improve a patient’s ability to engage with treatment. Equally important is maintaining an accessible safety net. Patients need reassurance that support remains available if concerns arise. Scheduled reviews, clear contact pathways and written guidance on when to seek help can help maintain clinical oversight while allowing patients greater autonomy in their care. When patients feel informed, supported and confident in their ability to manage aspects of treatment, participation in self-care becomes more achievable. Rather than replacing professional care, supported self-management enables clinicians and patients to work together, ensuring treatment remains both effective and sustainable.
Conclusion
Supporting patients who feel hesitant about self-care begins with understanding their perspective. What may initially be interpreted as resistance, often reflects understandable concerns, practical barriers or previous experiences that shape how individuals approach their care. When these factors are acknowledged and explored, reluctance becomes less of a barrier and more of an opportunity for conversation and understanding. Lower limb management frequently requires sustained engagement with treatments such as compression therapy, skin care and symptom and lifestyle monitoring. For many patients, this represents a significant commitment within the context of everyday life. Recognising the realities patients face,
including discomfort, lack of confidence, physical limitations and social circumstances, allows clinicians to tailor support and treatment in ways that make participation more achievable. Across this series of articles, we have explored
the broader context of lower limb self-care, the sustainability challenges facing services, the professional transition required from clinicians and, here, the patient perspective. These themes highlight an important
principle: sustainable models of care are not achieved simply by transferring responsibility from clinicians to patients, but by developing partnerships in which both are supported to contribute effectively. When clinicians approach patient behaviour with curiosity rather than judgement, conversations become more open and collaborative. Through education, reassurance and practical support, patients can gradually develop the confidence and capability required
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