Degrees of freedom – exploring unrecognised patient-empowerment in chronic wounds settings

This study explored an under-researched but critical element of patient empowerment in chronic wound care, namely degrees of freedom.This refers to the personalisation of everyday wound care based on patients' individual needs.To identify degrees of freedom in clinical practice, semi-structured interviews were conducted with 23 patients and 16 healthcare professionals and analysed using qualitative content analysis.The analysis yielded nine degrees of freedom with 42 concrete behaviours of primary control (shaping the actual treatment situation) and six degrees of freedom with 22 concrete behaviours of secondary control (shaping the patient's inner experience).These could be assigned to four main degrees of freedom, namely patients' self-action, cooperation between patients and health professionals, adaptation of treatment to patients' needs, and the use of emotional coping strategies.Furthermore, two types of patients could be distinguished: those who are active and take responsibility for their wounds, and those who remain passive and tend to endure.The implementation of degrees of freedom offers several positive effects, such as patients experiencing outcome efficacy and becoming experts on their wounds.However, there are several implementation issues, such as patient reluctance and time constraints, that need to be overcome first.