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Venous leg ulcers in the elderly patient: associated stress, social support, and coping.

Although psychosocial issues in wound management are critical considerations when formulating diagnostic and treatment algorithms, they frequently are overlooked. Clinician consideration and evaluation of associated stresses, social support, and coping are particularly important when caring for elderly patients with recalcitrant venous ulcers. The Health Belief Model and health locus of control may help explain patient responses to health issues. The psychosocial effects of chronic illness, emotional impact of pain, physiological responses to stress, and issues related to treatment adherence must be considered. Recent research has contributed substantially to understanding of these concerns in the general patient population and in persons with venous ulcers. However, quantitative data are limited and studies examining the effects of educational level, ethnicity, socio-economic status, and clinician-patient relationships on psychosocial health in general, and wound healing in particular, are needed. Despite these limitations, increased awareness of the psychosocial dynamic in elderly patients should be integral to the wound care protocol.