Page 130 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

104 Chapter 4. Quality of Life and Well- Being

• Information sharing with patients and carers’

• Comprehensive care pathways that include assessment of
QoL and well-being;

• Clinician and patient relationships are based on
collaboration
Taking a patient centred approach to wound management
should help ensure that these concerns are addressed (Reddy
et al. 2003 ). It has been suggested that patients’ greatest
problems occur because clinicians do not hear (or under-
stand) what they are saying in the context of their lives
(Husband 2001 ). For example, Jones et al. ( 2002 ) discovered
that the emotional distress presented by patients often goes
undetected by clinicians and carers.
During clinical assessment, it is therefore essential that
patients’ views and opinions are heard. One way of ensuring
this is for clinicians to use terminology that patients can
understand (Eagle 2009 ). Using this model, a patient’s per-
ceived needs in relation to their wound management can be
taken into account; for example, wound healing may not be
their top priority, but rather freedom from exudate or pain
relief. The emphasis is therefore on information and knowl-
edge provision, and collaborative decision making between
patient and clinician. Such collaboration in treatment and
management decisions fosters self-control whilst empower-
ing patients. Indeed, the patient-clinician relationship is a
vital part of the treatment planning process (Eagle 2009 ).
Assessing patient QoL and well-being is also an important
part of developing a treatment plan, and provides an effective
way of giving the patient a voice. Furthermore, assessing the
psychosocial factors associated with living with a wound
should be a routine part of practice, since factors such as pain
and stress can impact on healing and ulcer recurrence
;
(Moffatt et al. 2008 Cole-King and Harding 2001 ; Woo 2010 ;
Upton and Solowiej 2010 see Chap. 3 ). This delayed healing

;
can result either from the direct impact of psychological dif-
ficulties on physiological healing processes, or indirectly, as a
result of patients not adhering to treatment (Finlayson
et al. 2010 ). Routine assessment of QoL provides access to