Page 124 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

98 Chapter 4. Quality of Life and Well- Being

Both generic and wound specific measures of HRQoL
which can be used with a wound population are therefore
readily available. A recent review (Palfreyman et al. 2010 )
found that generic measures such as SF36, NHP and EQ-5D
did demonstrate that individuals with wounds had reduced
QoL in comparison to the general population. However the
ability of measures such as CWIS and CCVLUQ to detect
changes in QoL as patients healed was found to be limited.
This is in part because the measures all include questions
only relevant when an ulcer is present, limiting their applica-
bility following healing. CWIS was also criticised for
attempting to be too broad in its application. The CWIS was
designed to be applied to all chronic wound types ranging
from pressure ulcer, through sinuses, diabetes, trauma and leg
ulcers. Unfortunately the significant differences in impact
seen between these different types of wound seems to have
seriously limited the sensitivity of this measure. This under-
lines the importance of specificity for increasing sensitivity to
change and also underlines the importance of ensuring you
choose the right tool when measuring HRQoL. For example
Higginson and Carr ( 2001 ) suggest a two step method to
choosing and implementing a QoL measure in a clinical set-
ting. The first step (choosing the measure) advises clinicians
to answer ten questions about the measures being reviewed
including the relevance of the domains covered, the similarity
of the population and setting in which the measure was
developed to the one about to be assessed, the reliability and
validity of the measure, length of time taken to complete, and
easy of use. The second step – introducing the measure into
practice is considered later in this chapter.

Measuring Well-Being

Increasing importance is being placed on the well-being of
the individual living with a wound, as evidenced by the intro-
duction of an International Consensus Document ( 2012 ) on
well-being which has at its heart the aim of ensuring ‘that