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Comparison of Bodily Pain: Persons With and Without Venous Ulcers in an Indigent Care Clinic

Pieper, Barbara; Vallerand, April H.; Nordstrom, Cheryl K.; DiNardo, Ellen

Journal of Wound, Ostomy and Continence Nursing: September-October 2009 - Volume 36 - Issue 5 - p 493–502
doi: 10.1097/WON.0b013e3181b35ed1
WOUND CARE
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PURPOSE The purpose of this study was to examine bodily pain and its relationship with functional status, perception of control, coping, and depression for patients with and without venous ulcers who were receiving care in an urban, primary care clinic for low-income adults.

METHODS We used an exploratory, cross-sectional design. Participants (N = 301) completed demographic, pain severity and pain interference with function, depression, control, and coping questionnaires. Seventy patients (23.3%) had venous ulcers and 231 (76.7%) did not.

RESULTS Participants were generally male (53%, n = 159), mostly African American (92%, n = 277), and ranged in age from 22 to 74 years (M = 49.5, SD = 8.5). Persons with and without venous ulcers did not differ significantly based on gender, race, number of pain sites (n = 3.3), or self-rated health. Those with leg ulcers were significantly older, had more health problems, and were more likely to have pain-related disability. The pain descriptors used by patients with venous ulcers were sharp (89%), nagging (87%), tiring (87%), and throbbing (87%). Patients with leg ulcers reported significantly lower average pain (M = 6.0) than those without leg ulcers (M = 6.6) and greater 24-hour pain relief from treatments or medications (55% vs 44%). Patients with venous ulcers reported greater control over their pain and greater coping with pain. The 2 groups did not differ significantly on depression, life control, or purpose in life scores.

CONCLUSIONS Compared to patients without venous ulcers, those patients with venous ulcers rated their pain lower and reported higher coping and control over pain, which may be reflected in better subjective pain management despite having more pain sites and disability related to pain. Pain management for indigent patients with and without venous ulcers remains a concern and needs further study.

Barbara Pieper, PhD, RN, APCNS-BC, CWOCN, FAAN, Professor/Nurse Practitioner, College of Nursing, Wayne State University, Detroit, Michigan.

April H. Vallerand, PhD, RN, FAAN, Associate Professor, College of Nursing, Wayne State University, Detroit, Michigan.

Cheryl K. Nordstrom, PhD, MPH, CHES, Assistant Professor (Research), College of Nursing, Wayne State University, Detroit, Michigan.

Ellen DiNardo, MSN, RN, APNP-BC, Nurse Practitioner, 4A University Health Center/Detroit Receiving Hospital, Detroit, Michigan.

Corresponding author: Barbara Pieper, PhD, RN, APCNS-BC, CWOCN, FAAN, College of Nursing, Wayne State University, 5557 Cass Ave, Detroit, MI 48202 (bpieper@wayne.edu).

Copyright © 2009 by the Wound, Ostomy and Continence Nurses Society