Social isolation and humour in coping with the stress of living with venous leg ulceration: A case study

Background: Venous leg ulceration (VLU) can severely impact physical, psychological and social well-being. Aims: This case study explores how social isolation and humour functioned as coping strategies for a patient living with VLU. Methods: ‘Penny’, a 66-year-old female with VLU, was assessed following self-referral to a specialist wound care service. She expressed concerns about wound malodour and was reluctant to use compression hosiery. To understand her psychological responses, two stress theories were applied: the Transactional Model of Stress and Coping and the Generalised Unsafety Theory of Stress. Results: Social isolation was driven by feelings of shame linked to wound odour, which, in turn, contributed to loneliness, weight gain and reduced mobility. Penny used humour to express concerns about body image and ageing. While this may have offered temporary emotional relief, it likely concealed more complex feelings of vulnerability. Conclusions: To promote wound healing and emotional well-being, identifying social and emotional coping responses was essential to delivering person-centred care. Addressing the underlying cause of wound odour was central to improving social engagement and mobility. Recognising humour as an emotional response to distress was crucial to understanding Penny’s concerns. Therefore, clinicians should avoid interpreting humour as an absence of distress and instead assess its significance and emotional context on an individual basis.