Page 243 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

218 Chapter 9. Conclusion

severe impact on an individual’s quality of life and their well-
being. The evidence suggests that these psychological factors
not only influence the occurrence of further wounds, but they
also exacerbate the severity of a wound and affect its ability to
heal, resulting in the individual having to endure further psy-
chological problems as a consequence- a vicious circle that cli-
nicians must be aware of when treating patients with wounds.
This chapter explores some of the negative consequences
of a wound and how some psychological resources can help
both the clinician and, more importantly, the patient and their
family. Summarizing the material presented elsewhere in this
book and highlighting the clinical relevance, this chapter dem-
onstrates the importance of psychology in both the experience
of living with a wound and effective wound care.

Introduction

Chronic wounds have been described as: “ a silent epidemic that
affects a large fraction of the world population and poses a major
and gathering threat to the public health and economy ” (Sen
et al. 2009 , p. 763). It has been estimated that there are over
200,000 patients with chronic wounds in the UK (Posnett and
Franks 2007 ) although this figure, despite being frequently cited,
is probably a significant under-estimate. With an aging popula-
tion and increasing incidence of concomitant factors, such as
obesity and diabetes, it is possible that this figure has increased
considerably since their report and will continue to do so.
The cost in the UK to the NHS of these chronic wounds has
been estimated at £2–3 billion: approximately 3 % of NHS
budget (Posnett and Franks 2007 ). The health care costs of
chronic wounds in the European population accounted for
2 % of the European health budget (Bottrich 2014 ). In the
Scandinavian countries, the costs of chronic wounds comprised
2–4 % of the total health care expenditure (Gottrup et al.
2001 ). Graves and Zheng ( 2014 ) suggest that in Australia the
direct health care costs reach approximately US$2.85 billion.
Whatever country, continent or service, wounds are a
significant cost to the respective health economies. The elements
included in these estimates tend to focus on the medical costs