Page 97 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

Assessing Stress 71

settings. As with the other measures, higher score indicated
greater anxiety or depression. This measure can be particu-
larly advantageous to the wound health professional in that it
can be implemented at intervals in order to assess any differ-
ences which may be apparent over time (i.e. such as before,
during and after dressing changes).
The assessment and re-assessment of patient’s experi-
ences of pain and stress, using these tools or similar, should
be an essential aspect of wound care and management
(Freedman et al. 2003 ). Failure to assess pain and stress can
lead to considerable distress for the patient, not only during
treatment but also the period before treatment, due to the
emotive responses associated with anticipation of the pain-
ful experience (Soon and Acton 2006 ). Hence, appropriate
and consistent assessment of such pain can equip clinicians
with the understanding necessary in administering suitable
methods of pain relief (Upton and Solowiej 2010 ).
Additionally, accurate assessment and management of pain
can lead to significant reductions in patient’s psychological
stress. Hence, in order to fully facilitate wound healing, it is
important for health professionals to assess both pain and
stress (Tables 3.3 and 3.4 ).
However, using individual measures of psychological
stress alone can be problematic. The use of a single self-
report method to assess a patient’s level of psychological
stress could be subject to biases such as social desirability
and/or demand characteristics (for example, patients might
believe they should report higher levels of psychological
stress in order to meet the expectations of the clinician).
There are also a number of physiological measures of
stress that are commonly used when assessing patients’ stress
levels, which can be beneficial as physiological responses are
innate and are shielded from biases that self-report measures
are subjected to, such as demand characteristics. However,
physiological measures alone do not necessarily confirm the
presence of psychological stress, for example, an increase in
heart rate or blood pressure could be due to any number of
factors, and not just psychological stress. Table 3.4 shows a
number of methods that can be used to measure patients’
physiological responses to stress.