Health-related Quality of Life and Depression in Older Patients With Pressure Ulcers

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Author(s): 
Vitor Ângelo Carlucio Galhardo, MD, MS; Marta Garroni Magalhães, MD, MS; Leila Blanes, RN, PhD; Yara Juliano, PhD; Lydia Masako Ferreira, MD, PhD

Abstract: Objectives. To evaluate health-related quality of life (HRQoL) and depression in older patients with pressure ulcers who were living at home in the community. Methods. A cross-sectional analytical study conducted in southern Minas Gerais, Brazil. Forty-two outpatients 60 years and older, showing no cognitive deficit who were living in the community, participated in the study. They were divided into two groups: the study group (21 patients with pressure ulcers), and control group (21 patients without pressure ulcers). The instruments Mini-Mental State Examination (MMSE), Medical Outcomes Study 36-Item Short Form Health Survey questionnaire (SF-36), and 15-item Geriatric Depression Scale (GDS-15) were used, respectively, to identify cognitive impairment, and assess HRQoL and depression. Results. Among the 36 pressure ulcers detected on examination, Stage II ulcers were the most common finding (50%), and the sacral region was the most common location (44.5%). Patients with pressure ulcers had significantly lower HRQoL scores than controls in all SF-36 domains, with the lowest scores being reported for physical functioning, role physical and role emotional (P < 0.0001). Seventeen (80.9%) of the patients in the study group were identified as having depression (P = 0.002). Conclusion. A high rate of depression (GDS-15) was found in elderly patients with pressure ulcers, who also reported lower HRQoL scores in all SF-36 domains compared with controls.



Address correspondence to:
Vitor A. C. Galhardo, MD, MS
Rua Dr. José Marques de Oliveira, 88, Fátima I
CEP 37550-000 Pouso Alegre, MG, Brazil
Phone/Fax: +55 (35) 3449-2200
Email: vitor_galhardo@uol.com.br



     Pressure ulcers are defined as skin and soft-tissue lesions, which may be superficial or deep, of ischemic etiology, secondary to an increase in external pressure, and usually located over a bony prominence.1

     Pressure ulcers are a major cause of decrease in quality of life, aggravating and interfering with the treatment of other health problems, thus increasing suffering, morbidity, as well as nursing care time and care costs.2 The situation is worse among the elderly population because 71% of the pressure ulcers occur in patients 70 years or older.3,4

     The quality of life of patients with pressure ulcers is related to factors such as pain, suffering, costs to the healthcare system and the family, and limitations in performing activities of daily living.5,6

     Currently, there is a growing research and clinical interest in developing robust quantitative measures of quality of life that can be used in clinical assessments and economic models.

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