Coping Strategies Used By Patients With Chronic and/or Complex Wounds

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Author(s): 
J. Vermeiden RN; L.P. v. Doorn, RN, MA, ANP; A. Da Costa, MD, PhD; AA Kaptein, MSc, PhD; P. Steenvoorde, MD, MSc, PhD

Abstract: Objective. The aim of this study was to investigate coping strategies used by patients with chronic and/or complex wounds treated in an outpatient wound clinic. Methods. Coping strategies were assessed using the Utrecht Coping List (UCL). The Mini-Mental State Examination (MMSE) was used to assess the patient’s cognitive functioning. Fifty patients were selected for this study. The wound etiologies studied were: diabetic foot ulcers, lower extremity ulcers, surgical wounds, trauma wounds, and pressure ulcers. Results. Scores on the coping measure for men and women differed significantly from the control groups. It was also found that each wound etiology showed a preference toward different coping strategies. Furthermore, 28% of the studied group had a lowered score on the MMSE, indicating possible cognitive impairments. Conclusion. There might be an association between wound etiology and the coping strategy that is preferred; this knowledge could be used to guide treatment strategies used by clinicians. Further research could focus on the effects of coping strategies on wound healing rates.




Address correspondence to:
J. Vermeiden, RN
Afd. Wondcentrum
Simon Smitweg 1
2353 GA Leiderdorp
The Netherlands
Phone: +31 715 828513
Email: jorivermeiden@gmail.com





     Have you ever noticed during a treatment session for a patient with a wound that little or no attention is paid to psychosocial factors such as coping, social situation, and the activities of daily life? If the answer is yes to at least one of these factors, keep reading!

     The Rijnland Wound Clinic (Leiderdorp, The Netherlands) treats patients with chronic and/or complex wounds. Even though advanced techniques are used, some wounds still do not heal. It is not always clear why this occurs. Psychological, social, emotional, and cognitive factors play a significant role in the healing process1–8 and influences a patient’s quality of life.9–15 Nevertheless, in daily practice, it seems little attention is paid to these factors.1 It is suggested that stress can delay the healing of a wound.7,8 If a patient cannot cope with the situation, there might be more stress, and in turn, a delay in wound healing. Psychological care could be provided in such cases.16 One author suggests that a healthcare professional can influence a patient’s experience.14 Rich et al17 suggest that a patient needs a support network. Keeling et al18 report that there is a variation in the coping strategies used by elderly patients with chronic wounds, and that there was minimal social support.

     The quality of life for a patient with a wound has been researched; however, very few have focused on the coping aspect. Coping might have a big influence on the healing process and overall well being of the patient. An example of this is that if a patient is more able to cope with the situation, he or she might be more compliant to the prescribed therapy.6 It remains unclear whether patients with chronic and/or complex wounds use different coping strategies. Furthermore, it is unclear if patients with different wound etiologies use different coping strategies. If this is the case, knowledge of these differences might guide the clinician on how to approach these patients or improve the care that is given. As an example, perhaps some patients need written information while others need a verbal explanation.

     The aim of this study was to analyze which coping strategies are used by patients with chronic and/or complex wounds.

Methods

     Patients. The data for this study was collected at the Rijnland Wound Clinic of the Rijnland Hospital (Leiderdorp, The Netherlands) from December 2007 until March 2008.

References: 

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