Year: 2024
Type: article
Abstract: This study explored an under-researched but critical element of patient empowerment in chronic wound care, namely degrees of freedom.This refers to the personalisation of everyday wound care based on patients' individual needs.To identify degrees of freedom in clinical practice, semi-structured interviews were conducted with 23 patients and 16 healthcare professionals and analysed using qualitative content analysis.The analysis yielded nine degrees of freedom with 42 concrete behaviours of primary control (shaping the actual treatment situation) and six degrees of freedom with 22 concrete behaviours of secondary control (shaping the patient's inner experience).These could be assigned to four main degrees of freedom, namely patients' self-action, cooperation between patients and health professionals, adaptation of treatment to patients' needs, and the use of emotional coping strategies.Furthermore, two types of patients could be distinguished: those who are active and take responsibility for their wounds, and those who remain passive and tend to endure.The implementation of degrees of freedom offers several positive effects, such as patients experiencing outcome efficacy and becoming experts on their wounds.However, there are several implementation issues, such as patient reluctance and time constraints, that need to be overcome first.
Authors: Of the 39 participants (16 HCPs; 23 patients), patients were consecutively recruited at the outpatient clinic of the University Medical Center Hamburg-Eppendorf (Germany) and additionally via a web page of the founder of the study. All patients enrolled had chronic wounds defined as having failed to heal for 8–12 weeks., Their average age was 73.7 years (range: 51–87) and the underlying diseases causing the chronic wounds were peripheral arterial occlusive disease (PAD; n=11, 47.8%), chronic venous insufficiency (CVI; n=3, 13%), combination of PAD/CVI (n=9, 32.2%) with/without diabetes mellitus (n=3, 13%). Participating HCPs worked at the same clinic and in general practices. This group consisted of wound care nurses (n=3), medical assistants experienced in wound care (n=7), and medical specialists (n=6). The latter included four surgeons and two dermatologists, some of them with further specialisations, and all of them were considerably experienced in treating chronic wounds. Prerequisites for participating in the interview was the diagnosis of a chronic wound for patients, and practicing in wound care for HCPs.
Language: English
Topic: Wound Healing and Treatments
Subfield: Rehabilitation
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4405486267