Health-related quality of life in hospital inpatients with pressure ulceration: Assessment using generic health-related quality of life measures |
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Authors: | Holly N Essex MSc ; Michael Clark PhD ; Joyce Sims BSc RGN ; Ann Warriner BA RGN ; Nicky Cullum PhD RGN |
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Institution: | Department of Health Sciences, University of York, York, UK,; Wound Healing Research Unit, Cardiff University, Wales, UK, and; York Hospitals NHS Foundation Trust, York, UK |
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Abstract: | The objective of this study was to determine the impact of pressure ulceration on health-related quality of life (HRQoL) and to undertake a pilot study for a future larger study. The study comprised two parts. First, data from a large UK prospective cohort study were analyzed and the HRQoL of 218 people with pressure ulcers was compared with that of 2,289 people without ulcers using the Short Form-36 (SF-36) questionnaire. After adjusting for age, sex, and comorbidities, patients with pressure ulceration had significantly lower scores for both the physical (coefficient=?3.12, p <0.001) and mental (coefficient=?1.50, p =0.04) component summary scores of the SF-36. Second, a small pilot study was conducted to explore use of other tools. HRQoL was assessed in six patients with and 16 patients without pressure ulcers using the SF-36, the EQ-5D and a pain visual analog scale. SF-36 scores indicated that patients with pressure ulcers had significantly poorer physical functioning ( d =22.3, p =0.001), role limitations due to physical problems ( d =12.9, p =0.02), and vitality ( d =20.6, p =0.04) than those without. EQ-5D scores were also poorer for patients with pressure ulceration, for both the visual analog scale ( d =19.2, p =0.02) and the index ( d =0.29, p =0.08). Patients with pressure ulceration had more perceived pain than those without; however, this difference was of borderline significance ( d =?23.9, p =0.06). Pressure ulceration therefore has an impact on HRQoL that is measurable and persists after adjusting for potential confounding. |
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