Experiences of living with a malignant fungating wound: a qualitative study

Abstract

Aims and objectives: The purpose of this study was to explore the experience of cancer patients living with a malignant fungating wounds.

Background: Malignant fungating wounds are caused by cancerous cells invading skin tissue. These wounds can then bleed, become malodorous and painful causing physical and psychological distress. However, little is know about how individuals experience these lesions.

Design: Qualitative.

Methods: Ten in-depth interviews were conducted with patients in one medical teaching centre in Taiwan. Data were subject to a thematic analysis informed by elements of grounded theory.

Results: Five key themes demonstrated an emerging model that offers an insight into how patients experience their wound. Firstly, 'Declining physical well-being' refers to the initial impact of the wound, this is linked to two further themes; 'Wound related stigma' and the 'Need for expert help'. Another theme; 'Strategies in wound management' describes the initial, ineffective attempts by participants to manage their wound and the impact of professional help around wound management. This was linked to a fifth theme; 'Living positively with the wound' that reflected how patients adjusted to the presence of the wound -- significantly influenced by the wound care they received.

Conclusion: This study contributes to the understanding we have of how patients experience living with such wounds. It sets out the clear need for early use of wound specialists as part of the multi-disciplinary oncology team.

Relevance to clinical practice: The results of this study provides a description of patient experiences that can help to guide nursing practice as well as an understanding of what a malignant fungating wound means to cancer patients and how it influences their lives.