Page 159 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

134 Chapter 5. Different Wound Type

associated pain can be disabling and interfere with their
ability to undertake daily activities and having a detrimental
impact on psychological well-being (Gorecki et al. 2009 ).
Interestingly, the descriptive words used to describe pain
associated with the different stages of pressure ulcers (see
Table 5.3 ) demonstrated some significant similarities and
differences. Hence, sensory words were used by all patients
irrespective of PU category. Common words across all
Categories II-IV included tender, hurting, burning, sharp,
throbbing, hot burning, and aching. Words common for PU
Categories II and III included sore; for Categories II and IV:
itching and stinging; for Category III and IV: stabbing and
heavy (Gorecki et al. 2011 ).
A model that integrated both the psychosocial variables
associated with pain along with the physiological was pro-
posed by Gorecki et al. ( 2011 ) which included five main con-
ceptual domains: communicating the pain, feeling the pain,
impact of the pain, self-management behaviours, and profes-
sional pain management. Importantly, the model suggests that
the pain must be managed appropriately both by traditional
medical and nursing means but also by effective communica-
tion with the patient: “We need to help tissue viability and
community nurses link in with other pain management sys-
tems to enable them to engage with patients holistically and
provide the most effective PU pain management” (p. 456).
Spilsbury et al. ( 2006a , b ) found that pressure ulcer suf-
ferers reported feeling as though they were a burden due to
their increasing dependency on others to care for them. This
resulted in patient’s expressing resentment and frustration
at their incapability and need of consistent help. In relation
to the impact of pressure ulcers in patients who had suffered
traumatic and debilitating injuries (i.e. road accident), such
ulcers were considered unimportant. However, other patients
became preoccupied over their ulcers, resulting in increased
pain and feelings of anxiety whenever anticipating moving
positions. This led to further worry associated with the heal-
ing of the wounds. As such, patients suffered with feelings of
misery and depression. As with the wounds discussed previ-
ously the physical and social implications associated with
the pressure ulcers often led to a significant psychological