Zhang Lu, Gu Lan, Wu Lin-Zhu, Zhao Xue-Hua, Wang Xun, Chen Yi
MS, RN, Clinical Nurse, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China.
BS, RN, Enterostomal Therapist, Outpatient Department of Wound, Ostomy and Incontinence, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
J Wound Care. 2025 Apr 2;34(4):294-302. doi: 10.12968/jowc.2021.0212.
This study explored the perceptions, psychological changes and needs for home self-management in people with hard-to-heal wounds.
Participants were recruited from a wound care outpatient clinic of The First Affiliated Hospital of Soochow University, China, and qualitative, semi-structured interviews were conducted. A phenomenological approach of qualitative research was used, and the data were collected and analysed using Colaizzi's method.
The research cohort comprised 15 patients and three themes were extracted: (1) symptom management burden (symptom distress and lack of knowledge about wound care); (2) inadequate resources related to self-management (insufficient medical resources in primary hospitals, tortuosity of the treatment-seeking process, expectation of access to wound expertise); and (3) self-managing pressures coexisting with motivation (high expectations for and low level of attention to wound healing, varied treatment adherence, financial burden, negative emotions, the contradiction between work and rest, and social communication impact).
There was variation in the perception of self-management among patients with hard-to-heal wounds, with only some patients knowing how to perform wound self-management at home. Overall, patients with hard-to-heal wounds had poor perceptions of self-management. Healthcare workers should encourage and guide patients with hard-to-heal wounds to self-manage, which will help to increase the patient's motivation for self-management and reduce the burden of symptom management. Professional staff in community and secondary hospitals should be trained to improve their guidance skills for self-management for patients with hard-to-heal wounds.
本研究探讨难愈合伤口患者对家庭自我管理的认知、心理变化及需求。
从中国苏州大学附属第一医院伤口护理门诊招募参与者，进行定性的半结构式访谈。采用定性研究的现象学方法，运用Colaizzi法收集和分析数据。
研究队列包括15名患者，提取出三个主题：（1）症状管理负担（症状困扰及伤口护理知识缺乏）；（2）自我管理相关资源不足（基层医院医疗资源不足、就医过程曲折、期望获得伤口专业知识）；（3）自我管理压力与动机并存（对伤口愈合期望高但关注度低、治疗依从性各异、经济负担、负面情绪、作息矛盾及社交影响）。
难愈合伤口患者在自我管理认知方面存在差异，只有部分患者知道如何在家中进行伤口自我管理。总体而言，难愈合伤口患者的自我管理认知较差。医护人员应鼓励和指导难愈合伤口患者进行自我管理，这将有助于增强患者自我管理的动机并减轻症状管理负担。社区及二级医院的专业人员应接受培训，以提高其对难愈合伤口患者自我管理的指导技能。
