Upton D, Solowiej K
Institute of Health and Society, University of Worcester, UK.
J Wound Care. 2012 May;21(5):209-15. doi: 10.12968/jowc.2012.21.5.209.
To compare the pain and stress experiences of patients with chronic wounds being treated with atraumatic vs conventional dressings at dressing change.
This exploratory study adopted an independent samples design to identify any differences between reported levels of pain and stress associated with the use of atraumatic and conventional dressings used in treatment regimens of patients with chronic wounds. Physiological and psychological assessments of pain and stress were recorded at dressing change (including numerical ratings, heart rate, blood pressure, respiration rate, GSR, salivary cortisol and the Perceived Stress Scale (PSS) and State Trait Anxiety Inventory (STAI) questionnaire surveys).
In total, 49 patients with chronic wounds took part in the study. Fifty-three percent of patients were male (n=26) and 47% were female (n=23). Patients were aged 38-95 years, with a mean age of 69.11 ± 14.08 years. Overall, 10 patients were receiving atraumatic dressings with Safetac technology as part of their routine wound treatment and 39 were receiving conventional dressings. Patients receiving atraumatic dressings reported significantly lower numerical pain and stress ratings and experienced significantly lower GSR at dressing change. Mean heart rate, blood pressure, salivary cortisol were also lower for patients with atraumatic dressings. However, patients' PSS (atraumatic=24.60, conventional=22.72) and STAI (atraumatic=34.90, conventional=33.21) scores were similar for both dressing type groups.
This study provides a basis for understanding how different dressing types can impact pain and stress at dressing change. Acute episodes of pain and stress were much lower in patients receiving atraumatic dressings;0 however factors associated with the overall experience of living with a chronic wound may be contributing to underlying and ongoing feelings of stress and anxiety. The impact of these implications on selection of dressings and cost of care are also discussed.
This research was commissioned by Mölnlycke Health Care. None of the authors work for Mölnlycke Health Care of have any financial interests with the company. There are no additional conflicts of interest to declare.
比较慢性伤口患者在更换无创伤敷料与传统敷料时的疼痛和应激体验。
本探索性研究采用独立样本设计，以确定在慢性伤口患者治疗方案中使用无创伤敷料和传统敷料时，报告的疼痛和应激水平之间是否存在差异。在更换敷料时记录疼痛和应激的生理及心理评估结果（包括数字评分、心率、血压、呼吸频率、皮肤电反应、唾液皮质醇以及感知应激量表（PSS）和状态特质焦虑量表（STAI）问卷调查）。
共有49例慢性伤口患者参与了本研究。53%的患者为男性（n = 26），47%为女性（n = 23）。患者年龄在38 - 95岁之间，平均年龄为69.11 ± 14.08岁。总体而言，10例患者在其常规伤口治疗中接受使用Safetac技术的无创伤敷料，39例接受传统敷料。接受无创伤敷料的患者报告的数字疼痛和应激评分显著更低，且在更换敷料时皮肤电反应显著更低。使用无创伤敷料的患者平均心率、血压、唾液皮质醇也更低。然而，两种敷料类型组患者的PSS（无创伤=24.60，传统=22.72）和STAI（无创伤=34.90，传统=33.21）得分相似。
本研究为理解不同类型敷料如何影响更换敷料时的疼痛和应激提供了依据。接受无创伤敷料的患者疼痛和应激的急性发作要低得多；然而，与慢性伤口患者整体生活体验相关的因素可能导致潜在的持续应激和焦虑情绪。还讨论了这些影响对敷料选择和护理成本的作用。
本研究由莫林医疗保健公司委托进行。作者均不在莫林医疗保健公司工作，与该公司也无任何经济利益关系。无其他利益冲突需要声明。
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