Abstract
Improved health related quality of life (HRQOL) and symptom management are important objectives for the management of pressure ulcers given the high morbidity associated with these wounds. Previous pressure ulcer studies have frequently associated increased pain, high levels of wound exudate and odour as factors reducing the HRQOL of people with pressure ulcers. Such impact extends beyond the person with the pressure ulcer affecting family members and carers. It is generally recognised that healthcare professionals may underestimate the impact of pressure ulcers upon HRQOL.
Pressure ulcers place increased financial pressures upon healthcare systems, individual healthcare facilities and upon individuals with pressure ulcers. Recent recognition that pressure ulcers are one indicator of the quality of healthcare delivery has had significant impact upon increasing healthcare professional and patient information and education to deliver improved coproduction of effective pressure ulcer prevention and management.
Formal measurement of HRQOL among people with pressure ulcers presents significant challenges where self-reporting of HRQOL is restricted by the clinical condition of the people with pressure ulcers. Regardless generic quality of life tools have been used to show reductions in both physical and mental components of HRQOL when people with and without pressure ulcers are compared adjusting for age, gender and co-morbidities.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Agency for Healthcare Research and Quality (AHRQ). Are we ready for this change? Preventing pressure ulcers in hospitals: a toolkit for improving quality of care. Rockville, MD. April 2011. http://www.ahrq.gov/professionals/ systems/long-term-care/resources/pressure-ulcers/pressureulcertoolkit/putool1.html.
Russo CA, Elixhauser A. Hospitalizations related to pressure sores. In Statistical Brief #3. AHRQ Healthcare cost and utilization project. April 2006. www.hcupus.ahrq.gov/reports/statbriefs/sb3.pdf. Accessed 14 June 2013.
Vangilder C, Macfarlane GD, Meyer S. Results of nine international pressure ulcer surveys: 1989 to 2005. Ostomy Wound Manage. 2008;54:40–54.
Pancorbo-Hidalgo PL, et al. Risk assessment scales 4 pressure ulcer prevention: a systematic review. J Adv Nurs. 2006;54:94–110.
Elliott J. Strategies to improve the prevention of pressure ulcers. Nurs Older People. 2010;22(9):31–6.
Price P, Harding K. Cardiff. Wound Impact Schedule: the development of a condition specific questionnaire to assess health-related quality of life in patients with chronic wounds of the lower limb. Int Wound J. 2004;1:10–7.
Bowling A. Research methods in health. 2nd ed. Buckingham: Open University Press; 2002.
Gorecki C, et al. What influences the impact of pressure ulcers on health-related quality of life? A qualitative patient-focused exploration of contributory factors. J Tissue Viability. 2012;21:3–12.
Price P, Harding K. Measuring health-related quality of life in patients with chronic ulcers. J Wound Care. 1996;8:91–4.
Fallowfield L. The quality of life: missing dimension in healthcare. London: Souvenir Books; 1990.
Price P. Psychological impact of skin breakdown. In: Flanagan M, editor. Wound healing and skin integrity. Chichester: Wiley-Blackwell; 2013. p. 102–16.
Clark M. Pressure ulcers and quality of life. Nurs Stand. 2002;16:74–78, 80.
Franks PJ, Winterberg H, Moffatt CJ. Health-related quality of life and pressure ulceration assessment in patients treated in the community. Wound Repair Regen. 2002;10:133–40.
Gorecki C, et al. Patient-reported outcome measures for chronic wounds with particular reference to pressure ulcer research: a systematic review. Int J Nurs Stud. 2014;51:157–65.
Gorecki C, Brown JM, Lamping DL, Nixon J. Development of a patient-reported outcome measure of quality of life for use with patients with pressure ulcers. Pressure ulcers: not just a disease of the elderly-are your patients at risk 2009a. In: TWELFTH annual European Pressure Ulcer Advisory Panel Open Meeting, 2011.
Hopkins A, Dealey C, Bale S, Defloor T, Worboys F. Patient stories of living with a pressure ulcer. J Adv Nurs. 2006;56:345–53.
Whittington K, Patrick M, Roberts JL. A national study of pressure ulcer prevalence and incidence in acute care hospitals. J Wound Ostomy Continence Nurs. 2000;27:209–15.
Gorecki C, Brown JM, Nelson EA, Briggs M, Schoonhoven L, Dealey C, Defloor T, Nixon J, European Quality of Life Pressure Ulcer Project group. Impact of pressure ulcers on quality of life in older patients: a systematic review. J Am Geriatr Soc. 2009b;57:1175–83.
Franks PJ. Quality of life as an outcome indicator. In:A colour guide to the nursing management of chronic wounds. London: Mosby; 1997.
Spilsbury K, Nelson A, Cullum N, Iglesias C, Nixon J, Mason S. Pressure ulcers and their treatment and effects on quality of life: hospital inpatient perspectives. J Adv Nurs. 2007;57:494–504. https://doi.org/10.1111/j.1365-2648.2006.04140.x.
Fox C. Living with a pressure ulcer: a descriptive study of patients’ experiences. Br J Community Nurs. 2002;7:10, 12, 14, 16.
Essex HN, Clark M, Sims J, Warriner A, Cullum N. Health-related quality of life in hospital in patients with pressure ulceration: assessment using generic health-related quality of life measures. Wound Repair Regen. 2009;6:797–805.
Douglas V. Living with a chronic leg ulcer: an insight into patients’ experiences and feelings. J Wound Care. 2001;10:355–60.
National Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance. In: Haesler E, editor. Prevention and treatment of pressure ulcers: clinical practice guideline. Osborne Park, WA: Cambridge Media; 2014.
Langemo D, Emily H, Wayne N, Aletha T, Young T. Evidence-based guidelines for pressure ulcer management at the end of life. Int J Palliat Nurs. 2015;21:225–32.
Price P, Butterworth RJ, Bale S, Harding K. Measuring quality of in patients with granulating wounds. J Wound Care. 1994;3(1):49–50.
Franks P. Quality of life as an outcome indicator. In:A colour guide to the nursing management of chronic wounds. London: Mosby; 1998.
Mudge E. Meeting report. Tell me if it hurts: the patient’s perspective of wound pain. Wounds UK. 2007;3:6–7.
Gorecki C, Lamping DL, Brown JM, Madill A, Firth J, Nixon J. Development of a conceptual framework of HRQL in pressure ulcers: a patient focused approach. Int J Nurs Stud. 2010;47:1525–34.
Blanes L, Carmagnani MI, Ferreira LM. Quality of life and self-esteem of persons with paraplegia living in São Paulo, Brazil. Qual Life Res. 2009;18:15–21.
Bahaarestani M. The lived experience of wives caring for their frail, homebound elderly husbands with pressure ulcers. Adv Wound Care. 1994;7:40–52.
Albrecht GL, Devlieger PJ. The disability paradox: high quality of life against all odds. Soc Sci Med. 1999;48(8):977. https://doi.org/10.1016/S0277-9536(98)00411-0.
Phillips D. Quality of life: concept, policy and practice. London: Routledge; 2006.
Hammell W. Exploring quality of life following high spinal cord injury: a review and critique. Spinal Cord. 2004;42:491–502.
Bury M, Newbould J, Taylor D. A rapid review of the current state of knowledge regarding lay led self-management of chronic illness: evidence review. National Institute for Health and Clinical Excellence; 2005.
Hammer C, Cullum NA, Roe BH. Patients’ perception of chronic leg ulcers. J Wound Care. 1994;3(2):99–101.
Lucas LS, Martins JT, Robazzi ML. Quality of life of wound patients in the lower limbs. leg ulcer. Cienc Enferm. 2008;14(1):43–52.
Naylor WA. A guide to wound management in palliative care. Int J Palliat Nurs. 2005;11:572–9.
Alves P, Filomena M, Paulo R, Lúcia S. Epidemiology of pressure ulcers: interpreting Epidemiologic data as quality indicator. Lisboa: Servir; 2013.
Edwards IM, Moffatt C, Franks P. An exploration of patients understanding of leg ulceration. J Wound Care. 2002;11(1):35–9.
International Society of Lymphology. The diagnosis and treatment of Peripheral lymphedema: 2013 consensus document. Lymphology. 2013;46:1–11.
Gorecki C, Lamping DL, Nixon J, Brown JM, Cano S. Applying mixed methods to pretest the Pressure Ulcer Quality of Life (PU QOL) instrument. Qual Life Res. 2012;21:441–51.
Gorecki C, Brown JM, Cano S, Lamping DL, et al. Development and validation of a new patient reported outcome measure for patients with pressure ulcers: the PU QOL instrument. Health Qual Life Outcomes. 2013. https://doi.org/10.1186/1477-7525-11-95.
Luna P, Paulo A. Prevalence risk and pressure ulcer prevention in long-term care units. Dissertation in Evidence and Decision Health. Faculty of Medicine, University of Porto; 2012.
Franks PJ, Collier ME. Quality of life: the cost to the individual. In: Morisson M, editor. The prevention and treatment of pressure ulcers. London: Harcourt Publishers Limited; 2001. p. 37–45.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer-Verlag London Ltd., part of Springer Nature
About this chapter
Cite this chapter
Young, T., Furtado, K., Alves, P. (2018). Health Related Quality of Life (HRQOL) Implications for People with Pressure Ulcers. In: Romanelli, M., Clark, M., Gefen, A., Ciprandi, G. (eds) Science and Practice of Pressure Ulcer Management. Springer, London. https://doi.org/10.1007/978-1-4471-7413-4_6
Download citation
DOI: https://doi.org/10.1007/978-1-4471-7413-4_6
Published:
Publisher Name: Springer, London
Print ISBN: 978-1-4471-7411-0
Online ISBN: 978-1-4471-7413-4
eBook Packages: MedicineMedicine (R0)