Patient-Centered Concerns
Patient-centred Concerns
Assessment of Pain:
Assessment of pain related to venous leg ulcers using a validated tool is important, as patients regularly report mild to moderate or severe pain. Clinicians have a range of tools that make it possible to evaluate the patient’s pain pre-, during and post- procedure and at regular intervals. Pain affects patients’ mental health and wellness, and therefore their behaviours and attitudes toward care planning.
Practitioners can access pain screening tools at painbc.ca
Assessment of Nutritional Status
Protein malnutrition and malabsorption from gastrointestinal distress can contribute to chronic leg edema associated with VLUs. As well, VLUs can be heavily exudating, making fluid and protein intake important to consider. It is important to assess the nutritional status of individuals with or at risk of VLUs using a validated tool.
The Canadian Nutrition Screening Tool is a validated tool that asks two questions:
- Have you lost weight in the past 6 months without trying to lose this weight? (if the patient lost weight and regained it, it is not considered weight loss) and
- Have you been eating less than usual for more than a week? (Canadian Nutritional Society, 2014).
Two yes responses would indicate a positive screen result and requires a referral to a registered dietitian for an in-depth nutritional assessment.
Assessment of Quality of Life (QoL): A wide variety of quality-of-life and health-related quality-of-life assessment tools are available. To assess the patient’s quality of life generally, the 36-Item Short Form Health Survey (SF-36) is effective in clinical practice. A shorter version of the SF-36 is available as the SF-12. The Wound QoL tool can be used to measure quality of life in patients with chronic wounds (Vasquez, 2008).
Patient Adherence
Addressing patient adherence is often overlooked. Adherence to recommended treatment modalities, especially compression therapy, is important for positive, long-term outcomes. Listening to the patient’s preferences, adjusting treatment plans, adequate pain management, providing psychosocial support and securing funding for compression garments are only a few factors to consider. Clinicians should include the patient and their circle of care to develop a mutually agreed upon plan of care.
