Assessing perceived stress in people with hard-to-heal wounds: case series

Objective: To exemplify assessment of the stress, distress, and coping perceived by patients with hard-to-heal wounds (HHW) receiving treatment in an Enterostomal Therapy outpatient clinic. Method: An observational, prospective secondary study, approved by the ethics committee, involving 10 adult patients with HHW who were followed over two to six consultations. The following tools were used: sociodemographic and clinical data form; Brief Pain Inventory (sensitivity — BPIS; interference — BPII); Bates-Jensen Wound Assessment Tool (BWAT); Perceived Stress Scale (PSS), which included measures of coping and distress with data expressed as means. Results: Patients primarily had HHW located on the lower extremities, with a mean duration of 21.2 months. The BWAT score was 23.7,the BPIS score was 4, and the BPII was 3.2. Stress was characterized by a total PSS score of 28.5 points, with a distress score of 16.4 and a coping score of 16. In the final consultation, there was a decrease of 4.3 points in BWAT, 0.8 points in BPIS, and 7.6 points in PSS, resulting in a 5.3-point reduction in distress. The BPII increased by 0.7, and coping improved by 2.2. Conclusion: There is a tendency for a relationship between perceived stress and wound healing, with coping influencing the perception of stress. A multidisciplinary approach is necessary, and the potential role of the wound, ostomy, and continence nurse is highlighted for the early assessment of distress and management of coping.