Table 2.

Diagnosed health problems and actions taken related to the treatment of a wound.

Health Problem	Nursing Interventions	Justification Based on EBM
Repulsion and disgust caused by the sight of larvae wriggling in the wound	Increase patient knowledge about Medical Maggot Therapy (MDT) to reduce negative feelings. Reinforce positive health behaviors and focus education on the positive effects of rapid wound debridement with minimal discomfort. In order to gauge patient acceptance, it is recommended to use a questionnaire assessment, such as the Perceived Stress Scale (PSS10) to assess stress levels and an MDT acceptance assessment. Explain the mechanism of action of the larvae in the wound and the potential use of a “biobag” to reduce visual sensations. Implement procedures to limit the view of maggots in the wound, such as using posters (see Figure 2), brochures, and instructional videos. Facilitate direct communication with the healthcare provider who administers the therapy to reduce patient anxiety. After completing the therapy, encourage patients to assess the effects of wound debridement.	Patients who consented to the MDT application re-evaluated their initial expectations compared to the post-treatment period. Positive opinions about the therapy persisted; small larvae in the first growth phase did not frighten the patients [25,26,27]. MDT experiences and interpersonal relationships influenced the perception and interactions between the patients and other individuals, including medical staff, friends, family, and fellow patients. The longer the problems with wound healing lasted, the higher the acceptance of larval therapy [28].
Anxiety about the larvae leaving the wound	Explanation of application methods, including both closed and open techniques, and highlighting the potential benefits of each method, can help to address anxiety about the larvae leaving the wound. Ensuring continuous contact with a dedicated healthcare professional responsible for the treatment is essential. To further mitigate concerns, sealing the wound with an appropriate dressing and having medical staff regularly inspect the dressing for patients who may not be self-reliant, or implementing remote supervision using audio-visual techniques, are all recommended strategies.	Anxiety related to the fear of larvae leaving the dressing was discussed by Turkmen [30] and Sherman and Morozov [28]. Nursing staff’s uncertainty contributes to patients’ apprehension regarding the adoption of an unfamiliar therapy. Building confidence in their actions instills a sense of security in patients, reducing their anxieties both before and during MDT therapy [28]. Encouraging patient preferences and enhancing their involvement in treatment decisions are crucial components of quality improvement and better health outcomes. These findings hold significance for practitioners offering larval therapy [25,27,28]. Medical staff may also experience anxiety, especially concerning the appearance and movement of larvae, potentially leading to their hesitancy in using this method [31].
Lack of motivation to engage in health-related actions and resistance to treatment	If possible, assess the need for support, motivation, and self-care capabilities. In cases of the absence or limited functional resources, consider long-term care options and enhance collaboration with primary healthcare providers and caregivers.	Older age, loneliness, and limited self-care can lead to a decrease in or lack of motivation for health-related activities [32]. People subjected to larval therapy whose wounds did not heal for a long time showed a positive attitude and trust in wound healing [29]. In Nigam et al.’s study, 36% of the participants agreed that they would accept larval therapy as a first-line treatment for a hypothetical painful wound, although this number increased with wound severity. The most dominant concerns regarding larval therapy were the sensations and feelings of disgust associated with the therapy [33].