The locus of pain control in patients with lower limb ulcerations

J Clin Nurs. 2012 Dec;21(23-24):3346-51. doi: 10.1111/j.1365-2702.2012.04163.x. Epub 2012 Jul 27.

Abstract

Aims and objectives: (1) To analyse the distribution of pain control profiles of individuals suffering from the lower limb ulcerations. (2) To identify sociodemographic and clinical factors determine the locus of pain control in this group of patients.

Background: The locus of pain control can play a critical role in determining the quality of life in patients with lower limb ulcerations, and identification of individuals with an unfavourable pain control profile would enable the opportunity of offering them dedicated psychological counselling.

Design: Quantitative survey.

Methods: This study included 298 patients with lower limb ulcerations resulting from chronic venous insufficiency (n = 101), lower limb atherosclerosis (n = 98), or having mixed arteriovenous aetiology (n = 99). The study included the completion of the Polish version of the Beliefs about Pain Control Questionnaire.

Results: The most important role in the control of pain was assigned to the powerful others locus. This locus correlated directly with poorer educational level and higher professional activity. Additionally, the intensity of usual pain correlated inversely with the powerful others locus. Respondents' age was the only sociodemographic variable decreasing the level of the internal locus. Moreover, the severity of usual and maximal pain and the area of ulceration correlated inversely with the internal locus of pain control. In contrast, the aetiology of lower limb ulceration did not affect significantly any of the dimensions of pain control.

Conclusion: The control of pain in ulceration patients is mostly determined by the support of medical personnel, which generally should be considered a negative finding. Relevance to clinical practice. Determination of the locus of pain control should be included in the complex medical evaluation of individuals suffering from ulcerations.

MeSH terms

  • Aged
  • Chronic Disease
  • Female
  • Humans
  • Internal-External Control*
  • Leg Ulcer / complications*
  • Leg Ulcer / etiology
  • Leg Ulcer / physiopathology
  • Male
  • Middle Aged
  • Pain / complications
  • Pain / psychology*
  • Pain Management*
  • Quality of Life
  • Surveys and Questionnaires
  • Venous Insufficiency / complications