Korean J Adult Nurs.  2015 Oct;27(5):515-526. 10.7475/kjan.2015.27.5.515.

A Phenomenological Study on Illness Experience of Patients with Pressure Ulcer

• Yoo M
• Yi M

• KMID: 2221730
• DOI: http://doi.org/10.7475/kjan.2015.27.5.515

Abstract

PURPOSE
The purpose of this study was to describe the illness experience of patients with pressure ulcer.
METHODS
A phenomenological methodology was used for the study. The data were collected by individual in-depth interview with seven participants with pressure ulcer during 2013~2014. All interviews were audio-taped and verbatim transcripts were made for the analysis. The data were analyzed using Colaizzi's phenomenological method.
RESULTS
All participants had underlying disease, such as spinal paralysis and diabetes. Average period of having pressure ulcer was 18 months, ranged from 3 to 36 months. A total of seven theme clusters were derived from the analysis; unexpected wound, inherent vulnerability to infection, reversal of the treatment policy, unpleasant and strange feeling of wound, sweeping fear and helplessness, socioeconomic burden, and healing through specific actions and reflection. The participants faced various contradictory and paradoxical situations in managing their pressure ulcers as well as underlying diseases in their everyday life. However, they slowly overcome these situations by strictly practicing concrete action-oriented strategies that they have learned through suffering and appreciating miraculous wound healing.
CONCLUSION
The results of this study can help developing a patient-specific intervention program with sufficient emotional support by providing insights of the paradoxical illness experience of patients with pressure ulcer.

MeSH Terms

Humans
Paralysis
Pressure Ulcer*
Qualitative Research
Wound Healing
Wounds and Injuries

Reference

1.Bryant RA, Acute & chronic wounds. St. Louis, Missouri: Mosby;2000. p. 17–40.

2.Choi SJ., Bae SY., Choi JY., Bang HJ. Development and predictive validity of pressure ulcer predicting scale for patients with neurologic condition. Journal of Korean Clinical Nursing Research. 2005. 11(1):95–108.

3.Park SA. Development of a decision-making tree for the prevention of pressure ulcer [master's thesis]. Seoul: Yonsei University;2003. p. 1–65.

4.Langemo D., Anderson J., Hanson D., Hunter S., Thomson P. A quick overview on measuring pressure ulcer prevalence and incidence. Advanced in Skin & Wound Care. 2007. 20(12):642–4. http://dx.doi.org/10.1097/01.asw.0000284964.85110.85.

5.Schoonhoven L., Bousema MT., Buskens E. The prevalence and incidence of pressure ulcers in hospitalized patients in the Netherlands: a prospective inception cohort study. International Journal of Nursing Studies. 2007. 44(6):927–35. http://dx.doi.org/10.1016/j.ijnurstu.2006.02.011.

6.Whittington KT., Briones R. National prevalence and incidence study: 6-year sequential acute care data. Advances in Skin & Wound Care. 2004. 17(9):490–4. http://dx.doi.org/10.1097/00129334-200411000-00016.

7.Lee EJ., Yang SO. Clinical knowledge and actual performance of pressure ulcer care by hospital nurses. Journal of Korean Clinical Nursing Research. 2011. 17(2):251–61.

8.Lee JK. The relationship of risk assessment using Braden scale and development of pressure sore in neurological intensive care unit. Journal of Korean Academy of Adult Nursing. 2003. 15(2):267–77.

9.Kim HY., Park HA. Identifying minimum datasets for pressure ulcer assessment and analysis of nursing records in home nursing. Journal of Korean Academy Community Health of Nursing. 2003. 20(1):105–11.

10.Lee YJ., Park S., Kim JY., Kim CG., Cha SK. Clinical nurses'knowledge and visual differentiation ability in pressure ulcer classification system and incontinence-associated dermatitis. Journal of Korean Academy of Nursing. 2013. 43(4):526–35. http://dx.doi.org/10.4040/jkan.2013.43.4.526.

11.Makletbust J., Sieggreen M. Pressure ulcer guidelines for prevention & management. Philadelphia, Pennsylvania: Lippin-cott Williams & Wilkins;2000. p. 29–42.

12.Merleau-Ponty M. Phenomenology of perception (C. Smith, Trans). New York: Routledge & Kegan Paul;1962. (Original work published 1945). p. preface ⅶ-52.

13.Kleinman A. The illness narratives: suffering, healing and the human condition. New York: Basic Books;1988. p. 3–30.

14.Benner P. (Ed.). Interpretive phenomenology: embodiment, caring and ethics in health and illness. Thousand Oaks, CA: Sage;1994. p. 99–128.

15.McCracken G. The long interview: qualitative research methods. Thousand Oaks, CA: Sage;1988. p. 18–28.

16.Colaizzi PF. Psychological research as the phenomenologist views it. Valle R.S., King M., editorsExistential phenomenological alternatives for psychology. New York, NY: Oxford University Press;1978. p. 48–71.

17.Guba EG., Lincoln YS. Effective evaluation: improving the usefulness of evaluation results through responsive and naturalistic approaches. San Francisco: Jossey-Bass;;1981. p. 104–20.

18.Sandelowski M. The problem of rigor in qualitative research. Advances in Nursing Science. 1986. 8:27–37. http://dx.doi.org/10.1097/00012272-198604000-00005.

19.Pinkney L., Nixon J., Wilso L., Coleman S., McGinnis E., Stubbs N, et al. Why do patients develop severe pressure ulcers? A retrospective case study. BMJ Open. 2014. 4(1):e004303. http://dx.doi.org/10.1136/bmjopen-2013-004303.

20.Park SH., Park YS. Predictive validity of the Braden scale for pressure ulcer risk: a meta-analysis. Journal of Korean Academy of Nursing. 2014. 44(6):595–607. http://dx.doi.org/10.4040/jkan.2014.44.6.595.

21.Moon MK. The characteristics related to the development of pressure ulcers in long term care facilities: the use of 2009 national patient sample. Journal of the Korea Academia-Industrial Cooperation Society. 2013. 14(7):3390–9. http://dx.doi.org/10.5762/kais.2013.14.7.3390.

22.Chae KS., Lim NY., Song JH. The predictors on pressure ulcer stage of health status on the hospitalized elderly patients on long-term care facilities. Journal of the Korean Society of Living Environmental System. 2012. 19(6):697–709.

23.Salehi S., Ghodousi A., Ojaghloo K. The spiritual experiences of patients with diabetes-related limb amputation. Iranian Journal of Nursing and Midwifery Research. 2012. 17(3):225–8.

24.Lee HN., Park JS. Nutrition-related factors predicted pressure ulcers in intensive care unit patients. Journal of Korean Academy Fundamentals Nursing. 2014. 21(4):413–22. http://dx.doi.org/10.7739/jkafn.2014.21.4.413.

25.Jeong DH., Kong JY., Kwon HC. The review of factors of pressure sores associated with a wheelchair seating. The Journal of Korean Society of Physical Therapy. 2000. 12(2):229–38.

26.Yoo SM., Lim MJ. The application cases of assistive devices to prevent decubitus ulcer for the individual with C5 complete spinal cord injury. RESKO technical conference 2010;2010 November 5-6; Dong-Eui University. Busan: Rehabilitation Engineering and Assistive Technology Society of Korea;2010. p. 120–1.

27.Kim HJ., Jeong IS. Optimal time interval for position change for ICU patients using foam mattress against pressure ulcer risk. Journal of Korean Academy of Nursing. 2012. 42(5):730–7. http://dx.doi.org/10.4040/jkan.2012.42.5.730.

28.Lee CH., Kim SJ., Kim KJ., Song BJ., Lee BS. Development of system monitoring physical posture & urine and feces to prevent pressure ulcers. Proceedings of the Korea Information Processing Society Conference. 2011. April 30; Jeju National University. Jeju: Korea Information Processing Society. 2011. 18(1):1120–3.