Integrating factors associated with complex wound healing into a mobile application: Findings from a cohort study

Complex, chronic or hard-to-heal wounds are a prevalent health problem worldwide, with significant physical, psychological and social consequences. This study aims to identify factors associated with the healing process of these wounds and develop a mobile application for wound care that incorporates these factors. A prospective multicentre cohort study was conducted in nine health units in Portugal, involving data collection through a mobile application by nurses from April to October 2022. The study followed 46 patients with 57 wounds for up to 5 weeks, conducting six evaluations. Healing time was the main outcome measure, analysed using the Mann-Whitney test and three Cox regression models to calculate risk ratios. The study sample comprised various wound types, with pressure ulcers being the most common (61.4%), followed by venous leg ulcers (17.5%) and diabetic foot ulcers (8.8%). Factors that were found to impair the wound healing process included chronic kidney disease (U = 13.50; p = 0.046), obesity (U = 18.0; p = 0.021), non-adherence to treatment (U = 1.0; p = 0.029) and interference of the wound with daily routines (U = 11.0; p = 0.028). Risk factors for delayed healing over time were identified as bone involvement (RR 3.91; p < 0.001), presence of odour (RR 3.36; p = 0.007), presence of neuropathy (RR 2.49; p = 0.002), use of anti-inflammatory drugs (RR 2.45; p = 0.011), stalled wound (RR 2.26; p = 0.022), greater width (RR 2.03; p = 0.002), greater depth (RR 1.72; p = 0.036) and a high score on the healing scale (RR 1.21; p = 0.001). Integrating the identified risk factors for delayed healing into the assessment of patients and incorporating them into a mobile application can enhance decision-making in wound care.

Designing for Hope: Biophilic Color Associations and Their Relevance to Clinical Settings

AIM

To consider one common aspect of biophilic design (BD; i.e., color) and its relationship to an important element of well-being (i.e., hope).

BACKGROUND

BD is multifaceted making the identification of critical design elements difficult. Further complexity is introduced given that practice assumptions stemming from the biophilia hypothesis may be questioned. Consistent with the biophilia hypothesis, the author considers the study's findings from the perspectives of evolutionary psychology and psychobiology.

METHODS

One hundred and fifty four adult participants engaged in one of the three experiments. Using colored test cards, Experiment #1 sought to determine which of four biophilic colors (i.e., red, yellow, green, or blue) evoked the strongest experience of hope. Considering this color alone, Experiment #2 sought to manipulate "color depth." Participants were asked to identify what color depth evoked the strongest experience of hope. Experiment #3 sought to determine if the outcomes of Experiments #1 and #2 were due to a priming effect. All participants were asked about color associations they held.

RESULTS

Experiments #1 and #2 demonstrated that yellow at maximal color depth evoked the strongest experience of hope (p < .001). Experiment #3 demonstrated that no priming effect was evident (p < .05). No participant had a strong personal preference for/against yellow. Natural world color associations existed for yellow, green, and blue. Red held emotive associations.

CONCLUSIONS

These findings clearly associate yellow with hope. From the perspectives of evolutionary psychology and psychobiology this suggests color cues can evoke time-dependent motive states. Implications for practitioners designing spaces of hope within healthcare facilities are considered.

QUALIDADE DE VIDA EM PESSOAS COM ÚLCERA VENOSA E AS CARACTERÍSTICAS E SINTOMAS ASSOCIADOS À FERIDA

Objetivo:avaliar a qualidade de vida de pessoas com úlcera venosa e correlacionar com as características clínicas e sintomas associados à ferida. Método: estudo quantitativo, transversal e analítico. Para as análises das associações das variáveis qualitativas foram aplicados os testes Qui-quadrado e exato de Fisher, e para as variáveis quantitativas, o coeficiente de correlação de Spearman. Utilizou-se o instrumento Pressure Ulcer Scale for Healing para a avaliação da ferida e o Freiburg Life Quality Assessment Wound-wk para análise da qualidade de vida. Fizeram parte do estudo 103 sujeitos com tempo de feridas superior a seis semanas, de etiologia venosa. Resultados: houve correlação das características clínicas da úlcera venosa e sintomas associados com a qualidade de vida. Nas dimensões sintomas físicos, pessoas com úlcera venosa apresentraram pior escore em relação ao sintoma dor (p<0,0001). Associadas a isso, as características clínicas como a aparência (p< 0,0001) e a área (p=0,0037) da ferida também manifestaram correlação. Em relação à escala de avaliação da ferida (área, tecido na ferida e exsudato), o pior escore interferiu nos sintomas físicos. Conclusão: a dor, tamanho da ferida e seu aspecto influenciam negativamente na qualidade de vida de pessoas com úlcera venosa

QUALITY OF LIFE IN PEOPLE WITH VENOUS ULCERS AND THE CHARACTERISTICS AND SYMPTOMS ASSOCIATED WITH THE WOUND

Objective: to evaluate the quality of life of people with venous ulcers and correlate with the clinical characteristics and symptoms associated with the wound. Method: quantitative, cross-sectional and analytical study. For analyzes of associations of qualitative variables, the Chi-square and Fisher’s exact tests were applied, and for quantitative variables, Spearman’s correlation coefficient. The Pressure Ulcer Scale for Healing instrument was used to assess the wound and the Freiburg Life Quality Assessment Wound-wk for quality of life analysis. The study included 103 subjects with a wound time of more than six weeks, of venous etiology. Results: there was a correlation between the clinical characteristics of the venous ulcer and symptoms associated with quality of life. In the physical symptoms dimensions, people with venous ulcers had a worse score in relation to the pain symptom (p <0.0001). Associated with this, clinical characteristics such as the appearance (p <0.0001) and the area (p = 0.0037) of the wound also showed a correlation. Regarding the wound assessment scale (area, tissue in the wound and exudate), the worst score interfered with physical symptoms. Conclusion: the pain, size of the wound and its aspect negatively influences the quality of life of people with venous ulcers.