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Page 2 of 6 Kaima et al. Vessel Plus 2020;4:37 I http://dx.doi.org/10.20517/2574-1209.2020.50

INTRODUCTION
Chronic venous disease (CVD) is a condition that effect the veins of the leg. It includes various
clinical signs from mild to severe form such as telangiectasia, reticular vein, varicose vein, leg edema,
hyperpigmented skin changes, dermal sclerosis, and venous ulcer. Telangiectasia and reticular veins are
defined as the modest form of chronic venous disease. They are abnormalities of the vein inside or near
the skin layer, which are swollen with blood accumulating to blue or purple lines, usually in the legs or
feet. Varicose veins are larger than telangiectasia and are located below the skin layer and in subcutaneous
fat. They are common, especially for women, elderly individuals, pregnant women, obese people, family
history, and those who walk or stand for long periods of time, which gives fatigue, swelling, and other
[1-5]
symptoms . This disease usually does not cause serious complications such as death, but it can affect the
quality of life.

This study focuses on nurses. Nurses typically have to walk or stand constantly, which results in an
[4-7]
increased risk of developing CVD due to their working conditions . There is often a debate in the nursing
field that operating room nurses (OR nurses) walk and stand all day and are more likely to have varicose
veins than other nurses (non-OR nurses). However, non-OR nurses have claimed that because they are
constantly walking, they are more likely to have varicose veins. Thus far, there have been no studies to settle
the debate. Therefore, our study will investigate the prevalence of chronic venous disease in OR nurses and
non-OR nurses, as well as a comparative study between the two groups.

METHODS
Patients and data collection
A cross-sectional study was performed between May 2013 and June 2013. The study subjects were nurses
including OR nurses and non-OR nurses at Faculty of Medicine, Chiang Mai University, Chiang Mai,
Thailand. This study was approved by our local ethics committee, Faculty of Medicine, Chiang Mai
University (SUR-13-1390-EX). All subjects provided written informed consent. This study was conducted
per the guidelines of the Declaration of Helsinki. Data was collected by a questionnaire that was divided
into two sections. The first section of the questionnaire pertained to individual characteristics, risk factors,
and history of CVD. The second section pertained to quality of life by using Chronic Venous Insufficiency
Quality of Life Questionnaire-14 (CIVIQ-14) that was validated as a useful measurement in assessing
[8]
CVD . The physical examination was operated by the examiners for the varicose vein based on the
clinical finding using CEAP classification. The CEAP classification includes clinical, etiologic, anatomic,
[9]
and pathologic parts . The clinical classification consists C0 to C6. C0 is no visible sign of CVD. C1 is
telangiectasia or reticular veins. C2 is varicose veins. C3 is leg edema. C4 is hyperpigmented skin or dermal
sclerosis. C5 is healed venous ulcer and C6 is active venous ulcer.

Statistical analysis
All statistical analyses were performed with STATA 14.0 (StataCorp LP, USA) for Windows. Descriptive
statistics of continuous variables were represented using mean ± standard deviation (SD). Categorized
variables were represented with percentages. Differences between the two groups were analyzed with T-test/
Mann Whitney U test or Chi-square. Statistical significance was set at P < 0.05. Sample size calculation for
this study were based on the possible proportion of varicose veins from 30% to 35% . Significance levels
[4]
are 5% and power levels are 80%.

RESULTS
A total of 222 nurses were included in this study. Two hundred and nine (94.1%) nurses were female, and
99 (44.6%) were OR nurses. The baseline characteristics are shown in Table 1. We found that the height of
the OR nurses was greater than that of the non-OR nurses (155.61 ± 5.67 cm vs. 157.77 ± 6.05 cm; P = 0.013).