Page 230 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

Family Considerations 205

randomised controlled trials (RCTS)- the so called “gold
standard”- of wound healing benefit from social support
interventions (e.g. Weller et al. 2013 ). Despite this, social sup-
port community based interventions do appear to improve a
number of significant factors, such as wound care concor-
dance and well-being (Gordon et al. 2006 ; Harker 2000 ;
Edwards et al. 2009 ).

Family Considerations

One key element of social support is the family- the partner
or spouse in particular- and they have a key role to play sup-
porting the patient. This may be physical support- providing
care and management for the wound, or emotional support
for the pain, stress, or any psychological problems that the
patient may be experiencing. Indeed, there is some evidence
that being in a relationship may improve wound healing
(Kiecolt-Glaser and Newton 2001 ). Moffatt et al. ( 2006 )
reported that patients who live alone were significantly more
likely to have leg ulceration than those living with a spouse,
although this was a cross-sectional study and hence no direct
causality could be determined.
The informal carer is a considerable resource for both the
individual and the country. For example, it is suggested that
there are over six million carers in the UK who provide
unpaid care to someone who is ill, frail or disabled (Buckner
and Yeandle 2011 ). This contribution to care accounts for
£199 billion annually. This figure equates to £2.3 billion per
week, £326 million per day, £13.6 million per hour or £18 473
for every carer in the UK (Buckner and Yeandle 2011 ). The
support they provide is fundamental to the success of the
individual patient in not only successfully managing their
condition physically but also psychologically. Their support is
central to adaptation to chronic illness.
Conversely, of course, the experience of the family mem-
ber may also be of concern. Living with an individual may
bring with it significant psychosocial concerns which may be