Page 32 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

Social Isolation 5

to further wound-related difficulties (Persoon et al. 2004 ).
Thus patients with chronic wounds may experience quite
severe restriction in the daily activities we often take for
granted because of pain and limitations of movement.
Impaired mobility can also lead to the inability to work (Faria
et al. 2011 ), perform general household tasks (Woo et al.
2009 ) and maintain personal hygiene (Fox 2002 ). Such
restrictions can have significant implications for a patient’s
psychological health, and patients often believe them to be
one of the worse aspects of having a wound (Hamer et al.
1994 ). As such, it is possible for a negative cyclical relation-
ship to occur, whereby the negative consequences of the
wound result in a negative emotional state, impacting upon
wound healing and, subsequently, leading to further negative
emotions (See Fig. 1.1 ).

Social Isolation

These limitations in daily activities often result in individuals
becoming increasingly isolated from others (Gorecki et al.
2009 ). Exclusion from social activities has also been related
to the intrusion of treatment – either because of the need to
attend clinic, or wait in for a nursing visit (Hopkins 2004a , b ).
In addition it has been found that patients will limit their
involvement in leisure activities such as swimming, gardening,
walking and travelling (Krasner 1998 ; Chase et al. 2000 ;
Hareendran et al. 2005 ) which then results in reduced social
contact. For example, Hamer et al. ( 1994 ) found that almost
half of the patients they spoke to had given up some of their
hobbies. This reduction in social activities and interactions
with others may also stem from a lack of energy, caused by
the sleep deprivation that can result from the intense pain of
a chronic wound (Harlin et al. 2009 ; Upton and Andrews
2013a , b , c ). Furthermore, the feelings of helplessness and
anxiety associated with not being able to continue with daily
activities can contribute further to social isolation and feel-
ings of disconnection from society (Brown 2005a , b , c ).