Page 183 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

158 Chapter 6. Treatment

QoL of patients receiving NPWT was compared with that
of patients receiving standard treatment, using the SF-36
questionnaire, which was administered on the day before
treatment commencement and then again in the month fol-
lowing wound closure. It was found that healing time was
significantly lower in those receiving NPWT and that scores
improved considerably on all eight domains of the SF-36, and
on the Physical and Mental Component Summaries.
Since anxiety can impact upon patient wellbeing and also
on their treatment outcomes, the level of anxiety experienced
during treatment needs to be considered. This was investigated
in 20 patients undergoing NPWT for traumatic wounds of the
lower extremity, compared to 20 patients with similar wounds
who were receiving traditional treatment (Keskin et al. 2008 ).
Anxiety measures were taken on the day before NPWT was
applied and then on the 10th day of treatment using the
Hamilton Rating Scale for Anxiety and the State Anxiety
Inventory Test. A significant increase in anxiety was reported
for both groups during the 10 day period. However, the mean
differences in anxiety scores for the NWPT group over the 10
days were significantly higher than for those receiving standard
treatment. This suggests that NPWT can considerably increase
patient anxiety levels. However, the authors only looked at a
10-day period, so the findings do not tell us about anxiety levels
throughout the NPWT process and after treatment.
In a series of studies, Upton and Andrews ( 2013a , b , c )
reported on the pain and stress associated with NPWT from
both a clinician and patient perspective and across the differ-
ent time points of treatment. Findings from their sample of
50 patients and over 200 clinicians worldwide indicated that
the majority rated the experience of NPWT, and the impact
of the treatment on their wound, positively. However, it was
also clear that NPWT involved a number of challenges for
patients. For example, it was found that NPWT affected the
mobility, daily activities and sleep of over half the sample.
In addition to the various practical difficulties with NPWT,
patients also reported experiencing pain during treatment.
Whilst the majority of patients did not experience wound pain
generally (55 %), a large number of respondents reported
experiencing pain during dressing change. Dressing removal