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Dressing-related pain in patients with chronic wounds: an international patient perspective

Price, Patricia Elaine, Fagervik-Morton, Hilde, Mudge, Elizabeth Joan, Beele, Hilde, Ruiz, Jose Contreras, Nystrøm, Theis Huldt, Lindholm, Christina, Maume, Sylvie, Melby-Østergaard, Britta, Peter, Yolanda, Romanelli, Marco, Seppänen, Salla, Serena, Thomas E., Sibbald, Gary, Soriano, Jose Verdú, White, Wendy, Wollina, Uwe, Woo, Kevin Y., Wyndham-White, Carolyn and Harding, Keith Gordon 2008. Dressing-related pain in patients with chronic wounds: an international patient perspective. International Wound Journal 5 (2) , pp. 159-171. 10.1111/j.1742-481X.2008.00471.x

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Abstract

This cross-sectional international survey assessed patients’ perceptions of their wound pain. A total of 2018 patients (57% female) from 15 different countries with a mean age of 68.6 years (SD = 15.4) participated. The wounds were categorised into ten different types with a mean wound duration of 19.6 months (SD = 51.8). For 2018 patients, 3361 dressings/compression systems were being used, with antimicrobials being reported most frequently (n = 605). Frequency of wound-related pain was reported as 32.2%, ‘never’ or ‘rarely’, 31.1%, ‘quite often’ and 36.6%, ‘most’ or ‘all of the time’, with venous and arterial ulcers associated with more frequent pain (P = 0.002). All patients reported that ‘the wound itself’ was the most painful location (n = 1840). When asked if they experienced dressing-related pain, 286 (14.7%) replied ‘most of the time’ and 334 (17.2%) reported pain ‘all of the time’; venous, mixed and arterial ulcers were associated with more frequent pain at dressing change (P , 0<001). Eight hundred and twelve (40.2%) patients reported that it took ,1 hour for the pain to subside after a dressing change, for 449 (22.2%) it took 1–2 hours, for 192 (9.5%) it took 3–5 hours and for 154 (7.6%) patients it took more than 5 hours. Pain intensity was measured using a visual analogue scale (VAS) (0–100) giving a mean score of 44.5 (SD = 30.5, n = 1981). Of the 1141 who reported that they generally took pain relief,21% indicated that they did not feel it was effective. Patients were asked to rate six symptoms associated with living with a chronic wound; ‘pain’ was given the highest mean score of 3.1 (n = 1898). In terms of different types of daily activities, ‘overdoing things’ was associated with the highest mean score (mean = 2.6, n = 1916). During the stages of the dressing change procedure; ‘touching/handling the wound’ was given the highest mean score of 2.9, followed by cleansing and dressing removal (n = 1944). One thousand four hundred and eighty-five (80.15%) patients responded that they liked to be actively involved in their dressing changes, 1141 (58.15%) responded that they were concerned about the long-term side-effects of medication, 790 (40.3%) of patient indicated that the pain at dressing change was the worst part of living with a wound. This study adds substantially to our knowledge of how patients experience wound pain and gives us the opportunity to explore cultural differences in more detail.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
Uncontrolled Keywords: Chronic wound pain ; Dressing change ; International views ; Patient experience
Publisher: Wiley-Blackwell
ISSN: 1742-4801
Last Modified: 17 Jun 2017 05:33
URI: http://orca.cf.ac.uk/id/eprint/28368

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