Inception and validation of a pressure ulcer risk scale in oncology.

OBJECTIVE: To create and validate a specific tool to evaluate the pressure ulcer risk in cancer patients. METHOD: The Pressure Ulcer Scale in Oncology (PUSO) was developed and subsequently validated against the Norton and Braden scales in order to efficiently and reliably evaluate the pressure ulcer risk in adult cancer patients, with various sites and stages of the illness (both curative and palliative phases). Two series of prevalence surveys (three surveys over two days, at two-month intervals) were conducted in one and then two French Cancer Centres in 2002 and 2009, respectively. The surveys investigated a total of 933 patients. RESULTS: Multivariate logistic regression analysis identified three key items as being predictive of the development of pressure ulcers in cancer patients (mobility, incontinence and moisture/shearing), all with similar odds ratio weighting. A score was defined using this logistic model, the PUSO score (0-3)=bedridden/chair-ridden + incontinence + moisture/shearing. CONCLUSION: The extreme simplicity of this scale may appear disconcerting, but the PUSO is a simple, reliable and validated tool, which allows standardised evaluation of each patient's risk and, thereby, rapid introduction of appropriate measures.

Psychological profile of patients with neglected malignant wounds: a qualitative exploratory study.

Neglected malignant ulcerating tumours often result from failure to seek medical attention, even when the advancing tumour is visible to the patient and their friends and families. Although the appropriate wound treatment procedures are the same as for non-neglected malignant wounds, clinicians must take such neglect into account when planning the patient's care. Over a 2-year period, 25 patients at the National Cancer Centre Wound Care Unit in Paris were identified as presenting with a neglected tumour; 18 of these agreed to participate in a structured interview with a psycho-oncologist for an evaluation of their neglect behaviour. Initial results demonstrate a frequent, but not systematic, presence of a wide range of psychopathological disorders.