Page 181 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

156 Chapter 6. Treatment

impact of NPWT on patients’ pain and functional activities.
Other studies have also considered ways in which pain can be
minimised with NPWT. For example, Wolvos ( 2004 ) conducted
a retrospective analysis of five cases of patients receiving
NPWT and reported that instillation of a topical anaesthetic
into the wound reduced pain for people having NPWT.
Additionally, studies have considered the use of low-
pressure NPWT and the effects on pain levels. In a case
study of two patients with Fournier’s Gangrene, average pain
scores were reported to be low to moderate during treat-
ment and dressing changes. It was also reported that this type
of NPWT was easy to use and promoted patient comfort
(Verbelen et al. 2011 ). Another study exploring low-pressure
NPWT in three wound patients found that average pain lev-
els were moderate (4–5 out of 10) and that pain levels tended
to reduce during the course of treatment (Nease 2009 )
The majority of the studies reported so far did not take
measures to explore patients’ experiences throughout the
treatment intervention. Fixed scoring measures, such as
inferring pain through pain-killer dosage, were used in order
to report wound pain, odour and ease of dressing changes.
Therefore, whilst the findings provide some insight into the
pain associated with NWPT, they say little about patients’
experience during treatment.
Research focusing on the quality of life (QoL) of patients
receiving NPWT has reported mixed findings, although
several studies have reported patient benefits of NPWT, such
as reduced frequency of dressing changes and less time spent
in hospital (Assenza et al. 2011 ). Bryan and Dukes ( 2009 )
reported the case of a 55-year-old woman receiving NPWT
who was able to spend time at home rather than in hospi-
tal due to the treatment, although the noise of the device
impacted upon her ability to sleep, and regular visits to the
hospital resulted in her requiring support from family mem-
bers. However, the patient in this study suffered a bereave-
ment during the process, so this is likely to have affected her
life considerably.
Despite such findings, the above studies have not directly
explored quality of life in patients receiving NPWT. One study
that focused on the impact of NPWT on QoL involved the use