Page 128 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

102 Chapter 4. Quality of Life and Well- Being

activities (Persoon et al 2004 ). Lack of energy, which also
limits physical functioning, has also been reported in some
studies (Fagervik-Morton and Price 2009 ).
Psychological functioning is also reduced in people with
wounds, with one of the most commonly reported responses
being depression or feeling ‘low’ (e.g. Finlayson et al. 2010 ;
Finlayson et al. 2011 ; Jones et al. 2006 ; Jones et al. 2008a ;
;
Byrne and Kelly 2010 Upton et al. 2012 ); some people even
report feeling so low that they have thoughts of suicide
;
(Byrne and Kelly 2010 Mapplebeck 2008 ). Physical symp-
toms such as pain and length of healing time have been
linked with feelings of depression (Byrne and Kelly 2010 ).
Other factors which have been shown to increase problems of
mood include limited knowledge of one’s condition and
;
treatment (Douglas 2001 Flaherty 2005 ); a lack of confidence
in healthcare professionals (Mudge et al. 2006 ); being cared
for by unfamiliar nurses (Hopkins 2004a ; Byrne and Kelly
2010 ; Walshe 1995 ; Brown 2005a , b ); feeling ignored or mis-
treated by clinicians (Ebbeskog and Emami 2005 ); and
finally, conflicts in the nurse-patient relationship due to a dif-
ference in focus on treatment outcomes versus symptom-
relief (Brown 2005a , b ).
In addition to low mood, studies have highlighted feelings
of embarrassment, anxiety and reduced self-confidence in
relation to body image; more extreme emotional responses to
body image such as shame, disgust and self-loathing have also
been recorded (Hopkins 2004a ; Byrne and Kelly 2010 ; Jones
et al. 2008a ; Mapplebeck 2008 ; Douglas 2001 ; Ebbeskog and
Ekman 2001a ; Mudge et al. 2006 ; Flaherty 2005 ). Fear of
amputation may also be an issue for people with venous leg
ulcers (Mapplebeck 2008 ; Hopkins 2004a ). Other high arousal
feelings such as anger and frustration have also been noted
(Jones et al. 2008a ; Mapplebeck 2008 ). Finally, patients may
report feeling helpless, as though they lack control (Walshe
;
1995 Jones et al. 2008a ).
Social functioning has also been found to be compromised
in people with chronic wounds (Adni et al. 2012 ; see Chap. 1 ).
Problems associated with having a wound (in particular