The Lived Experience of the Soft Heel Cast, Management of Heel Pressure Ulcerations in the Acute Setting, an Interpretative Phenomenological Study
Abstract
Joanna Louise Woollard and Dr. Chris MorrissRoberts
Background: Prevention of pressure ulceration is a key quality indicator throughout both acute and community settings however, good quality evidence and national guidance on how to prevent heel pressure is limited [1]. An alternative offloading device a soft heel cast has been introduced into Podiatric practise. This qualitative research study aims to seek the patient perspective of the soft heel cast.
Methods: Patients who had been provided with the soft heel cast were purposively sampled via a recruitment letter. The aim was to recruit between six and eight participants. All participants opted in and provided their written consent to take part in the study. The data was collected using the exemplary method for an Interpretative phenomenological approach (IPA) [2]. All interviews were transcribed and the six stages of analysis appropriate to IPA followed meticulously.
Results: The analysis identified three inter-related Superordinate themes. It revealed the intimate relationship between the most complex and powerful theme of pain alongside, ‘ergonomics of the optimal offloading device’ and the participant’s ‘ability to cope’. Five sub-themes were identified and discussed; suffering, comfort, size, identity and ulceration duration.
Conclusion: Pain is a complex and subjective phenomenon which cannot be measured directly rather established by the person experiencing it [3]. Pain is unique and often difficult to describe, as a consequence it remains poorly understood and inadequately managed. Quality of life should be considered an equal factor alongside the wellknown triad of ‘how to heal a wound’. This research clearly highlights how patients often suffer in silence.