Understanding pain and quality of life for patients with chronic venous ulcers

Aim. To identify the impact of pain on quality of life (QOL) of patients with chronic venous ulcers.

A cross-sectional study was performed on 40 outpatients with chronic venous ulcers who were recruited at one outpatient care center in São Paulo, Brazil. WHOQOL-Bref was used to assess QOL, the McGill Pain Questionnaire-Short Form (MPQ) to identify pain characteristics, and an 11-point numerical pain rating scale to measure pain intensity. Kruskall-Wallis or ANOVA test, with post-hoc correction (Tukey test) was applied to compare groups. Multiple linear regression models were used.

The mean age of the patients was 67 ± 11 years (range, 39-95 years), and 26 (65%) were women. The prevalence of pain was 90%, with worst pain mean intensity of 6.2 ± 3.5. Severe pain was the most prevalent (21 patients, 52.5%). Pain most frequently reported was sensory-discriminative and evaluative in quality. Pain was significantly and negatively correlated with physical (PY), environmental (EV), and overall QOL. Compared to a no-pain group, those with pain had lower overall QOL. On multiple analyses, pain remained as a predictor of overall QOL (b = -0.73, P = 0.03) and was also predictive of social QOL, whereas pain did not have any impact on physical, emotional, or social relationships QOL (b = -3.85, P = 0.00) when adjusted for age, number, duration and frequency of wounds, pain dimension (MPQ), partnership, and economic status.

To improve QOL of outpatients with chronic venous ulcers, the qualities and the intensity of pain must be considered differently.