Page 42 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

Implications for Practice 15

studies (e.g. Lindsay 2013 ; Shuter et al. 2011 ) those patients
with seemingly intractable leg wounds heal once they start
attending support groups within the community. Known as a
‘leg club’, these interventions aim to improve an individual’s
well-being. Some well-known programmes include ‘Lively
legs’ programme (Heinen et al. 2012 ); ‘Look after your legs’
support group (Freeman et al. 2007 ); and the ‘Lindsay leg
club’ ® (Lindsay 2013 ). It may well be that these groups are
effective because they are able to promote resilience, and
provide the right context for physiological features of heal-
ing, such as the oxytocin mechanism, to be activated (more
discussion on social support and such Leg Clubs are pre-
sented in Chap. 8 ).

Implications for Practice

Modern wound care practices include many advanced tech-
niques, yet despite these there are patients with chronic, com-
plex wounds that do not heal (Vermeiden et al. 2009 ). It has
been recognised that for these patients psychosocial factors
play a significant role in the healing process (Guo and
DiPietro 2010 ). However, there is evidence that in daily prac-
tice, little attention is paid to these factors (Gorecki et al.
2009 ). There are three possible explanations for the neglect
of psychosocial factors. Firstly, many clinicians admit that
symptom control is usually the main nursing priority, (Naylor
2002 ). Secondly, clinicians may not always be aware of the
patient’s emotional response (Green and Jester 2009 ). For
example Searle and colleagues ( 2005 ) found that podiatrists
caring for patients with diabetic foot ulcers were often not
aware of the patient’s true feelings as patients were able to
present a positive exterior in order to dissemble. Finally, it
must be acknowledged that managing the psychological
component of wound care can be challenging.
It has therefore been suggested that more translational
work is needed to develop innovative treatments which have
the power to reduce stress-induced delays in wound healing
(Gouin and Kiecolt-Glaser 2010). Whilst this is undoubtedly