title: Malignant fungating wounds: the meaning of living in an unbounded body.
abstract: BACKGROUND
  Malignant fungating wounds may have significant physiological, psychological and emotional consequences on patients and their families. This study focuses on understanding the lived experiences of patients with a malignant fungating breast wound and their informal carers.
  
  
  METHODS
  The methodological framework of interpretative phenomenological approach according to Heidegger was used. Nine patients were interviewed from January until November 2009.
  
  
  RESULTS
  The results demonstrate that most of the patients and their informal carers were on their own while struggling with the erosion of their physical boundaries. The women report a lack of information and advice about how to manage the wound as well as the physical and social limitations imposed on them because of copious wound exudate, odour and bleeding. The women used many different methods and approaches to maintain the boundedness of the body.
  
  
  CONCLUSIONS
  This study contributes to understanding that losing control over the body meant for the women losing control over themselves and their lives. The unboundedness was demonstrated through the symptom experiences. Therefore the care of women needs strategies that are integrated in a palliative, holistic, empathic approach. In particular skills for palliative wound care among medical and nursing staff need to be developed as the women and their carers report a lack of information and advice about how to manage the wound as well as the physical limitations and psychosocial consequences of struggling to maintain the boundedness of the body.
authors.affiliation: Zurich University of Applied Sciences, Department of Health, Institute of Nursing, Switzerland. sebastian.probst@zhaw.ch
authors.forename: Sebastian
authors.initials: S
authors.lastname: Probst
authors.forename: Anne
authors.initials: A
authors.lastname: Arber
authors.forename: Sara
authors.initials: S
authors.lastname: Faithfull
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000150:complications* / Q000451:nursing* / Q000523:psychology; D017028:Caregivers / Q000523:psychology*; D005122:Exudates and Transudates; D005260:Female; D006801:Humans; D008875:Middle Aged; D009859:Oncology Nursing / Q000379:methods; D010166:Palliative Care / Q000379:methods; D010361:Patients / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D013315:Stress, Psychological; D014947:Wounds and Injuries / Q000150:complications* / Q000451:nursing* / Q000523:psychology