Page 129 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

Implications for Clinical Practice 103

exudate and odour) may lead to social isolation (Herber
;
et al. 2007 Price 2009), social withdrawal (Fagervik-Morton
and Price 2009 ) and changes in relationships with others, par-
ticularly carers Fagervik-Morton and Price 2009 ). Treatment
type may also prohibit involvement in social activities (Upton
et al. 2013 ). All of this may lead to loneliness (Green and
Jester 2009 ) as well as increasing psychological distress and
other negative emotional responses. In addition to this some
studies have noted a relationship between reduced capacity
to work, limitations of social functioning and financial diffi-
culties (Green and Jester 2009 ).
In contrast to what we know about changes in QoL for
patients with wounds, little is known about changes in well-
being. To date a small number of studies have demonstrated
the positive emotions that some people with VLU experi-
ence despite living with a range of negative consequences
(Hopkins 2004a ; Flett et al. 1994 ). Research into other
chronic health conditions suggests that such positivity in the
face of adversity can be explained by mediating variables
such as coping style, personality, hope, and resilience (Stanton
et al. 2001 ). Certainly hope and resilience have also been
reported in VLU patients (Hopkins 2004a Ebbeskog and
;
Ekman 2001a ; Byrne and Kelly 2010 ) and it has been pro-
posed that these are protective variables that must be
explored further in relation to well-being in wounds (Upton
et al. 2014 ).

Implications for Clinical Practice

Studies reviewed in this chapter have highlighted a number
of issues that directly impact upon the QoL and well-being of
patients with wounds and which have implications for clinical
practice including the importance of ensuring:

• Effective assessment and management of pain and stress;

• Effective strategies to manage wound exudate and
malodour;