Estudio calidad de vida en pacientes portadores de úlceras cutáneas de difícil cicatrización
[Study on quality of life in patients with hard-to-heal cutaneous ulcers]
DOI:
https://doi.org/10.5281/zenodo.15710065Palabras clave:
Calidad de vida, lesiones cutáneas, Cicatrización de HeridasResumen
Objetivo: Evaluar los cambios en la calidad de vida y las actividades básicas de la vida diaria (ABVD) en pacientes con úlceras cutáneas de difícil cicatrización, y comparar los resultados según el tipo de tratamiento recibido. Métodos: Este estudio analítico, observacional, transversal y prospectivo se realizó en la Unidad de Úlceras y Heridas de la Universidad Católica de Valencia. Se incluyeron 278 pacientes con heridas de al menos seis semanas de evolución. Se aplicaron los cuestionarios EuroQoL-5D, DLQI e índice de Barthel en varias visitas (inicial, quinta y final). Se llevó a cabo un análisis estadístico descriptivo y se utilizaron pruebas de Friedman y ANOVA de medidas repetidas. Resultados: Se observó una mejora significativa en la calidad de vida de los pacientes a lo largo del seguimiento, manifestada en la disminución del dolor, la vergüenza y el impacto social, así como en una mejor percepción del tiempo libre y la funcionalidad física. Las puntuaciones de los índices DLQI y EuroQoL-5D fueron más favorables tras el tratamiento, especialmente con terapias menos invasivas. Sin embargo, la independencia funcional total disminuyó en algunos pacientes, atribuido a la progresión de la enfermedad o a comorbilidades. Conclusiones: El tratamiento de las úlceras cutáneas de difícil cicatrización mejora la calidad de vida y la funcionalidad de los pacientes. No obstante, en casos complejos persisten limitaciones en la independencia funcional. Es fundamental un abordaje integral que incluya manejo del dolor, apoyo psicológico y estrategias para la recuperación funcional.
ABSTRCT:
Objective: To evaluate changes in the quality of life and basic activities of daily living (ADL) in patients with difficult-to-heal cutaneous ulcers, and to compare the results based on the type of treatment received. Methos: This analytical, observational, cross-sectional, and prospective study was conducted at the Ulcers and Wounds Unit of the Catholic University of Valencia. A total of 278 patients with wounds of at least six weeks' evolution were included. The EuroQoL-5D, DLQI, and Barthel Index questionnaires were applied during several visits (initial, fifth, and final). A descriptive statistical analysis was performed, and Friedman and repeated measures ANOVA tests were used. Results: A significant improvement in patients' quality of life was observed throughout the follow-up, manifested by a decrease in pain, embarrassment, and social impact, as well as an improved perception of free time and physical functionality. Scores from the DLQI and EuroQoL-5D indices were more favorable after treatment, especially with less invasive therapies. However, total functional independence decreased in some patients, attributed to disease progression or comorbidities. Conclusions: Treatment of difficult-to-heal cutaneous ulcers improves patients' quality of life and functionality. Never-theless, in complex cases, limitations in functional indepen-dence persist. A comprehensive approach is fundamental, including pain management, psychological support, and strategies for functional recovery. Keywords: Cutaneous ulcer, Quality of life, Wound healing, Outcome assessment (health care).
Citas
Frykberg RG, Banks J. Challenges in the treatment of chronic wounds. Adv Wound Care. 2015;4(9):560-582.
Agale SV. Chronic leg ulcers: epidemiology, aetiopathogenesis, and management. Ulcers. 2013;2013:413604.
Blome C, Baade K, Debus ES, Price P, Augustin M. The “Wound-QoL”: a short questionnaire measuring quality of life in patients with chronic wounds based on three established disease-specific instruments. Wound Repair Regen. 2014;22(4):504-514.
Finlayson KJ, Courtney MD, Parker CN, Edwards HE. Risk factors and early sign detection for venous leg ulcer recurrence. J Clin Nurs. 2014;23(17-18):2665-2673.
Augustin M, Herberger K, Kroeger K, Muenter K, Goepel L, Radtke MA. Quality of life evaluation in chronic wounds: an international approach. Int Wound J. 2012;9(3):246-255.
Lindsay E, Renyi R, Wilkie P. Chronic wounds: quality of life and impact on daily living. J Wound Care. 2017;26(11):590-597.
Kapp S, Miller C, Santamaria N. The quality of life of people who have chronic wounds and who self-treat. J Clin Nurs. 2018;27(1-2):182-192.
Renner R, Seikowski K, Strassburg S, Simon JC, Vogt PM. Quality of life and prevention of recurrence in leg ulcer patients. Int Wound J. 2015;12(1):22-26.
Flaherty G, Brenner M, Mullins M, FitzGerald M, FitzGerald D. An evaluation of the DLQI in assessing quality of life following minor and severe dermatological problems. Dermatol Res Pract. 2011;2011:463157.
Augustin M, Zschocke I, Schafer I, et al. Characteristics of chronic wounds and treatment outcomes in patients treated in a multi-center cohort study. Wound Repair Regen. 2015;23(3):299-306.
Salomon JA, Vos T, Hogan DR, Gagnon M, Naghavi M, Mokdad A. Common values in assessing health outcomes in the context of non-communicable diseases. Lancet. 2012;380(9859):2129-2143.
Herberger K, Rustenbach SJ, Haartje O, et al. Quality of life and satisfaction with care in leg ulcer patients: results from a large clinical cohort in dermatology. J Eur Acad Dermatol Venereol. 2011;25(4):474-481
Price P, Harding KG. Measuring health-related quality of life in patients with chronic leg ulcers. Wounds. 2009;21(2):29-36.
Salomon JA, Haagsma JA, Davis A, et al. Disability weights for the Global Burden of Disease 2013 study. Lancet Glob Health. 2015;3(11):e712-e723.
Brooks R. EuroQol: the current state of play. Health Policy. 1996;37(1):53-72.
Herdman M, Gudex C, Lloyd A, et al. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res. 2011;20(10):1727-1736.
Schoonhoven L, Al-Kalbani MA, Shubbar AS, van Achterberg T. Nurses’ and nursing students’ knowledge and attitudes towards pressure ulcer prevention: a descriptive cross-sectional multicenter study. Nurse Educ Today. 2015;35(2):95-100.
Blome C, Baade K, Debus ES, Price P, Augustin M. The “Wound-QoL”: a short questionnaire measuring quality of life in patients with chronic wounds based on three established disease-specific instruments. Wound Repair Regen. 2014;22(4):504-514.
Renner R, Seikowski K, Strassburg S, Simon JC, Vogt PM. Quality of life and prevention of recurrence in leg ulcer patients. Int Wound J. 2015;12(1):22-26.
Lindholm C, Searle R. Wound management for the 21st century: combining effectiveness and efficiency. Int Wound J. 2016;13(Suppl 2):5-15.
Finlayson KJ, Courtney MD, Parker CN, Edwards HE. Risk factors and early sign detection for venous leg ulcer recurrence. J Clin Nurs. 2014;23(17-18):2665-2673.
Gethin G, Cowman S, Kolbach DN, Heinen M, Lappin F, Filler T. International consensus: Optimising wellbeing in people living with a wound. Wounds International. 2012;3(4):1-15.
Frykberg RG, Banks J. Challenges in the treatment of chronic wounds. Adv Wound Care. 2015;4(9):560-582.
Augustin M, Zschocke I, Schafer I, et al. Characteristics of chronic wounds and treatment outcomes in patients treated in a multi-center cohort study. Wound Repair Regen. 2015;23(3):299-306.
Schoonhoven L, Al-Kalbani MA, Shubbar AS, van Achterberg T. Nurses’ and nursing students’ knowledge and attitudes towards pressure ulcer prevention: a descriptive cross-sectional multicenter study. Nurse Educ Today. 2015;35(2):95-100.
Brooks R. EuroQol: the current state of play. Health Policy. 1996;37(1):53-7
Herdman M, Gudex C, Lloyd A, et al. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res. 2011;20(10
Herber OR, Schnepp W, Rieger MA. A systematic review on the impact of leg ulceration on patients’ quality of life. Health Qual Life Outcomes. 2007;5:44. doi:10.1186/1477-7525-5-44.
González-Consuegra RV, Verdú J. Adaptación al castellano del “Charing Cross Venous Ulcer Questionnaire” para medir calidad de vida relacionada con la salud en pacientes con úlceras venosas. Gerokomos. 2011;22(1):25-33.
Cifuentes-Rodríguez CM, Guerrero-Gamboa SA. Estilo de vida y úlceras venosas: revisión narrativa. Av Enferm. 2021;39(2):215-227. doi:10.15446/av.enferm.v39n2.89034.
Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI): a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;19(3):210-216. doi:10.1111/j.1365-2230.1994.tb01167.x.
Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI): a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;19(3):210-216. doi:10.1111/j.1365-2230.1994.tb01167.x
Kind P, Brooks R, Rabin R. EQ-5D concepts and methods: a developmental history. Springer; 2005. doi:10.1007/1-4020-3687-4.
O’Donnell TF, Passman MA, Marston WA, et al. Management of venous leg ulcers: Clinical practice guidelines. J Vasc Surg. 2014;60(2 Suppl):3S-59S. doi:10.1016/j.jvs.2014.04.049.
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2025 David Palomar Albert , Jorge Zamora Ortiz , Federico Palomar Llatas , Marta Escudero Martínez , Andrés Naranjo Cuellar , María Isabel Pastor Orduña
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.
En caso de que el artículo sea publicado, se permite al autor(es) mantener los derechos de autor sin restricciones y retener los derechos de publicación y distribución sin restricciones. Los artículos publicados en la revista se acogen a la licencia Creative Commons de Reconocimiento – No Comercial – Compartir Igual (BY-NC-SA). Se permite al autor(es) el autoarchivo del artículo durante su acceso como “avance de publicación (ahead of print)”.
Todo el contenido de esta revista está bajo una 