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.

Effect of cholera enterotoxin preparations on cutaneous response in rabbit under varied conditions.

Enterotoxic activity of two preparations obtained from Vibrio cholerae, B-53-6 Inaba and B-53-10 Ogawa was tested in ligated ileal loops of rabbit. The biologically active enterotoxic preparations were further used to study the permeability reaction in rabbit skin. Cutaneous response tended to be linear only with higher concentrations of the toxin and showed maximum blueing intensity between 16 and 24 hrs of intracutaneous inoculation. Exposure of enterotoxin preparations to elevated temperatures greatly reduced the cutaneous response and the activity was completely lost at 100 degrees C. Change in pH towards alkaline side lowered the permeability activity to lesser extent as compared to a shift on acidic side. However, a residual activity could still be detected when pH of the enterotoxins was lowered to 3 at 30 degrees C for 4 hrs.