Page 104 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

78 Chapter 3. Stress

influence their experience of pain. Stress can have a signifi-
cant impact on the way in which a patient perceives pain, with
research highlighting high stress and pain anticipation as
resulting in the experience of increased pain intensity
;
(Solowiej et al. 2009 Upton et al. 2012a ,). Therefore, it is rea-
sonable to conclude that heightened stress and anxiety can, as
previously noted, result in a lowered pain threshold and
reduced pain tolerance (Woo et al. 2009 ).
Due to the detrimental impact of stress upon pain and
wound healing, it is essential for health professionals to adopt
some form of ‘stress management techniques’ in order to
minimise or manage its occurrence (Upton 2011a , b ). A num-
ber of such methods have been developed in order to try and
reduce or teach patient’s to cope with their stress some of
which will be outlined below.

Managing Stressors

Firstly, in order to reduce stress it is necessary to remove, if at
all possible, the stressor or modify the exposure to stressful
situations. However, achieving this with stressors related to
patients with chronic wounds can prove difficult. For instance,
wound related stressors such as dressing changes cannot be
‘removed’ due to its essential element in the treatment of
wounds. If patients were to avoid such essential elements of
wound care, negative physical consequences may arise (this
will be discussed later in the book). Alternatively, rather than
remove the stressor (i.e. the dressing change), it may be more
appropriate for the clinician to modify the technique used.
Research has highlighted a number of wound dressings
that can cause pain and tissue trauma during the dressing
change procedure. These include alginate, foam, film, hydro-
gel, and hydrocolloid (Hollinworth and Collier 2000 ). The
pain experienced during the use of one of these dressings can
result in the patient experiencing heightened stress and sub-
sequent pain. Thus, a more appropriate dressing which facili-
tates reduction in pain and trauma should be considered as