Pressure ulcer knowledge, beliefs and practices in a group of South Africans with spinal cord injury

Skin self-management of community-dwelling patients with spinal cord injury: A cross-sectional study

BACKGROUND

community-acquired pressure injury is one of the most common and troublesome complications of discharged patients with spinal cord injury. Previous studies have shown that pressure injury can not only increase the financial burden and care burden of patients, but also seriously affect their quality of life.

AIM

To evaluate the skin self-management of community-dwelling patients with spinal cord injury and to explore the related independent influencing factors.

METHODS

This was a cross-sectional survey study. A convenience sample of 110 community-dwelling patients with spinal cord injury recruited from three rehabilitation centers in Guangzhou and Chengdu in China completed the survey from September 2020 to June 2021. They were asked about their demographic data, skin self-management, knowledge about skin self-management, attitude to skin self-management, self-efficacy, and functional independence. Univariate analysis and multiple linear regression were performed to isolate the most important relationships.

RESULTS

The skin self-management of community-dwelling patients with spinal cord injury was relatively low, and they also performed poorly in the three categories of: skin check, preventing pressure ulcer, and preventing wounds. Skin self-management was found to be most often associated with level of knowledge about skin self-management, higher reimbursement and self-efficacy.

CONCLUSION

Community-dwelling patients with spinal cord injury with lower level of knowledge about skin self-management, with lower self-efficacy, and those with higher reimbursement have worse skin self-management.

Prevalence of secondary health conditions and mental status in persons with long-term spinal cord injury in South Africa: Comparison between public and private healthcare sectors

BACKGROUND

Spinal cord injuries typically result in a range of negative health outcomes and health states, which impacts overall functioning, health and well-being. It remains important to establish the prevalence (burden) of health outcomes to help with the development of optimal treatment strategies.

OBJECTIVES

To determine the prevalence and treatment rates of secondary health conditions (SHCs) and mental health states in persons with long-term spinal cord injury (SCI) receiving public compared with private healthcare services in South Africa.

METHODS

A cross-sectional survey included 200 community-dwelling persons with long-term SCI, 60% with paraplegia, 53% with complete injuries and 156 from the public and 44 from private healthcare sectors. The following modules of the International Spinal Cord Injury (InSCI) community survey were used: (i) demographic and injury characteristics; (ii) SHCs and treatment rates; and (iii) vitality and emotional well-being. All statistical analyses were stratified according to healthcare sector.

RESULTS

Pain (47% v. 57), sexual dysfunction (59% v. 41%) and muscle spasms (54% v. 43%) were the most common SHCs in both cohorts, and the period prevalence was significantly higher for sleeping problems (41% v. 25%), sexual dysfunction (59% v. 41%) and contractures (42% v. 20%) in the public compared with the private cohort. Persons with SCI in the private cohort received treatment more often for sleeping problems (100% v. 45%), autonomic dysreflexia (75% v. 27%) and pain (56% v. 33%) than their counterparts with public insurance. Negative mental health states were prevalent in both groups.

CONCLUSION

SHCs and negative mental health were common in persons with SCI in South Africa, while those with public insurance reporter a higher occurrence of sleep problems and contractures, as well as lower treatment rates. Overall, a need exists to better support persons with SCI in the long-term context to facilitate improved functioning and wellbeing.

Nurses' Knowledge Concerning Prevention and Treatment of Pressure Ulcers

Pressure ulcers have high prevalence in patients and can be prevented with proper nursing interventions. The aim of this study was to evaluate nurses' knowledge about prevention and treatment of pressure ulcers. The present study was conducted with 111 nurses working in a General hospital in Greece. In this study, nurses had adequate knowledge about prevention and treatment of pressure ulcers. Respondents answered correctly in questions about staging of pressure ulcers (98.2%, 98.2%, 99.1%, 97.3%, 93.7%), the role of changing position in prevention of pressure ulcer (97.3%), the use of foam mattress (85.6%) and stretched sheets (92.8%), the use of antiseptic solution (95.5%, 85.6%), and interventions to reduce pressure on patients' heels (88.3%). A number of participants had adequate level of knowledge in the questions about the role of diet in healing of pressure ulcers (71.2%), products or devices for prevention or treatment of pressure ulcers (61.3%, 36.9%), healing of pressure ulcers (58.6%, 46.8%), prevention of bone pressure ulcers (31.5%), cleaning of a pressure ulcer (52.3%), and the role of low blood pressure as a risk factor for pressure ulcer (55.9%). However, the development of educational programs can help nurses to improve their knowledge about prevention and treatment of pressure ulcers.

Pressure ulcer prevention knowledge, practices, and their associated factors among nurses in Gurage Zone Hospitals, South Ethiopia, 2021

A pressure ulcer is a localized skin injury and underlying tissue, usually as a result of friction or pressure against the surface of the skin. The global mortality rate of pressure ulcers was above 60% for hospitalized patients who wait 1 year of hospital stay. Nurses are the primary responsible body and forefront line care providers for the prevention of pressure ulcers, so nurses’ knowledge and practices are the major rollers to handling this preventable problem.

Peer support for traumatic injury survivors: a scoping review

PURPOSE

Peers are uniquely able to draw on their lived experiences to support trauma survivors' recovery. By understanding the functions and outcomes of peer support and the factors that impact implementation, evidence can be mobilized to enhance its application and uptake into standard practice. As such, we aimed to review the literature on peer support for trauma survivors to: examine the role of peer support in recovery; describe the nature and extent of peer support; Examine the influence of peer support on health and well-being; and identify the barriers and facilitators to developing and implementing peer support.

METHODS

Scoping review methodology as outlined by Arksey and O'Malley.

RESULTS

Ninety-three articles were reviewed. Peer support was highlighted as an important component of care for trauma survivors and provided hope and guidance for the future post-injury. Most peer support programs were offered in the community and provided one-on-one support from peer mentors using various modalities. Interventions were successful when they involved knowledgeable peer mentors and maintained participant engagement. Prior negative experiences and stigma/privacy concerns deterred trauma survivors from participating.

CONCLUSIONS

Peer support fulfills several functions throughout trauma survivors' recovery that may not otherwise be met within existing health care systems. Implications for rehabilitationBy understanding the functions and outcomes and the factors that impact implementation of peer support, evidence can be mobilized to enhance its application and uptake into standard practice.Peers provide trauma survivors with socioemotional support as well as assistance in daily management and life navigation post-injury.Peer support provided hope and guidance for the future after injury and improved self-efficacy amongst trauma survivors.Peer support programs are most likely to be successful when they involve knowledgeable peer mentors, are flexibly delivered, align with organizations' values and priorities, and have adequate resources and funding to support their implementation.

The Effect of an Educational Intervention on Self-Care in Patients with Venous Leg Ulcers-A Randomized Controlled Trial

Background: Although patients with venous leg ulcers are involved in ulcer management, little is known about why and how these patients self-treat their ulcers without direct supervision by health professionals. Yet patients’ knowledge of ulcer management can be important for achieving ulcer closure and/or preventing recurrence. This study thus investigates the effects of an educational intervention on knowledge of self-care among patients with venous leg ulcers, mainly on wound dressing practice, compression therapy, physical activity and nutrition. Methods and participants: This research was conducted in three outpatient hospitals in central Croatia. An educational brochure was made and distributed to patients; patients were surveyed about caring for venous leg ulcers before the brochure was distributed and after 3 months. Results: In total, 208 patients were involved in the study: 112 in the experimental group and 96 in the control group. The educational intervention increased awareness of compression therapy, knowledge of recurrence prevention, appropriate lifestyle habits, and warning signs related to venous leg ulcers. Conclusions: Patient education on illness and self-care is necessary to achieve positive effects in self-care knowledge. In this study, patients learned how to change dressings, learned how to improve their lifestyle, and were empowered to deal with their illness.

Pressure Ulcers in Admitted Patients at a Tertiary Care Hospital

Background Pressure ulcers (PUs) occur when the skin covering a weight-bearing part of the body is compressed for a long time between bone, any other part of the body, bed, chair, or any other hard surface. This study aimed to determine the prevalence of pressure ulcers at a tertiary care hospital in all specialty departments including COVID-19. Methods A retrospective study was conducted at North West General Hospital and Research Center, Peshawar, Pakistan. After obtaining ethical approval, data were obtained from the hospital database from July 2020 to June 2021. The keywords "bed sore," "pressure sore," and "pressure ulcer" were used to search for relevant cases, and patient demographics, including age and gender, site of pressure ulcer, stage of pressure ulcer, whether the pressure ulcer was single or multiple, length of stay at the hospital, and specialty department, were collected. Results In total, 99 patients met the inclusion criteria, of which 65 (65.7%) were males, while 34 (34.3%) were females. The age of the patients ranged from 15 to 92 years, with a mean age of 59.93 years. Of the patients, 87 (87.9%) had acquired only a single pressure ulcer. Stage 2 pressure ulcers were the most documented, making up 43.1% of the total cases reported, while stage 4 cases were only 3.3%. The sites most frequently affected by pressure ulcers were the gluteal and sacral regions, accounting for 34.4% and 30.3%, respectively. The incidence of pressure ulcers was the highest in the COVID-19 ward, i.e., 25.3%, followed by the neurosurgery ward with a 20.2% incidence. Conclusion Pressure ulcers occur frequently in almost all the specialty departments of a healthcare setting, especially in COVID-19 and neurosurgery wards, and impose significant physical, psychological, and financial burdens. The prevention of pressure ulcers is the best approach to avert patients and their families from all the burdens associated with pressure ulcers.