59.5 The impact of pressure ulcers on patient quality of life: validation of the Cardiff wound impact questionnaire        

Jeremy Adams, BA, SC; Laura Teague, RN, MN, ACNP; James Mahoney, MD, FRSC(C); University of Toronto, St. Michael's Hospital      

Purpose: The purpose of this study was to validate the Cardiff Wound Impact Questionnaire (CWIQ) for patients living with pressure ulcers (1).

Study Design: Patients with pressure ulcers (PPUs) were recruited from hospitalized and community population associated with an urban 600 bed tertiary centre in Toronto, Canada. Consenting subjects completed both the CWIQ and SF-36, a gold standard generic HRQL tool. Construct validity was assessed by comparing the CWIQ scores to specific domains of the SF-36 and evaluating the responsiveness of the tool to differing health states and wound types.

Results: Eighteen (18) patients were enrolled in the study. The mean age was 46. The CWIQ's Social Life domain was correlated with both Social Functioning (SF-36) (r = 0.514, P < 0.05) and Physical Role Limitation (SF-36) (r = 0.569, P < 0.05). Physical Symptoms and Daily Living (CWIQ) correlated with Bodily Pain (SF-36) (r = 0.640, P < 0.01). PPUs had lower CWIQ scores in Social Life and Physical Symptoms and Daily Living domains compared to mean scores from patients with healed leg and diabetic ulcers (67.5 versus 76.1, P < 0.05; 63.3 versus 71.1, P < 0.01). No significant difference was found between CWIQ mean scores of PPUs and a sample of patients with other chronic wounds. However, trends toward lower mean scores in the PPU group were observed. Similarly, a trend toward lower scores among those with chronic medical conditions was observed. No significant correlation was found between wound severity and CWIQ means for PPUs.

Conclusions: The results of this study provide the first evidence for the validation of the CWIQ in PPUs. Modest correlations of 2 CWIQ domains with the SF-36 were documented. Two domains of the CWIQ were able to discriminate between PPUs and patients with healed venous and diabetic ulcers. In order to illustrate the tool's ability to discriminate between PPUs and other types of non-healed chronic wounds, a larger sample size is required. Wound severity does not appear to correlate with CWIQ scores.