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02SCIENCE, PRACTICE AND EDUCATION DOI : 10.35279/jowm202110.02 Healthcare practitioners’ views on the assessment and management of pain in chronic lower limb wounds Nicoletta Frescos , PhD, MPH, B.Appl.Sci (Podiatry), Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, VIC, Australia William McGuiness , PhD, RN, Dip T, BEd, MNS, School of Nursing and Midwifery, La Trobe University, VIC, Australia Correspondence: n.frescos@latrobe.edu.au · Conflicts of Interest: None Keywords: Wound pain, assessment, management, chronic wounds ABSTRACT Conclusion Wound-related pain in people with chronic lower There is a need for a universal clinical multidimen- limb wounds is often underestimated and undertreat- sional wound pain assessment tool that incorpo- ed by clinicians 1,2 (Briggs, Bennett, Closs, & Cocks, rates clinical guidelines and prescriptive pathways 2007; Coutts, Woo, & Bourque, 2008). This paper for managing wound-related pain. provides an overview of the findings from a mixed methods study exploring the perceptions and experi- INTRODUCTION ences of healthcare practitioners (HCP) on the as- Healthcare practitioners often underestimate wound- sessment and management of wound-related pain, related pain, as they do not perceive chronic wounds in an effort to provide insights into the above deficit. as a medical priority or life-threatening condition. 3,4 The presence of wound pain can be an indicator of Aim ineffective wound management where the underlying The aim of this study was to explore whether assess- causal pathology has not been identified or treated, ments of wound pain are undertaken and what the or infection is present. 5-7 Inadequate or inappropri- barriers are to wound pain management, from the ate interventions can contribute to persistent painful perspectives of HCP. sensory inputs, which can result in delayed healing and a lack of patient compliance. 8,9 Up to 80% of Method people with chronic wounds experience pain all the This study encompassed two research activities (an time, and half of them rate their pain as ‘moderate’ HCP survey and focus groups). An explanatory, se- to ‘the worst possible’; they report that it is inad- quential mixed method design combining data from equately managed and, consequently, affects their the survey and the focus groups was used for the quality of life. 5,10-12 Pain in lower limb wounds has study. been shown to be associated with decreased energy levels, decreased mobility, sleep disturbance, depres- Results sion, social isolation and decreased ability to manage At present, there is no consistent method for the as- normal daily work or activities. 8,9,13 sessment and management of wound-related pain. The key barriers to effective management of pain The complexity of pain is influenced by many fac- identified here are pain language, the attitudes and tors, including emotions, social background and beliefs of HCP in relation to pain assessment and the meaning of pain, along with beliefs, attitudes a lack of knowledge and skills in evidence-based and expectations of both health practitioners and practice in wound-related pain. patients. 14,15 Attitudes and beliefs are key determi-  JOURNAL OF WOUND MANAGEMENT OFFICIAL JOURNAL OF THE EUROPEAN WOUND MANAGEMENT ASSOCIATIONPage 2

iPaper

Nicoletta Frescos, William McGuiness: Healthcare practitioners’ views on the assessment and management of pain in chronic lower limb wounds
DOI: 10.35279/jowm202110.02

First published 4 October 2021

This article should be referenced as: Fresco N, McGuiness W: Healthcare practitioners’ views on the assessment and management of pain in chronic lower limb wounds, Journal of Wound Management, 2021

ABSTRACT
Wound-related pain in people with chronic lower limb wounds is often underestimated and undertreated by clinicians. This paper provides an overview of the findings from a mixed methods study exploring the perceptions and experiences of healthcare practitioners (HCP) on the assessment and management of wound-related pain, in an effort to provide insights into the above deficit.
Aim
The aim of this study was to explore whether assessments of wound pain are undertaken and what the barriers are to wound pain anagement, from the perspectives of HCP.
Method
This study encompassed two research activities (an HCP survey and focus groups). An explanatory, sequential mixed method design combining data from the survey and the focus groups was used for the study.
Results
At present, there is no consistent method for the assessment and management of wound-related pain. The key barriers to effective management of pain identified here are pain language, the attitudes and beliefs of HCP in relation to pain assessment and a lack of knowledge and skills in evidence-based practice in wound-related pain.
Conclusion
There is a need for a universal clinical multidimensional wound pain assessment tool that incorporates clinical guidelines and prescriptive pathways for managing wound-related pain.