Pressure ulcers and their treatment and effects on quality of life: hospital inpatient perspectives

Abstract

( 2 0 0 7 ) ( 2 0 0 7 ) Pressure ulcers and their treatment and effects on quality of life: hospital inpatient perspectives. Journal of Advanced Nursing 57(5), 494-504 doi: 10.1111/j. 1365-2648.2006.04140.x Abstract Title. Pressure ulcers and their treatment and effects on quality of life: hospital inpatient perspectives Aim. This paper reports a study exploring patients' perceptions and experiences of the impact of a pressure ulcer and its treatment on their health and quality of life. Background. Pressure ulcers are a significant health problem, and their prevention and management in primary and secondary care is high on the clinical and policy agenda. However, patients' perspectives and experiences of the impact of pressure ulcers on health and quality of life is not understood. Method. Qualitative semi-structured interviews were carried out from 2002 to 2004 with a purposive sample of 23 hospital inpatients (five men, 18 women: aged 33-92 years) with a pressure ulcer (graded 2-5) at various anatomical sites and with varied reasons for hospital admission. Data were analysed thematically. Findings. The majority of participants (91%; n ¼ 21) indicated that the pressure ulcer and its treatment affected their lives emotionally, mentally, physically and socially. They presented their perspectives on the causes of their pressure ulcer and descriptions of pain (experienced by 91%), appearance, smell and fluid leakage. Patients described amounts and quality of care they received, including levels of comfort of dressings and pressure relieving equipment and the timing of interventions. They were largely dependent on others to treat, manage and care for their ulcer, but indicated that the pain, discomfort and distress of pressure ulcers was not acknowledged by nursing staff. The pressure ulcers could be pivotal in preventing full recovery, were perceived to increase hospital stays and resulted in ongoing treatments. Conclusion. Healthcare professionals can learn from these patients' experiences about the management of dressings, providing information (in particular about realistic time expectations for healing), providing preventative interventions and understanding the importance of comfort and positioning for patients. The study highlights the complexities of evaluating the impact of pressure ulceration.

Including psychosocial factors in screening for surgery: A preliminary literature review from a social work perspective (Preprint)

“…The current review found that psychosocial issues may be overlooked against competing demands in traditional hospital structures and surgical procedures [27], which may result in increased length of stay or other consequences. In light of fiscal constraints on services, and pressure to reduce length of stay [29,32], a greater focus on screening may be warranted.…”

“…Second, regarding the influence of psychosocial factors, reviewed studies indicated that psychosocial and quality of life factors may impact the speed and nature of physical healing and recovery [27]. Specifically, psychosocial wellbeing, mood state and related factors have a major influence over hospitalisation, healing and surgical outcomes [14,24].…”

“…In summary and acknowledging the ranked quality and relevance of articles, four of the highly ranked articles emphasised the link between psychosocial issues, poorer treatment outcomes and longer hospital stays [5,14,27,29]. This underscored the importance of these connections.…”

“…Reviewed articles noted that for many patients, emotional, psychological and practical concerns are particularly pronounced on admission [32], however the pre-surgical processes and procedures rarely accommodate such screening or responses to these concerns [27]. Further, while many of the identified screening tools included psychosocial dimensions, they had a strong focus on biomedical factors, and most were administered by nurses.…”

Bed rest for pressure ulcer healing in wheelchair users

“…Pressure ulcers have a large impact on those affected; the ulcers can be painful, and may become seriously infected or malodorous. It has been shown that after adjustment for age, sex and co-morbidities, people with pressure ulcers have a lower health-related quality of life than those without pressure ulcers (Spilsbury 2007;Essex 2009). More specifically, when people with both spinal cord injury and pressure ulcers are compared with similar people without pressure ulcers, those with pressure ulcers had significantly lower scores (worse health status) on all SF-36 sub scales (Lourenco 2014).…”