Lived experiences of Jamaican hospital patients with delayed wound healing

Abstract

Introduction: Many individuals suffer from chronic or complex wounds that can be very difficult to heal and cause severe pain and hardship. In the absence of any evidence based local information on the topic, this study explored the lived experiences of Jamaican hospital patients with delayed wound healing using physiological, psychological, socio-cultural, developmental and spiritual perspectives. Methods: A qualitative descriptive study design with a purposive sampling method was used to select five patients, two males and three females (aged 33 years old to 56 years old) from a regional hospital in western Jamaica, who were recruited into the study. They each had a single chronic ulcer on an extremity. Following ethical approval and informed consent, individual interviews were conducted and thematic analyses were done on the data. Results: Diabetes mellitus and infection were the etiologic factors in their delayed wound healing. All of the participants experienced social isolation, low self-esteem, "frustration", job loss/loss of man hours, financial dependence and impaired physical mobility. They desired improved communication with healthcare personnel, more supportive and caring attitudes from family and caregivers; as well as enhanced learning experiences to acquire the self-care skills needed for all aspects of diabetes control and wound care. Conclusions: The patients' lived experiences and stated needs should be noted by all caring health professionals. Future interventions and care plans should address all the perspectives experienced and described by these patients.

Diyabetik Ayak Ülseri Olan Hastalarda Uyku Kalitesi Ve Öz-Yönetim Algısı: Çorum/Türkiye

“…In our study more than half of the patients (68.9%) had a HbA1c level >7%, which means patients had uncontrolled blood sugar levels. So that impaired sleep quality disrupts the adequate glycemic control, the most important factor in the development of diabetic foot ulcers is untreated or uncontrolled blood sugar levels (Ekpo et al, 2016;Obilor and Adejumo, 2015;Luyster and Dunbar-Jacob).…”

“…Diabetic foot is one of the diabetic complications that are resulted from motor, sensory and autonomic neuropathy, macrovascular disease, skin infections and mechanical factors (Demirci et al, 2016). At the same time, diabetic foot is one of the important public health problems that can lead to organ loss over time, psychological, physical, social and economical problems, affecting quality of life and increasing hospitalization duration with gradually increasing mortality and morbidity (Ekpo, Duff, Bailey and Lindo, 2016;Yazdanpanah, Nasiri and Adarvishi, 2015;Yücel and Sunay, 2016). The prevalence of diabetic foot ulceration in the diabetic population is 4-10%; the condition is more frequent in older patients (Alexiadou and Doupis, 2012).…”

“…Sleep process which is one of the most important daily life activities has healing roles such as tissue regeneration, repair of cell damage and hormonal regulation of persons and a positive supportive role in quality of life. Therefore, sleep is quite important in wound healing in diabetic foot ulcers (Ekpo et al, 2016;Salomé, Pellegrino, Blanes and Ferreira, 2013;Luyster and Dunbar-Jacob, 2011). The inadequate control of blood sugar is the primary cause of DFU and lead to impaired wound healing, resulting in reduced quality of life (Ekpo et al, 2016;Depner, Stothard and Wright 2014;Luyster and Dunbar-Jacob, 2011).…”

“…Therefore, sleep is quite important in wound healing in diabetic foot ulcers (Ekpo et al, 2016;Salomé, Pellegrino, Blanes and Ferreira, 2013;Luyster and Dunbar-Jacob, 2011). The inadequate control of blood sugar is the primary cause of DFU and lead to impaired wound healing, resulting in reduced quality of life (Ekpo et al, 2016;Depner, Stothard and Wright 2014;Luyster and Dunbar-Jacob, 2011). The poor sleep quality and daytime sleepiness negatively affect multiple psychological and social factors required for optimal diabetes self-management (Chasens et al, 2013;Arora and Taheri, 2015;Adwan and Najjar, 2013;Hu, Amirehsani, Wallace and Letvak 2013).…”

Literature Review: The Influence Of Illness Perceptions On Patients With Diabetic Foot Ulcer

“…They also confront financial burdens due to medical expenses and transportations from home to medical services [12]. For the spiritual aspect, the patients will be unable to attend spiritual activities due to physical limitations and embarrassed feelings [17] There are numerous factors that developed the ulceration in diabetic patients. According to American Diabetic Association (ADA) [18], the main contributor factors for ulceration among diabetic patients are peripheral neuropathy (PN), peripheral vascular disease (PVD), poor glycemic control, visual impairment, smoking, foot deformities, diabetic nephropathy, previous amputation, and past ulcer history.…”