Page 154 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

Venous Leg Ulcers 129

• Family history • Pain
• Comorbidities • Exudate and odour
• The cause, position and • Emotional effects of
duration of ulceration ulceration

The Uncer Symptoms

Wound Effects on
management daily life

• The nurse • Restrictions on daily life
• Location of treatment • Mobility
• Concordance • Hygiene
• Clothes and shoes
• Sleep
• Relationship
Figure 5.3 Four themes underpinning impact of VLU

overwhelming. They suggested that the impact of VLUs could
be conceptualised in the model presented in Fig. 5.3 .
Qualitative research has highlighted the substantial
impact that pain has on the patient’s experience. For exam-
ple, Walshe ( 1995 ) conducted semi-structured interviews
with patients suffering from venous leg ulcers. Within these
interviews, it was reported that pain profoundly affected the
life of the patient due to it acting as a constant reminder of
their ulceration and, in turn, produced feelings of a loss of
control. Similarly, Ebbeskog and Ekman ( 2001a , b ) found
that in highlighting pain as a central factor in their daily
lives, patients believed it to be a controlling aspect of their
lives often making them have feelings of anger and sadness,
often resulting in tears. Such emotions are particularly
important in assessing patients, particularly when consider-
ing the association of such affects with the onset of depres-
sion and anxiety, as illustrated above. Another consequence
reported as a result of pain is the restrictions often expe-
rienced by patients in relation to daily living and physical
functioning (Walshe 1995 ). Reduced mobility was has also