Initial psychometric testing and validation of the patient participation in pressure injury prevention scale

Factors influencing Patient engagement in preventing pressure injuries: A cross-sectional study in Orthopedic inpatients

AIM

This study aimed to explore the level of patients' engagement behaviours in preventing pressure injury (PI) and the influencing factors related to it.

BACKGROUND

The importance of "Patient and Family Engagement" was recognized as one of the key components in the outline of the 2023 Global Patient Safety Report. PIs were common and concerning patient safety events in Orthopaedics department. Active patient participation behaviour can effectively prevent the occurrence of PIs.

METHOD

This was a cross-sectional study involving 366 participants from Orthopaedics in China who has high level of risk in PI. The behavioural level of patients' participation in PI prevention was measured using a research tool designed by the research team. Based on the theory of planned behaviour, the possible influencing factors were determined, and the corresponding research tools were selected for evaluation. Univariate analysis, correlation analysis and multiple stepwise regression were used to determine the influencing factors of patients' participation behaviour with SPSS 25.0.

RESULTS

The total score of orthopaedic inpatients participating in PI preventive behaviour was 89.45 ± 10.64, with a scoring rate of 85.19 % (actual score/maximum possible score × 100 %), indicating relatively high adherence. Multiple regression analysis revealed that social support showed the strongest positive association (β = 0.291, P < 0.001), suggesting enhanced support networks facilitate engagement. Participation attitude (β = 0.211, P < 0.001) and health literacy (β = 0.233, P < 0.001) were key cognitive facilitators. Unexpectedly, cohabitation with children exhibited negative correlation (β = -0.141, P = 0.001), potentially indicating caregiving role transfer. Inter-hospital transfers (β = -0.120, P = 0.004) and medium-length stays (4-7 days, β = -0.089, P = 0.010) were inversely related, possibly reflecting care continuity challenges. Social Security recipients demonstrated greater participation (β = 0.108, P = 0.009), highlighting socioeconomic influences.

CONCLUSION

Our findings may guide clinical healthcare providers to develop more targeted interventions to promote patient engagement in self-care, including encouraging family members to involve in PI prevention with patients, improving patients' attitude of participation, and supporting more health education of PI prevention. It was a potential suggestion for patient participation behaviour in medical services to prevent other types of adverse events as well.

The effects of educational intervention on patient participation in pressure injury prevention: a pilot study

OBJECTIVE

Patients' roles in reducing pressure injuries (PIs) are emphasised in clinical guidelines, although patients' preferences are undetermined. This study evaluated the effects of a pilot six-month educational intervention on patient participation in PI prevention.

METHOD

A convenience sampling method was used to select patients admitted to medical-surgical wards at one of the teaching hospitals in Tabriz, Iran. This is a one-group pre-test and post-test interventional study, conducted via quasi-experimental design. Using a pamphlet, patients received education in preventing PIs. Data collected before and after intervention through a questionnaire were analysed using descriptive and inferential statistics (McNemar and paired t-tests) in SPSS software (IBM Corp., US).

RESULTS

The study cohort consisted of 153 patients. Findings revealed that the knowledge of the patients about PIs, patients' ability to talk with the nurses, information received about PIs, and patients' ability to participate in decisions related to PI prevention had significantly increased following the intervention (p<0.001).

CONCLUSION

Educating patients can improve their knowledge to enable them to participate in PI prevention. The findings of this study suggests further research is necessary on factors influencing patients' participation in such self-care behaviours.

Patient Participation and the Environment: A Scoping Review of Instruments

Patient participation and the environment are critical factors in achieving qualitative healthcare. We conducted a systematic scoping review using Arksey and O'Malley's framework to identify instruments intended to measure patient participation. We assessed those instruments' characteristics, which areas of the healthcare continuum they target, and whether environmental factors are considered. Instruments were considered eligible if they represented the patient perspective and measured patient participation in healthcare. The search was limited to articles written in English and published in the last 10 years. We extracted concepts (i.e., patient empowerment, patient participation, and patient-centeredness) based on the framework developed by Castro et al. and outcomes of significance regarding the review questions and specific objectives. The search was conducted in PsycINFO, CINHAL/EBSCO, and PubMed in September 2019 and July 2020. Of 4802 potential titles, 67 studies reported on a total of 45 instruments that met the inclusion criteria for this review. The concept of patient participation was represented most often in these studies. Although some considered the social environment, no instrument was found to incorporate and address the physical environment. Thirteen instruments were generic and the remaining instruments were intended for specific diagnoses or healthcare contexts. Our work is the first to study instruments from this perspective, and we conclude that there is a lack of instruments that measure aspects of the social and physical environment coherently as part of patient participation.

Process evaluation of an intervention to test the effectiveness of foam border dressings in preventing hospital-acquired sacral pressure injuries (the EEPOC trial): A protocol

BACKGROUND

Prophylactic foam border dressings are recommended for high-risk patients in addition to standard pressure injury prevention protocols despite limited high-quality evidence regarding their effectiveness. This protocol describes the process evaluation that will be undertaken alongside a multisite randomised controlled trial investigating the clinical and cost-effectiveness of these dressings in reducing hospital-acquired sacral pressure injury incidence.

METHODS

This theory informed parallel process evaluation using qualitative and quantitative methods will be undertaken in medical and surgical units. To evaluate fidelity, recruitment, reach, dose delivered and received, and context, process data will include: research nurses' self-reported adherence to intervention protocols; semi-structured interviews with participants and research nurses and focus groups with nursing staff; participants' satisfaction and comfort with the dressings and perceived level of participation in pressure injury prevention; and nurses' attitudes toward pressure injury prevention. The proportion of the target population recruited, participant characteristics, and adherence to intervention protocols will be reported using descriptive statistics. Chi square or t-tests will compare differences in demographic characteristics between groups, and non-participants, and multivariate modelling will investigate potential moderators on the trial outcomes. Analysis of qualitative data will be guided by the Framework Method, which provides a clear, systematic process for developing themes.

DISCUSSION

This process evaluation will provide valuable insights into mechanisms of impact and contextual and moderating factors influencing trial outcomes. Process data will enhance reproducibility of the intervention and trustworthiness of findings, and inform clinicians, researchers, and policy makers about the extent to which foam border dressings can be feasibly implemented in clinical practice.

TRIAL REGISTRATION

ACTRN12619000763145p.

A systematic review of the validity and reliability of patient-reported experience measures

OBJECTIVES

To identify patient-reported experience measures (PREMs), assess their validity and reliability, and assess any bias in the study design of PREM validity and reliability testing.

DATA SOURCES/STUDY SETTING

Articles reporting on PREM development and testing sourced from MEDLINE, CINAHL and Scopus databases up to March 13, 2018.

STUDY DESIGN

Systematic review.

DATA COLLECTION/EXTRACTION METHODS

Critical appraisal of PREM study design was undertaken using the Appraisal tool for Cross-Sectional Studies (AXIS). Critical appraisal of PREM validity and reliability was undertaken using a revised version of the COSMIN checklist.

PRINCIPAL FINDINGS

Eighty-eight PREMs were identified, spanning across four main health care contexts. PREM validity and reliability was supported by appropriate study designs. Internal consistency (n = 58, 65.2 percent), structural validity (n = 49, 55.1 percent), and content validity (n = 34, 38.2 percent) were the most frequently reported validity and reliability tests.

CONCLUSIONS

Careful consideration should be given when selecting PREMs, particularly as seven of the 10 validity and reliability criteria were not undertaken in ≥50 percent of the PREMs. Testing PREM responsiveness should be prioritized for the application of PREMs where the end user is measuring change over time. Assessing measurement error/agreement of PREMs is important to understand the clinical relevancy of PREM scores used in a health care evaluation capacity.