Page 184 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

Negative Pressure Wound Therapy 159

90
Least pain
80
70
60
Most pain
50
40
30
20
10
0
Removal of foam Removal of dressing Application of suction Application of foam Removal of gauze Application of gauze Cleaning Immediately after NPWT During NPWT Application of dressing

% clinicians reporting minimal/no pain
Figure 6.3 Clinicians reports of minimal/no pain

was considered to be the most painful stage, with 53 % expe-
riencing some level of pain during this stage, followed by
dressing application (49 %). Clinician reports are indicated in
Fig. 6.3 and suggest that they considered removal of foam to
be the most painful, with the application of the dressing the
least painful. Given the changes over time, these findings indi-
cate that accurate pain assessment is needed throughout the
stages of NPWT so as to ensure appropriate support is given.
The experiences of patients in these studies suggested that
pain is greatest at the beginning of treatment, during the initial
dressing changes. In a similar way, respondents also stated that
stress or anxiety in relation to NPWT tended to be greatest at
the start and to reduce over time (however, somewhat different
to the Parvaneh et al. ( 2014 ) study that reported greater stress
at dressing change compared to prior to dressing change).
Over a third of patients had experienced some anxiety during
NPWT, with others suggesting that stress had occurred early
on. One source of stress identified by both patients and clini-
cians is fear of the unknown, or not knowing what to expect.
Since this is recognised as a source of stress, efforts should be
made to ensure patients are given adequate information about