Page 178 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

Compression Bandaging 153

research has indicated that this type of bandaging causes
pain, and achieving the correct compression is nurse depen-
dent (Anand et al. 2003 ).
As highlighted, compression bandages are required for as
long as there is venous leg ulceration, which may be a lifetime
(O’Meara et al. 2009 ; Moffatt 2004b ). Bandages are typically
applied from the base of the toes to just below the knee and
this may have a significant impact on both an individual’s
body appearance and their body image. Indeed, a number
of studies have suggested that compression bandages may
negatively affect body image, appearance and social activ-
ity, which may significantly reduce patient concordance with
treatment. For example, Annells et al. ( 2008 ) suggested that
patients decided to stay at home when not being able to
wear normal shoes due to bulky bandages or because of the
unsightly visibility of the bandages. Similarly, Finlayson et al.
( 2009 ) identified that in their sample of 122 patients with
venous leg ulcers more than half used padding or covered
their legs or avoided going outside or in any situation which
may cause any trauma to the legs, which again could lead to
social isolation. Furthermore, Dereure et al. ( 2005 ) evaluated
concordance rates with compression therapy in patients with
venous leg ulcers using a questionnaire completed by 1,397
patients. It was identified that 40 % were unable to wear
their regular shoes and 45 % regarded compression ban-
dages as unaesthetic which then led to lower concordance to
treatment.
Similarly, Mudge et al. ( 2006 ) identified that special-
ist footwear formed a central focus of the patient’s body
image. Having to wear specialist footwear caused patients
embarrassment and consequently affected them going out
or socialising This also affected a patient’s decision on what
to wear, with many feeling that wearing trainers was unac-
ceptable with a skirt, and therefore wore trousers. As well
as this the authors found that patients would modify their
footwear to accommodate the bandages. Furthermore, King
et al. ( 2007 ) reported on the views of 102 patients, of which
26 % of patients wore socks, slippers or no foot wear at all