Pressure Injuries: The Wound in the Patient is More Than Just Skin Deep

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Pressure injuries (PIs) represent an enormous cost to the healthcare system. This AHQR report indicated that between nine and twelve billion dollars a year are spent on caring for pressure injuries. Beyond the financial costs, however, PIs take a heavy toll on patient quality of life and life expectancy. A significant aspect of this problem is the psychological effects of PIs on patients and their caregivers. Nurses know that effective care can be achieved only when the full range of a patient’s physical and mental needs are addressed. This includes providing warmth, empathy, and emotional support during this difficult and painful time. As indicated in this Nursing Times article, some of the physical and emotional issues nurses can help patients with include:

  • Stress of constant pain: Nearly all PI patients experience a significant degree of pain. The pain levels vary in intensity and can be intermittent or constant. It can be a particular problem when the wound is debrided or the dressing is changed. Unrelenting pain can also disrupt sleep leading to fatigue, anxiety, and loss of appetite. It is important that nurses educate their patients about the options for pain relief and encourage them to ask for these remedies as needed.
  • Denial: Many times patients try to ignore or rationalize the degree to which a PI is affecting their quality of life and ability to function. This type of emotional response makes it difficult for caregivers to assess and treat the wound appropriately.
  • Guilt: Patients may feel somehow responsible for causing their wounds. In these cases, nurses can help patients to gain more perspective on their situation and view themselves less harshly. Nurses can also try to offer hope based on an honest assessment of the situation and prognosis.
  • Anger: Feelings of anger and hostility can be a byproduct of pain and injury. These emotions may tend to increase stress hormones, dampen the immune system and delay wound healing.  Helping patients learn relaxation skills and other coping mechanisms may improve their quality of life.
  • Depression: Patients who endure long hospitalizations for a serious wound or injury may be vulnerable to depression, even after they have recovered. Feelings of anger and denial that often accompany a significant illness may cause the patient to become emotionally withdrawn. Providing psychosocial support can help the patient and their family adapt during the recovery process.
  • Body image: An altered body image can evoke a range of emotions in the patient including grief, depression, low self-esteem, sexual difficulties, and guilt. Nurses can help their patients come to terms with these changes by listening to their concerns and communicating acceptance and support. They can also provide information that can help patients better understand their situation.

In addition to managing the patient’s physical needs, nurses play a vital role in their recovery by providing education and emotional support. Click here to learn more about the important role nurses play in our healthcare system and calculate the actual cost of pressure injuries. We invite you to also subscribe to subscribe to our blog for the latest industry information.

Pressure Injuries

Michelle Daniels
Michelle Daniels is the Managing Director, TPF & TSS Brands for Encompass Group. She can be reached at

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