Health‐related quality of life in hospital inpatients with pressure ulceration: Assessment using generic health‐related quality of life measures

Holly N. Essex, Michael Clark, Joyce Sims, Ann Warriner, Nicky Cullum

The objective of this study was to determine the impact of pressure ulceration on health-related quality of life (HRQoL) and to undertake a pilot study for a future larger study. The study comprised two parts. First, data from a large UK prospective cohort study were analyzed and the HRQoL of 218 people with pressure ulcers was compared with that of 2,289 people without ulcers using the Short Form-36 (SF-36) questionnaire. After adjusting for age, sex, and comorbidities, patients with pressure ulceration had significantly lower scores for both the physical (coefficient=-3.12, p<0.001) and mental (coefficient=-1.50, p=0.04) component summary scores of the SF-36. Second, a small pilot study was conducted to explore use of other tools. HRQoL was assessed in six patients with and 16 patients without pressure ulcers using the SF-36, the EQ-5D and a pain visual analog scale. SF-36 scores indicated that patients with pressure ulcers had significantly poorer physical functioning (d=22.3, p=0.001), role limitations due to physical problems (d=12.9, p=0.02), and vitality (d=20.6, p=0.04) than those without. EQ-5D scores were also poorer for patients with pressure ulceration, for both the visual analog scale (d=19.2, p=0.02) and the index (d=0.29, p=0.08). Patients with pressure ulceration had more perceived pain than those without; however, this difference was of borderline significance (d=-23.9, p=0.06). Pressure ulceration therefore has an impact on HRQoL that is measurable and persists after adjusting for potential confounding.