Page 231 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

206 Chapter 8. Family, Friends and Social Support

detrimental to health for the partner or family member
(Bennett et al. 2013 ). Indeed, the impact of chronic illness on
the whole family can be significant and result in increased
morbidity, impaired family dynamics and ultimately family
break-ups, psychological morbidity and ill-health. This sec-
tion will explore these two elements of the family involve-
ment in wound care.
Family caregivers are recognised as an important compo-
nent of support for individuals with chronic conditions
(Spence et al. 2008 ). Many take on a supportive role with
little or no training, yet are involved in an array of complex
and challenging tasks, such as symptom assessment, as well as
assisting with activities of daily living or helping with wound
management (Aranda and Hayman-White 2001 ; Thomas
et al. 2002 ). The ongoing and frequent nature of some of these
wound-related routines requires family adaptation, and
patients’ success at maintaining these routines benefits from
effective family support. Moreover, family members can take
an active role in helping adults with chronic illness execute
complex self-management tasks, make disease-related deci-
sions, and cope with disease-related stress (Gleeson-Kreig
et al. 2002 ). Partners or spouses are frequently involved in
their partners’ chronic health conditions (Ell 1996 ), often by
seeking to promote greater adherence to treatment regimens.
Spouses are uniquely positioned to notice such non-
concordance, and as such, often are directly involved in moni-
toring and influencing many of their partners’ health related
behaviours (Trief et al. 2003 ).
In contrast to the positive support that the family and
spouse/partner may provide they may experience some costs
for their involvement. However, relatively little research has
examined whether spouses incur any costs from involvement
in their marital partners’ chronic woundcare and most of the
evidence comes from either other conditions or as a by-
product of other research into the patient experience. For
example, in a study by Upton and Andrews ( 2013a , b ),
respondents were asked to consider the level of sleep distur-
bance they experienced as a direct result of NPWT with their
findings suggesting that NPWT treatment itself directly