Page 28 - APPENDIX B: Trials Investigating the Management of Acute Radiation-Induced Skin Reactions Reading Qualitative Research

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WOUND CARE

indicators such as changes in body image and activities of daily living make the patient’s

experiences a vital part of nursing care. Wound-care management is a collaborative effort

because chronic wounds may impose lifestyle changes and lead to severe physical consequences

(Slachta, 2012). An understanding of the patient’s experiences and psychological effects during

radiation oncology wound management would be beneficial in planning care. In the context of

chronic wounds, Sibbald, Woo, and Ayello (2008) emphasize, “Clinicians need to remember that

wound healing is not always the primary outcome” [and] “consider other wound related

outcomes such as: reduced pain reduced bacterial load, reduced dressing changes or an improved

quality of life” (p. 34). In addition, Kohr (2007) explored the nurse’s experience of dressing

changes and suggests that both qualitative and quantitative approaches facilitate the

understanding of experiences in the complex world of human health (p. 19). The focus and

scope of this inquiry is on the context of nursing practice in wound management during

radiotherapy.

Current practice in Canada. A telephone survey by Bolderston (2003) regarding skin

care recommendations among 26 radiotherapy departments across Canada revealed that the

management of moist desquamation in most centres appeared to be the realm of the radiation

oncologist, as a prescription is usually required. The survey demonstrated that most centres were

unable to give a single management approach as recommendations for moist desquamation were

dependent on the preferences of the treating oncologist. According to the survey, “the most

common way of managing moist desquamation was Flamazine ◊ (Silver Sulphadiazine) followed

by hydrocortisone cream and various dressings” [and] “this area showed the most diversity in

management with many agents and methods being recommended by individual centres” (p. 5).