The role of disgust emotions in predicting self-management in wound care

Objective: An observation study, employing a nominal questionnaire, was conducted to explore the relationship between disgust emotions, response to surgical wounds and engagement in wound management. Method:A total of 101 patients were recruited at the Royal Free Hospital plastic surgery dressing clinic, following a variety of elective or emergency surgical procedures. Participants were asked to complete the Haidt Disgust Sensitivity Questionnaire and a Wound Management Questionnaire. Participants were observed during the consultation to assess characteristics of the wound and indicators of disgust. Data were analysed using analysis of variance (ANOVA) and Z-test, with the primary outcome measure being engagement in care, as rated by the dressing nurses. Results: Mean disgust sensitivity was significantly higher in females and in those who were observed to avert their gaze or appeared tearful during the consultation. Sensitivity was lower in participants who felt able to help the nurse with their dressing, those able to clean their wound, and those able to do their own dressing at home and who were not worried about the appearance of their scar. Wound size and severity were also found to have a significant impact on engagement in care. Conclusion: Both biomedical factors, such as size and severity of a wound, and psychological factors, such as disgust sensitivity, are important in wound care. Screening for disgust sensitivity pre-operatively, in association with the modified Wound Management Questionnaire, has the potential to identify patients who are at risk of avoidant behaviour and to develop psychological interventions to promote wound self management.