Page 118 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

92 Chapter 4. Quality of Life and Well- Being

QoL might fluctuate over time. Thus at Time 2 an event, such
as diagnosis of a venous ulcer provokes a change in a person’s
perception of themselves, thus widening the gap between
actual and ideal self and lowering QoL. At Time 3 the same
individual has come to terms with their altered functioning
and lowered their expectations of their ideal self in line with
this change in actual self. The gap has therefore diminished
and QoL will have improved, even if it may not be back to the
initial level. As health improves so expectations of self
increase and QoL returns to its original set point.
One idea about how we arrive at this ideal and actual self
is the social comparison theory. This theory proposes that we
make QoL judgements by comparing ourselves, our status
and/or our situation with that of others (Suls et al. 2002 ).
Sometimes we choose to compare ourselves to others who
are in a more fortunate situation than we are, at other times
we might compare ourselves to individuals or groups who are
worse off than we are. Either of these comparisons can result
in enhancement or diminishment of our own situation – and
therefore either widen or shrink the gap between reality and
aspiration. For example, a patient undergoing NPWT might
compare themselves with someone else who has undergone
the same treatment for the same diagnosis and is now cured,
and believe that they too will get better. The cured role model
therefore provides hope and inspiration by demonstrating
what can be achieved (Suls et al. 2002 ). Alternatively com-
parison to someone who is more fortunate could suggest to
an individual that they are relatively disadvantaged, leading
to a reduction in QoL assessment. In contrast a patient being
treated with traditional wound care might look at someone
who they see as worse off than they are (undergoing NPWT
for example) and feel better about their own situation so
enhancing their own perceived QoL, or remind them that
their own status could also decline leading to reduced
QoL. So just what influences whether or not social compari-
son serves a self-enhancement function?
One factor that may influence these social comparisons is
affect (Wheeler and Miyake 1992 ). This is consistent with