Engaging in the prevention of pressure injuries in spinal cord injury: A qualitative study of community-dwelling individuals’ different styles of prevention in Switzerland

Abstract

Context: Spinal cord injury (SCI) is a complex chronic condition with multiple self-management requirements and a high prevalence of complications. Pressure injuries (PIs) are among the most common ones and represent a frequent reason for re-hospitalization. This study aimed to identify styles of prevention that individuals with SCI adopt to deal with the risk of developing PIs. Design: Qualitative explorative interview study. Data was collected through semi-structured interviews, which were transcribed verbatim and analyzed following the principles of thematic analysis. Setting: Switzerland. Participants: The participants were a purposive sample of community-dwelling Swiss residents with SCI for at least five years. Interventions: Not applicable. Outcome measures: Not applicable. Results: Although all participants (N = 20) showed at least a basic knowledge of prevention of PIs by describing some preventive measures, they had different prevention styles characterized by different behavioral patterns (i.e. complying with all recommended measures, performing only a selection of them or delegating them to others) and different beliefs and attitudes towards prevention. Conclusion: By identifying the style of prevention of an individual, it is possible to develop tailored interventions that have an impact on the factors which seem to play a role in determining the adoption of preventive behaviors (i.e. perceived susceptibility to PIs, attitudes towards prevention, and self-efficacy). Such interventions would constitute a concrete effort to support individuals with SCI during their self-management. Besides alleviating a frequent and disabling medical complication and contributing to an enhanced quality of life, these interventions might also help decrease healthcare costs.

Co-designing a Self-Management App Prototype to Support People With Spinal Cord Injury in the Prevention of Pressure Injuries: Mixed Methods Study

“…User personas are fictitious characters to represent different prospective user types who are characterized by specific goals and behaviors [ 35 ]. The user personas adopted for this study described the three different prevention types that had been identified in earlier work: the thoughtful, the selective, and the delegator [ 13 ]. Each prevention type is characterized by different preventive behaviors, knowledge, and attitudes toward the prevention of pressure injuries; collaboration with health care professionals; and attitudes toward spinal cord injury in general [ 13 ].…”

“…The user personas adopted for this study described the three different prevention types that had been identified in earlier work: the thoughtful, the selective, and the delegator [ 13 ]. Each prevention type is characterized by different preventive behaviors, knowledge, and attitudes toward the prevention of pressure injuries; collaboration with health care professionals; and attitudes toward spinal cord injury in general [ 13 ]. For example, in one of the exercises, participants worked in smaller groups to create a list of app features and functionalities that would be perceived as “cool” or “not cool” by the respective type their group had been assigned.…”

“…Yet, research indicates that individuals with spinal cord injury may not always follow evidence-based recommendations regarding physical activity, diet, and other preventive measures (eg, regular skin checks and pressure relief) once they return to their daily routine after the first rehabilitation [ 10 - 12 ]. These findings may be explained by considering that individuals with spinal cord injury adopt different prevention styles, characterized by different preventive behaviors and attitudes toward pressure injuries and prevention more generally [ 13 ]. Understanding what matters to individuals is essential to ensure that interventions are acceptable and rooted in the reality of the individuals’ daily lives [ 14 ].…”

‘I forget to do pressure relief’: Personal factors influencing the prevention of secondary health conditions in people with spinal cord injury, South Africa

“…Notwithstanding that preventative care is a collaborative effort amoung health professionals, caregivers and patients, the patient’s role and intrinsic influences in preventative care are important (Zanini et al 2019 , 2020 ).…”

“…Patients’ activation (Greene & Hibbard 2012 ); outlook and control over personal care (Munce et al 2014 ); knowledge levels of SHCs; attitude to prevention care; belief in personal susceptibility and taking responsibility for personal well-being influence prevention care practice (King, Porter & Vertiz 2008 ; Zanini et al 2020 ). Moreover, belief in one’s ability to self-manage has been identified as an essential component of managing a chronic condition (Disler, Gallagher & Davidson 2012 ; McCorkle et al 2011 ).…”