Page 156 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

Pressure Ulcers 131

resilience and hope, particularly related to the healing of
their ulcers.
The results of these studies are in line with other stud-
ies (e.g. Ebbeskog and Ekman 2001a , b ), and in some cases
the health care professional (particularly the community
nurse) was essential in developing social interaction. The leg
club model of leg ulcer management (Lindsay 2001 ) aims
to address the psychosocial aspects of living with a chronic
venous leg ulcer and will be explored further in Chap. 8 .
Morgan and Moffatt ( 2008 ) explored the relationship
between patients and the community nurses caring for
them. The importance of the nurse-patient relationship was
stressed, particularly in developing effective strategies for
daily living. However, patients often felt that nurses showed
a lack of understanding and a gap was noted between the
patient goals for comfort and the nurse goal of healing (more
information on the nurse-patient relationship is discussed in

Chap. 7 ). Studies (e.g. Douglas 2001 ) have highlighted the
issues of recurrent problems included nurses experiment-
ing with various dressings and patients receiving conflicting
advice about management of their leg ulcer. Furthermore,
patients felt that the pain assessment and management issues
were not adequately addressed during the consultation. This
is important, given that most studies have indicated that
pain is the fundamental issue of living with VLU (e.g. Green
et al. 2013 ; see Chap. 2 ). Pain assessment is essential with all

wounds, irrespective of cause and it is interesting to note that
the terms and pain descriptors used by patients may differ
dependent on the wound (see Table 5.2 ).

Pressure Ulcers

Pressure ulcers have become an increasing healthcare prob-
lem in many countries (Kaltenthaler et al. 2001 ). Also known
as pressure sores, bedsores and decubitus ulcers, these wounds
are often found in individuals who are older, neurologically
compromised, have mobility problems, seriously ill, or have
nutritional deficiencies (Spilsbury et al. 2006a , b ). Pressure