Chronic ulcers and everyday living: patients' perspective in the United kingdom

Our knowledge of patients' concerns with regard to living with chronic ulceration remains incomplete. This cross-sectional survey collected the self-reported views of patients using a specifically designed questionnaire developed from issues relevant to UK patients captured through focus groups. Results were obtained for 196 patients from Wales and England with a mean age of 74.4 years (SD 12.86), and mean wound duration of 25.52 months (SD 56.95). Wound symptoms reported by patients as problematic in every day life were pain, difficulties in bathing, leakage, impaired mobility, odor, and slippage of the dressing or bandage; pain symptoms were reported as particularly distressing. In free text responses, many patients stated that nothing could be done to ease pain at dressing related procedures either on their own at home or by the healthcare professionals involved in their care. However, many patients were able to identify several factors that were important to them in reducing pain at dressing related procedures. For example, the way in which the wound was treated was important in reducing the severity of pain whilst having consistent quality of care, thorough communication, and rapport was beneficial in easing pain at dressing related procedures. Being consulted, listened to, and distracted from the procedure itself was helpful. There was a small portion of patients who volunteered that they were satisfied with their current care regardless of pain. These data highlight the importance of gaining insight into which factors and processes aid successful psychosocial adjustment and coping mechanisms associated with chronic ulceration.