Impact of pressure ulcers on quality of life in older patients: a systematic review

Objectives:To identify the impact of pressure ulcers (PUs) and PU interventions onhealth-related quality of life (HRQL).

Design: Systematic review and metasynthesis of primary researchreporting the impact of PU and PU interventions on HRQL according to directpatient reports. Quality assessment criteria were developed and applied. Dataextraction identified findings in the form of direct quotes from patients orquestionnaire items and domain results. Combined synthesis of qualitative andquantitative research was performed using content analysis to generatecategories and themes from findings. Thirteen electronic databases weresearched, and hand searching, cross-referencing, contact with experts, and anonline search was undertaken. No language restrictions were applied.

Setting: Adults with PUs in acute, community, and long-term caresettings across Europe, the United States, Asia, and Australia.

Participants: Thirty-one studies including 2,463 participants withPUs were included in the review. Ages ranged from 17 to 96.

Results: The review included 10 qualitative and 21 quantitativestudies; 293 findings, 46 categories, and 11 themes emerged. The 11 HRQL themeswere physical impact, social impact, psychological effect, PU symptoms, generalhealth, and other impacts of PUs: healthcare professional-client relationships,need for versus effect of interventions, impact on others, financial impact,perceived etiology, and need for knowledge.

Conclusion: There is evidence that PUs and PU interventions have asignificant impact on HRQL and cause substantial burden to patients.