Conclusions
Practice implications and future research Pain with leg ulcers is traditionally associated with treatment and the healing process, however our findings suggest
that pain persists at time of healing, which in turn may limit or alter mobility and increase the risk of leg ulcer recurrence. The primary message for clinicians is
the need to consider pain as the ‘fifth vital sign’ [39] all the way along the trajectory of healing, including at the time of healing. As accreditation and other oversight bodies include pain with vital signs assessment, it will be increasingly important from a health services and policy perspective as well as being clinically important [40]. Community care nurses should monitor and assist individuals to verbalize and manage their pain both during and after wound healing with pharmaceutical and nonpharmaceutical interventions. It will be important to consider pain issues at the time of care planning on admission as well as at follow-up. Those individuals with
pain at time of healing may benefit from remaining on service or being referred to their primary care provider for ongoing follow up until pain is managed or resolves.
This may reduce the likelihood of recurrence due to mobility limitations. Although pain scales (e.g. a VAS or Numeric Rating Scale (NRS) measure) are commonly
used in practice, the same is not true for documentation of quality of pain. During leg ulcer care, community care nurses can enhance the monitoring of pain by asking
patients to describe their pain using ‘pain descriptors’ such shooting, stabbing and burning. This may signify the presence of chronic pain conditions. This will improve
the overall management and care planning when additional referrals may be needed.
Conclusions
Practice implications and future research Pain with leg ulcers is traditionally associated with treatment and the healing process, however our findings suggest
that pain persists at time of healing, which in turn may limit or alter mobility and increase the risk of leg ulcer recurrence. The primary message for clinicians is
the need to consider pain as the ‘fifth vital sign’ [39] all the way along the trajectory of healing, including at the time of healing. As accreditation and other oversight bodies include pain with vital signs assessment, it will be increasingly important from a health services and policy perspective as well as being clinically important [40]. Community care nurses should monitor and assist individuals to verbalize and manage their pain both during and after wound healing with pharmaceutical and nonpharmaceutical interventions. It will be important to consider pain issues at the time of care planning on admission as well as at follow-up. Those individuals with
pain at time of healing may benefit from remaining on service or being referred to their primary care provider for ongoing follow up until pain is managed or resolves.
This may reduce the likelihood of recurrence due to mobility limitations. Although pain scales (e.g. a VAS or Numeric Rating Scale (NRS) measure) are commonly
used in practice, the same is not true for documentation of quality of pain. During leg ulcer care, community care nurses can enhance the monitoring of pain by asking
patients to describe their pain using ‘pain descriptors’ such shooting, stabbing and burning. This may signify the presence of chronic pain conditions. This will improve
the overall management and care planning when additional referrals may be needed.
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