Page 126 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

100 Chapter 4. Quality of Life and Well- Being

Symptoms Pain Treatment Social impact

Psychological
QoL Well-Being
resources

Psychological outcome

Figure 4.4 A hypothesised model of wellbeing

appropriate measures of patient well-being. Whilst the CWIS
(Price and Harding 2004 ) does include a well-being scale, the
scale is limited by its focus on questions concerning negative
affect such as anxiety and worry. It seems therefore that there
is a gap in the assessment process, since QoL and well-being
represent quite different aspects of the patient experience.
As it has developed, HRQoL has evolved into a measure
of deficit of daily living. Thus HRQoL tools typically ask
patients to consider whether their health problem hinders
physical functioning (e.g. getting dressed), disrupts social
activities (e.g. seeing friends), prevents productivity behav-
iours (e.g. going to work), or causes emotional problems such
as depression, anxiety or stress. Whilst it is of course vital that
any restrictions of physical, social and mental functioning are
documented, focusing solely on these aspects of the patient
experience is rather limited, especially since it emphasises the
deficits in a patient’s standard of living. It is also important
that an absence of negative affect is not take as an indicator
of positive mental health; just because a patient is not