Self-management perceptions and experiences of patients with hard-to-heal wounds: a qualitative study

This study explored the perceptions, psychological changes and needs for home self-management in people with hard-to-heal wounds.

Participants were recruited from a wound care outpatient clinic of The First Affiliated Hospital of Soochow University, China, and qualitative, semi-structured interviews were conducted. A phenomenological approach of qualitative research was used, and the data were collected and analysed using Colaizzi's method.

The research cohort comprised 15 patients and three themes were extracted: (1) symptom management burden (symptom distress and lack of knowledge about wound care); (2) inadequate resources related to self-management (insufficient medical resources in primary hospitals, tortuosity of the treatment-seeking process, expectation of access to wound expertise); and (3) self-managing pressures coexisting with motivation (high expectations for and low level of attention to wound healing, varied treatment adherence, financial burden, negative emotions, the contradiction between work and rest, and social communication impact).

There was variation in the perception of self-management among patients with hard-to-heal wounds, with only some patients knowing how to perform wound self-management at home. Overall, patients with hard-to-heal wounds had poor perceptions of self-management. Healthcare workers should encourage and guide patients with hard-to-heal wounds to self-manage, which will help to increase the patient's motivation for self-management and reduce the burden of symptom management. Professional staff in community and secondary hospitals should be trained to improve their guidance skills for self-management for patients with hard-to-heal wounds.