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难以愈合伤口患者的体验:一项初步调查的见解。

Experiences of patients with hard-to-heal wounds: insights from a pilot survey.

机构信息

Wound Care Experts, NV, US.

HCA Mountain View Hospital, NV, US.

出版信息

J Wound Care. 2024 Oct 2;33(10):788-794. doi: 10.12968/jowc.2024.0109.

Abstract

OBJECTIVE

To learn about the experiences of people who seek treatment for hard-to-heal wounds, we distributed a nationwide pilot survey, asking questions about the nature of their wound, how it shaped their daily lives, pathways to receiving care and experiences with treatment. The long-term objective is to quantify the journey of patients with hard-to-heal wounds to identify ideal intervention points that will lead to the best outcomes. This article summarises the findings, implications, limitations and suggestions for future research.

METHOD

Qualitative data were self-reported from patients with hard-to-heal wounds (open for ≥4 weeks) in a pilot chatbot survey, (Wound Expert Survey (WES)) provided online in the US on Meta platforms (Facebook and Instagram) between 2021 and 2022.

RESULTS

The US national pilot survey attracted responses from 780 patients, 27 of whom provided a video testimonial. Some 57% of patients delayed treatment because they believed their wound would heal on its own, and only 4% saw a wound care specialist. Respondents reported the cost of care as the most frequent reason for not following all of a doctor's treatment recommendations. Queries regarding quality of life (QoL) revealed that more than half (65%) said they have negative thoughts associated with their wound at least every few days. Some 19% of respondents said their wound had an odour and, of them, 34% said odour had a major or severe negative impact on their self-confidence. Economically, nearly one-quarter of respondents said having a wound led to a drop in their total household income and 17% said their wound led to a change in their employment status.

CONCLUSION

A national pilot survey of patients with hard-to-heal wounds revealed that many delay seeking professional assistance and only a small minority see a wound care specialist. Experiencing an ulcer, even for a few months, can have significant negative effects on a patient's QoL. Patients frequently had negative thoughts associated with their wound, and odour compounded these negative effects, leading to major or severe negative impacts on self-confidence. Households experienced a decline in income, due to both the direct reduction or loss of patient employment and the additional time spent by family members assisting in patient recovery. Thus, a variety of factors contribute to poor outcomes for patients with hard-to-heal wounds. To validate and extend these preliminary results, future surveys of patients with hard-to-heal wounds should focus on additional reasons patients do not seek professional help sooner. To improve health outcomes and QoL, assessment of patient socioeconomic variables should occur whenever wound closure stalls.

摘要

目的

为了了解寻求治疗难愈伤口患者的治疗体验,我们开展了一项全国性的试点调查,调查问题包括伤口的性质、伤口如何影响日常生活、寻求治疗的途径以及治疗体验。长期目标是量化难愈伤口患者的就医之旅,以确定理想的干预点,从而获得最佳治疗效果。本文总结了研究结果、意义、局限性和对未来研究的建议。

方法

在 2021 年至 2022 年期间,我们通过在 Facebook 和 Instagram 等 Meta 平台上提供的在线美国聊天机器人调查(Wound Expert Survey,WES),对患有难愈伤口(开放超过 4 周)的患者进行了自我报告的定性数据调查。

结果

这项美国全国性试点调查共吸引了 780 名患者的回复,其中 27 人提供了视频证词。约 57%的患者因认为伤口会自行愈合而延迟治疗,只有 4%的患者看了伤口护理专家。受访者报告称,治疗费用是不遵医嘱的最常见原因。关于生活质量(QoL)的问题显示,超过一半(65%)的人表示,他们每隔几天就会对自己的伤口产生负面想法。约 19%的受访者表示自己的伤口有异味,其中 34%的人表示异味对他们的自信心有很大或严重的负面影响。在经济方面,近四分之一的受访者表示伤口导致他们的家庭总收入下降,17%的人表示伤口导致他们的就业状况发生变化。

结论

对难愈伤口患者的全国性试点调查显示,许多患者延迟寻求专业帮助,只有一小部分患者看了伤口护理专家。即使是经历几个月的溃疡,也会对患者的 QoL 产生重大负面影响。患者经常对自己的伤口产生负面想法,而异味则加剧了这些负面影响,导致他们的自信心受到重大或严重的打击。由于患者就业减少或丧失以及家庭成员为帮助患者康复而花费的额外时间,家庭收入减少。因此,各种因素导致难愈伤口患者的治疗效果不佳。为了验证和扩展这些初步结果,未来对难愈伤口患者的调查应重点关注患者延迟寻求专业帮助的其他原因。为了改善治疗效果和 QoL,应在伤口愈合停滞时评估患者的社会经济变量。

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