Page 223 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

198 Chapter 8. Family, Friends and Social Support

may be close to healing and that their wound is similar to
theirs). Whereas a downward social comparison occurs when
an individual dissociate themselves with others who they con-
sider to be worse off than themselves to make them feel better
(e.g. an individual thinking that their wound situation is better
than someone else’s wound).
Uchino ( 2006 ) outlined a more detailed model that dem-
onstrated the potential pathways between social support and
health. One pathway involves behavioral processes including
health behaviors and adherence to medical regimens as out-
lined by social control and social identity theorists (Lewis
and Rook 1999 ; Umberson 1987 ). It is suggested that social
support is health-promoting because it facilitates healthier
including better adherence to medical regimes.
The other major pathway involves psychological processes
that are linked to appraisals, emotions or moods (e.g., depres-
;
sion), and feelings of control (Cohen 1988 Gore 1981 ; Lin
1986 ). A variable that has been investigated thoroughly is
control – defined as the extent to which a person feels they
are able to change their own circumstances. Broadly, the
results suggest that the more control you have the less stress-
;
ful it is (e.g. Troup and Dewe 2002 Gibbons et al. 2011 ).
Obviously, there comes a point where you have more control
but also considerable responsibility and this can be stressful
as well. This has important considerations when exploring
self-management by the patient with the wound. It is obvi-
ously important for the health care practitioner to ensure the
patient is fully involved in their own wound management and
takes control over his or her own condition and treatment.
However, this needs to be balanced within the confines of the
patient’s ability and circumstances. Responsibility and con-
trol without the ability to control leads to increased stress and
all the consequences that result.
Finally, it is important for the health care professional to
understand how the patient copes with their wound related
problems. If the patient uses social support strategies, it may
be useful to involve family and friends in their treatment. If a
patient prefers a more active approach it may be useful for