Page 202 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

Health Beliefs, Self-Regulation and Illness Perception 177

1. Sufficiently concerned about their wound;

2. Feels threatened by the medical and social consequences

of leaving the wound untreated;

3. Believes that the recommended treatment will reduce the

medical and social consequences of the wound and that
these benefits outweigh the costs of engaging in the

treatment;
4. Believes that they can successfully carry out the prescribed

treatment (self-efficacy)
According to the HBM, by weighing up the pros and
cons of taking therapeutic action such as wearing compres-
sion bandages, people arrive at a decision as to whether
the perceived benefits (e.g. wound healing, or prevention
of recurrence) outweigh the perceived barriers or cost (e.g.
Compression causing pain and discomfort at night; Crookes
1997 ). As Moffatt ( 2004a , b ) notes, it is important to under-
stand the patient’s beliefs about compression during consul-
tation, particularly if there have been previous episodes of
failed treatment. Research into the extent to which burns
patients wear the pressure garments which they are pre-
scribed also supports the HBM; Stewart et al. ( 2000 ) found
that 56 % of burns patients were uncertain about the ability
of their pressure garments to reduce their hypertrophic scars
with almost a third of the sample not wearing the pressure
garments they had been prescribed for the full 20–24 h that
were recommended.
Self-care can be an important part of wound management,
as it was for the burns patients in the study by Stewart and
colleagues (2000). One of the barriers to wearing the pressure
suit which was described by patients, concerned the difficulty
of putting on and taking off the garment they had been
prescribed. Another barrier related to the challenge of cop-
ing with the itching and discomfort created by the suit. Those
patients who described difficulties donning and wearing the
suit could be said to lack self-efficacy – that is the belief
that they can cope with, or carry out particular behaviours.
Patients who felt unable to cope with the discomfort would
be less likely to wear their suit for the recommended length