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Oral Abstracts (Session 4 of 5)
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(Presentation 35.5) Closing the gap: process model of healing in persons living with chronic skin wounds Katherine Rosa, PhD, APRN, BC, University of Massachusetts, Lowell, Mass The gap in knowledge about chronic wound healing and patient perception of the experience motivated this research. Research to date concerning the problem of chronic skin wounds focuses primarily on wound characteristics, healing times, treatment approaches, and models of care. A phenomenological approach to the problem of living with a chronic skin wound revealed lives of physical pain, disability, social isolation, and dependence on restrictive therapies. After IRB approval, data generation occurred within Newman's hermeneutic-dialectic method of inquiry. Participants' reflections in both narrative and a self-expressive creative drawing were examined. Ten men and 8 women, most of whom were of retirement age and had lived with a chronic skin wound for 1 year or more, participated in 2 in-depth interviews focused on understanding the important people and events in their lives and particularly since living with a chronic skin wound. Emerging from each participant's stories was the link among participants' responses to previous life problems, personal awareness of the current problem, and processing a serious physical threat. Participants reflected on self and wound healing gaining insights and deciding to change lifestyle behaviors. Considering data across participants, 5 themes emerged from the data. Key components to the process of understanding the personal meaning of living with chronic skin wounds were self-awareness, stoicism, selflessness, problem recognition, and support. In addition, a process model of healing that has implications for clinical practice emerged from the data. An understanding of an individual's experience living with chronic skin wound provided information about participants' circumstances and decisions that hindered as well as promoted wound healing. Anecdotal evidence suggesting increased wound healing rates in those who participated in the research needs to be verified. References Whitney JD. Overview: acute and chronic wounds. Nurs Clin North Am. 2005;40(2):191–205. Fivenson D, Scherschun L. Clinical and economic impact of Apligraf for the treatment of nonhealing venous leg ulcers. Int Soc Dermatol. 2003;42:960–965. Doughty D. Dressings and more: guidelines for topical wound management. Nurs Clin North Am. 2005;40(2):217–231. Capasso V, Burke D, Stanley D, Abbott W. Unit-based specialty vascular transitional home care program: an example of evidence-based nursing practice. The Online Journal of Knowledge Synthesis for Nursing. 2002;(Doc N 3C):1–3. Chase SK, Melloni M, Savage A. A forever healing: the lived experience of venous ulcer disease. J Vascular Nurs. 1997;15(2):73–78. Langemo DK, Melland H, Hanson D, Olson B, Hunter S. The lived experience of having a pressure ulcer: a qualitative analysis. Adv Skin Wound Care. 2000;13(5):225–235. Walshe C. Living with a venous leg ulcer: a descriptive study of patients' experiences. J Adv Nurs. 1995;22:1092–1100. Newman MA. Health as expanding consciousness, 2nd edition. New York, NY: National League for Nursing Press, 1999. |
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