PubMed Health⌕ Search

Biomedical subjects

Sue Bale

Publications and source records attributed to Sue Bale.

7 recordsLinked to original sources
PubMed2006

Patient stories of living with a pressure ulcer.

AIM: This paper reports the findings of a pilot study exploring the experience of older people living with pressure ulcers. BACKGROUND: Pressure ulcers are known to be a significant health burden, but little is known of the impact on the quality of life of the sufferer. They mainly affect older people, and this is a neglected group in previous studies of this topic. METHODS: A Heideggerian phenomenological approach was used and patients were recruited if they were over 65 years of age and had a grade 3 or 4 pressure ulcer that had been present for more than a month. Patients were recruited from multiple centres but the data were analysed centrally. The study took place in 2003-2004. FINDINGS: Analysis of the transcripts revealed three main themes, all with associated subthemes: pressure ulcers produce endless pain; pressure ulcers produce a restricted life; coping with a pressure ulcer. The endless pain theme had four subthemes: constant presence, keeping still, equipment pain and treatment pain. Some patients found that keeping still reduced their pain. Several patients also reported that pain was exacerbated by their pressure relieving equipment and at dressing change. There were three subthemes for the restricted life theme: impact on self, impact on others and consequences. Patients found that the pressure ulcer restricted their activities and had an impact on their families. In addition, for some, the restrictions delayed their rehabilitation. To cope with their pressure ulcers, patients developed ways of accepting their situation or comparing themselves with others. CONCLUSIONS: Although a pilot, this study has produced a wealth of data that demonstrates the impact of pressure ulcers on people. While a larger study is required to obtain a European perspective, it is still reasonable to conclude that the issues of pain and restrictions should be considered in the development of pressure ulcer treatment and prevention guidelines.

Activities of Daily Living↗
PubMed2004

A topical metronidazole gel used to treat malodorous wounds.

Patients with malodorous wounds often experience social isolation, depression, shame, embarrassment and poor appetite, all of which can have a negative impact on their quality of life. The healthcare professionals caring for them face difficult clinical challenges in terms of treating the cause and managing the symptoms. This study employed a randomized, placebo-controlled double blind design to investigate the effectiveness of metronidazole gel on wound malodour, the main focus of this article. In addition, changes in self-report of mood state were also explored. There was a 100% success rate for the metronidazole gel, mostly within 3 days, with no adverse events reported. As there was a 76% success rate in the placebo group, there was no significant difference in success rates between the two groups. Odour ratings given by patients and nurses were significantly correlated (P<0.001). There was no significant difference in mood state between the groups over time. This study provides some evidence to support the use of metronidazole gel in the treatment of patients with malodorous wounds, but indicates the need for further research in this area.

Administration, Cutaneous↗
PubMed2004

The benefits of implementing a new skin care protocol in nursing homes.

This study explored the extent to which a new skin care protocol comprising a skin cleanser, barrier cream and barrier film could be implemented in nursing homes, and its effects on patients' skin condition, staff time and associated costs. A pre- and post-intervention study design was used. Data were collected on current skin condition and skin care procedures, before and after the introduction of a new skin care protocol. Nurses and carers were observed as they undertook skin care following episodes of incontinence. The time taken, products and amounts used were recorded. The presence and severity of incontinence dermatitis was recorded, together with the presence and severity of pressure ulceration. A supportive education programme was delivered to staff. All patients with incontinence and all staff working in six nursing homes were included in this study. Two nursing homes were randomly selected to participate in detailed skin assessments, documentation of skin care procedures and product usage. A total of 164 patients were included in detailed assessments, 79 pre-intervention, 85 post-intervention; 49 were male (29.9%) and 115 were female (70.1%). Their mean age was 83.44 years (standard deviation = 8.38). Only 3% of patients were under 70 years of age, with 72% over 80 years of age. Pre-intervention 29.1% were incontinent of urine only, 64.6% were doubly incontinent and 6.3% were catheterised. Post-intervention 29.4% had urinary incontinence, 65.9% were doubly incontinent, and 4.7% were catheterised. Skin condition was maintained or improved using the new skin care protocol. The presence of grade 1 pressure ulcers was found to significantly decrease over time (p = 0.042). The presence of incontinence dermatitis was found to be significantly lower after introducing the skin care protocol (p = 0.021). There was significant reduction in time taken to deliver skin care post-intervention (p < 0.001) with a mean time saving of 4 minutes and 2 seconds, per patient per procedure. On average this procedure was carried out 8.5 times per day, giving a time saving of 34 minutes and 17 seconds per patient per day using the new skin care protocol. This was associated with an average saving per patient per day of 8.83 Pounds for qualified staff and 3.43 Pounds for unqualified staff. Staff adherence to the new skin care protocol was good, with only one observed episode when the protocol was not followed, suggesting a high degree of success in its implementation. This study demonstrated that the introduction of a new skin care protocol, supported by an educational programme, maintained or improved patients' skin condition, and significantly reduced the resources used in delivering nursing care.

Aged↗
PubMed2004

Using different designs in wound healing research.

Wounds are common, expensive to treat and prevent patients from returning to their normal activities. Wound healing as a clinical specialty has only developed over the past 20 years, and this is an area of practice where there is a very strong impetus towards ensuring that, as far as possible, all health care is evidence based. Scientific wound healing research has a long history, but clinical research in this field is much more recent. Clinical wound healing research has particular challenges related to the nature of the patients and the interventions being studied. Wounds are a symptom, rather than a disease, and patients often present with multiple or complex pathology. Wound healing interventions typically include dressings, bandages and mattresses, all of which are highly visible to researchers and patients alike. This makes the design and execution of experimental studies challenging. For example, the 'blinding' of researchers, patients and staff to highly visible interventions is very difficult. In this article, Sue Bale discusses the use of four different designs that have been employed: case studies, non-comparative studies, quasi-experimental studies, and randomised controlled trials. The value and contribution of each is explored.

Evidence-Based Medicine↗
PubMed2003

Managing patients unable to tolerate therapeutic compression.

Managing patients with venous ulceration who are unable to tolerate therapeutic compression bandaging is a challenging clinical problem. This study followed a group of 28 such patients who were treated with three layers of graduated Tubigrip as an alternative to therapeutic compression. It also investigated factors that influenced nurses in deciding to use this bandaging system. Patients were followed until their ulcers healed or for a maximum of 12 weeks. The decision to use three layers of graduated Tubigrip was based on 19 patients' desire to wear their normal shoes (67.9%) and the convenience of access to the ulcer by eight patients (28.6%) (to permit frequent dressing changes for large or infected ulcers, and for the daily application of steroidal creams to periulcer skin). Fourteen patients' ulcers had healed within the 12-week study period. The remaining 14 patients had a mean reduction in ulcer area of 4.6 cm(2) (SD = 7.4), and median of 2.3 cm(2) (range 28.5). The authors found three layers of graduated Tubigrip useful for managing patients who cannot tolerate therapeutic forms of compression.

Aged↗
PubMed2002

Evaluating the effectiveness of a dressing for use in malodorous, exuding wounds.

Malodorous, exuding wounds can cause problems for patients in terms of discomfort and social isolation. A prospective, noncomparative, multicenter study was conducted to evaluate the effectiveness of an odor-controlling dressing in the management of patients with chronic and acute exuding, malodorous wounds. Forty-six patients with various malodorous wounds (mean duration prior to study entry of 231.6 weeks) participated in the study. The majority of the patients were > 65 years of age (mean 70.7 years). Wound characteristics, odor, and dressing exudate absorption were assessed at baseline and at every dressing change (total: 348 dressing changes). Overall assessment of the dressing's ability was rated as good or excellent for odor control (91% of patients), exudate management (82%), and overall comfort (86%). Patient and nurse perception of odor were similar. While appropriate treatment to address the cause of exudate and wound odor remains a priority, the results of this study suggest that discomfort and isolation may be reduced through the use of odor-control dressings.

Aged↗