Quality of life in patients with chronic wounds: magnitude of changes and predictive factors

Abstract

Objective:To assess health-related quality of life, its predictors and magnitude of changes in health-related quality of life in patients with chronic wounds receiving specialized outpatient treatment. Method: Secondary, retrospective, descriptive, quantitative study with patients with chronic wounds from two specialized outpatient services in Brazil assessed through Ferrans & Powers Quality of Life Index-Wound Version, Visual Analog Pain Scale, Global Assessment Scale, Pressure Ulcer Scale for Healing, sociodemographic and clinical questionnaires at baseline and after 60 days of treatment. Data were analyzed by ANOVA, Spearman Coefficient, Mann-Whitney test and multivariate logistic regression. Results: Twenty-seven patients participated in the study. The overall health-related quality of life scale, health and functioning subscale and socioeconomic subscale scores increased after 60 days of treatment compared to baseline. Pain reduction was a predictor of changes in overall health-related quality of life score as well as religious practice in the family subscale. 92.6% patients perceived moderate to extensive changes in health-related quality of life. Conclusion: there was improvement of health-related quality of life for the sample studied in the period; pain and religious practice have emerged as predictors of changes in health-related quality of life. DESCRIPTORS INTRODUCTIONChronic wounds are among health conditions which the patient may suffer for several years, often causing impairment of work activities that results in early retirement and restrictions in daily living and leisure activities (1)(2)(3)(4) , thus reducing the quality of life (QoL) at any stage of the life cycle and across all life domains (2) . Chronic wounds lead to feelings of frustration, anxiety, isolation, depression, low self-esteem, and negative self-concept, thus reducing the QoL of patients (1,4) . The way patients experience their lives, deal with the problem, and perceive family support are challenges faced by nurses. Emotions and thought patterns emerge as key determinants of overall health (5) . Thus, the assessment of health-related quality of life (HRQoL) is an important way for evaluating the results of health interventions by focusing on biopsychosocial needs in search of improved living conditions (6) . There are numerous definitions of HRQoL that include fundamental ideas. The concept should indicate whether the health status measured or estimated is relatively desirable (7) . The assessment of HRQoL is an attempt to quantify the consequences of diseases and treatments, according to the subjective perception of patients (8) .For the purpose of this study, QoL is defined as "a person's sense of well-being that stems from satisfaction or dissatisfaction with the areas of life that are important to him/her", as proposed by the authors of the instrument (9) . This theoretical framework laid the foundation of Ferrans and Powers Quality of Life Index (FPQLI) (10) , a generic instrument for evaluating QoL, from which ...

Qualidade de vida de pessoas com feridas crônicas

“…Other studies have also highlighted pain as a negative factor for QoL, since it causes discomfort and limits daily and social life activities. (25)(26)(27) In addition to impairing wound healing, pain causes decrease in quality of life, difficulty in activities of daily living, changes in lifestyle, frustration and immobility, which may result in social isolation. (6) Thus, it is essential to conduct other studies that investigate the etiological factor of pain in patients with wounds and evaluate the care measures and the methods adopted, since the technological innovations developed to minimize this aggravation are increasing.…”

Systematic review of the efficacy of topical haemoglobin therapy for wound healing

“…It is well known that patients with chronic wounds often experience pain, especially that associated with changes in dressings, which causes distress to patients. 41,42 Haemoglobin therapy offers a potential solution to this problem. A large number of studies found that this technique was able to relieve pain to a significant degree.…”

Quality of life related to clinical aspects in people with chronic wound

“…Investigations on the etiology, risk factors and treatment of chronic wounds resulted in evidence-based consensus and treatment guidelines (7) . However, overall management of the problem is still incipient, as people with chronic wounds have negative functional and psychological consequences, which generally result in poor QoL (8) . Even when promoting care that considers the best evidence, many wounds do not heal easily.…”

“…In addition, frequent complications that result in complex morbidities and the scarcity of care records are also systemic factors which interfere in the QoL (6) of people with chronic wounds. However, the clinical pain parameter is the factor that most frequently influences the QoL (8) of these people.…”