Page 105 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

Managing Stressors 79

an alternative technique, thereby modifying the stressful situ-
ation. These may involve the use of soft silicone which
adheres without damaging the fragile tissue of the wound.
Hence, clinicians substituting one of the dressings noted
above with ones utilising newer technologies can significantly
reduce and sometimes prevent the occurrence of pain and
wound trauma of their patients (Dykes et al. 2001 ; Dykes
2007 ; White 2008 ; WUWHS 2007 ). Subsequently, the patient’s
perceived anxiety and stress would reduce resulting in the
disruption of the pain-stress-pain cycle.
Sometimes it is possible to get the patient to reappraise
the situation. When a stressor cannot avoid a particular
stressor it may be beneficial to get the patient to focus more
on the positive aspects of their wound management, such as
improved health and removed pain. This approach is often
adopted in cognitive behavioural interventions and has been
discovered to be useful to the wound-healing process.
Similarly, it may be beneficial to teach patients coping tech-
niques such as relaxation, active wound management and
reappraisal. This could also include the promotion of social

support (see Chap. 7 ), through sharing and discussing emo-
tions and experiences with other patients.
A number of techniques have been adopted in promoting
relaxation including Progressive Muscle Relaxation (PMR).
This relaxation technique was developed by Jacobson ( 1938 )
and proposed that the determining mechanism for relaxation
was the patient’s ability to understand the difference between
tension and relaxation. This ability to differentiate between
the two is taught through the successive tensing and relaxing
of a number of muscle groups.
Health care professionals can also influence a patient’s
perceived pain and stress through effective communicating

with their patients (Chap. 8 ). Furthermore, clinicians can
ensure that the environment in which the wound treatment is
conducted is calm throughout the procedure. Visual imagery
can also assist the alleviation of pain with clinicians guiding
the imagery (i.e. asking patients to imagine they are on a
beach, listening to the breeze, or even imagining they are at a