Quality of life in patients with chronic wounds: magnitude of changes and predictive factors.

Ana Flávia dos Santos Amaral,Alcicléa dos Santos Oliveira,Erika Tihemi Nishi,Vera Lúcia Conceição de Gouveia Santos,See Hee Park Kim,Jaqueline Betteloni Junqueira

doi:10.1590/s1980-220x2016049603250

Abstract

To assess health-related quality of life, its predictors and magnitude of changes in health-related quality of life in patients with chronic wounds receiving specialized outpatient treatment. Secondary, retrospective, descriptive, quantitative study with patients with chronic wounds from two specialized outpatient services in Brazil assessed through Ferrans & Powers Quality of Life Index-Wound Version, Visual Analog Pain Scale, Global Assessment Scale, Pressure Ulcer Scale for Healing, sociodemographic and clinical questionnaires at baseline and after 60 days of treatment. Data were analyzed by ANOVA, Spearman Coefficient, Mann-Whitney test and multivariate logistic regression. Twenty-seven patients participated in the study. The overall health-related quality of life scale, health and functioning subscale and socioeconomic subscale scores increased after 60 days of treatment compared to baseline. Pain reduction was a predictor of changes in overall health-related quality of life score as well as religious practice in the family subscale. 92.6% patients perceived moderate to extensive changes in health-related quality of life. there was improvement of health-related quality of life for the sample studied in the period; pain and religious practice have emerged as predictors of changes in health-related quality of life.

Highlights

Chronic wounds are among health conditions which the patient may suffer for several years, often causing impairment of work activities that results in early retirement and restrictions in daily living and leisure activities[1,2,3,4], reducing the quality of life (QoL) at any stage of the life cycle and across all life domains[2]
The increase in overall health-related quality of life (HRQoL) and health/functioning, socioeconomic, psycological/spiritual subscale scores on the Ferrans and Powers Quality of Life Index (FPQLI)-WV was associated only with a reduction in the worst pain experienced in the past week (P < 0.05), explaining 36%, 34%, 52% and 28%, respectively, of the variance in differences in HRQoL between baseline and endpoint
Patients with chronic wounds receiving specialized outpatient treatment had a substantial improvement in HRQoL after 60 days of treatment, as indicated by significant differences of large magnitude in effect size and a significant increase in overall HRQoL and subscale scores,especially on the health/functioning and socioeconomic subscales of the FPQLI-WV,between baseline and endpoint.No significant increase in the psychological/spiritual and family subscale scores was detected between the two time points, probably because patients had already reported high scores on these subscales at baseline

Summary

Introduction

Chronic wounds are among health conditions which the patient may suffer for several years, often causing impairment of work activities that results in early retirement and restrictions in daily living and leisure activities[1,2,3,4], reducing the quality of life (QoL) at any stage of the life cycle and across all life domains[2]. Chronic wounds lead to feelings of frustration, anxiety, isolation, depression, low self-esteem, and negative self-concept, reducing the QoL of patients[1,4]. Emotions and thought patterns emerge as key determinants of overall health[5].,the assessment of health-related quality of life (HRQoL) is an important way for evaluating the results of health interventions by focusing on biopsychosocial needs in search of improved living conditions[6]. The assessment of HRQoL is an attempt to quantify the consequences of diseases and treatments, according to the subjective perception of patients[8]

Methods

Results

Discussion

Conclusion