Volume 42 Number 4

Reaffirmation has several meanings, including to re-state, reiterate, confirm, endorse or repeat¹. Within this issue and the previous March, June and September issues of the WCET^® Journal there are numerous examples or themes that encompass the meaning of reaffirmation. Primarily, as clinicians, educators, managers or researchers, our respective practices should be founded on current available evidence and principles of best practice.

The importance of early engagement with biomedical statisticians when commencing clinical research in wound management has been reiterated frequently by Dr John Stephenson in his series of articles addressing study design, questionnaire design and descriptive methods for presenting wound care data. In this issue and within his fourth article that addresses statistical testing in wound care, he reaffirms this premise. Prior consultation with a biomedical statistician allows discussion on the purpose and type of research, the study population to be examined, hypotheses or questions to be asked and, consequently, what statistical tests may need to be considered to determine study outcomes and practice implications. These articles are practical guides for novice researchers and those undertaking quality improvement projects as well as being timely reminders for those more experienced^2–4.

The potential for peristomal skin complications (PSC) is well recognised, and improving our understanding of and consensus of opinion on the taxonomy associated with stomal, parastomal and PSCs was addressed by Carville et al in our September issue⁵. Hansen et al, in proposing a risk factor model on PSC, reaffirms that PSC have a negative impact on patients’ quality of life, and, further, that clinicians are better able to assist patients to avoid PSC if they are able to apply a framework such as the risk factor model to guide clinical decision making. Processes used to determine inherent factors within the risk factor model are described and defined under three main categories – Healthcare system, Individual with an ostomy, and Ostomy product.

Listening to and understanding the patients’ perspective of their medical condition and how this may impact on identified goals of care is further reiterated by Costa and Camargo-Plazas in their qualitative study that explored patients’ experiences of living with type 1 and type 2 diabetes and associated complications such as diabetic foot ulcers (DFU). The authors explored patients’ perceptions of diabetes, the complexity of care, and consequences of unregulated diabetes and living with a DFU using two frameworks – social constructivism and symbolic interactionism. A conclusion drawn is that healthcare professionals would benefit from additional training to focus on holistic and cooperative management of diabetes and DFUs.

Dr Elizabeth Ayello, our third WCET^® recipient of the 2022 Lifetime Achievement Award from the World Union of Wound Healing Societies reaffirms, in conjunction with Dr Delmore, the availability of pressure injury (PI) risk assessment instruments to identify patients’ susceptibility to developing PIs. The genesis of risk assessment instruments is described, as are some changes in the subcategories of these tools to better align with current evidence and guidelines for PIs. Risk factors for specific patient populations at ‘higher risk’ of PI development are highlighted, as are specific anatomical locations. Ayello and Delmore reiterate that PI risk assessment instruments are adjuncts to clinical decision making with a view to preventing avoidable PIs occurring through early and comprehensive care planning.

As Editor, endorsing the sentiments of the WCET^® President Laurent Chabal and President Elect Denise Hibbert that education comes first is not difficult. I can reaffirm an ongoing aim of the WCET^® Journal is to always facilitate dissemination of others’ clinical, research, educational or managerial expertise in the field of wound, ostomy and continence nursing for the greater global benefit of health professionals and the people we care for. The WHAM Evidence Summaries for low-and middle-income countries by Haesler are a further example of this.

In closing, I wish to thank all who have contributed to the WCET^® Journal throughout the year. Your support is greatly appreciated. Very best wishes for the festive season and new year celebrations.

Sincerely,

Jenny

Author(s)

Jenny Prentice
PhD, BN, RN, STN, FAWMA

References

1. Merriam-Webster.com. “Reaffirmation”; 2022. Available from: https://www.merriam-webster.com/dictionary/reaffirmation.
2. Stephenson J. Study designs in wound care. WCET^® J 2022;42(1):12–15. doi:10.33235/wcet.42.1.12-15
3. Stephenson J. Designing an effective questionnaire in wound care. WCET^® J 2022;42(2):24–29. doi:10.33235/wcet.42.2.24-29
4. Stephenson J. Descriptive presentation of wound care data. WCET^® J 2022;42(3):30–33. doi:10.33235/wcet.42.3.30-33
5. Carville K, et al. A consensus on stomal, parastomal and peristomal complications. WCET^® J 2022;42(3):12–22. doi:10.33235/wcet.42.3.12-22