Page 185 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

160 Chapter 6. Treatment

treatment prior to starting NPWT and that effective communi-
cation is maintained between patient and clinician.
Although some studies have measured quality of life in peo-
ple receiving NPWT, these studies do not tell us about patients’
actual experiences. Abbotts ( 2010 ) conducted a qualitative
study in order to explore patients’ views of NPWT. The author
adopted a ‘subtle realism’ theoretical basis, acknowledging
the socially-constructed meanings surrounding one’s external
reality. Focus groups and interviews were conducted with
12 participants who had a variety of wound types, including;
abdominal surgery, cardiac bypass surgery, mastectomy, toe
amputation in diabetic foot, diabetic foot ulcers, skin graft over
venous leg ulcer and leg degloving injury. Nine major themes
emerged from the data; these were: healing, smell, embarrass-
ment, pain, nurse training, self-care, information provision,
getting out of hospital and getting back to normal. It was found
that patients felt embarrassed due to the noise and aesthetics
of the system and the odour of the exudate. This restricted
their social life and resulted in anxieties as they worried that
others would smell the exudate. Participants also reported
that the nurses who cared for them were unfamiliar with the
NPWT system, and that they had to demonstrate to nurses
how to change dressings. A need for information regarding the
system was also noted. Despite these anxieties, participants felt
that the system was effective in healing their wounds.
More recently, Bolas and Holloway ( 2012 ) conducted a
qualitative investigation to examine patients’ experiences and
perceptions of NPWT. Six participants, two male and four
female, were interviewed. Two participants had wounds on
their hip, two on their foot, one had an abdominal wound and
one had a wound on their lower thigh/knee area. The authors
adopted a phenomenological approach, allowing them to col-
lect rich data on the patient’s own experiences. Interviews
covered the physical, psychological and social impact of using
NPWT, lasting approximately 1 h. Three major themes were
reported; an altered sense of self, new culture of technology,
and restricted lives. Patients did not feel comfortable with the
NPWT system as it affected their self-image through remind-
ing them of their wound and disfigured appearance. This had a
significant impact on the patient’s self-esteem and motivation.