Centre for Disability and Rehabilitation Studies
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- ItemDo clients with spinal cord injuries know what they need to know about pressure ulcers? A descriptive study on the knowledge, beliefs and practices about pressure ulcers(Stellenbosch : Stellenbosch University, 2016-12) Visser, Adri Marica; Visagie, Surona; Hendry, Jenny; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY : Background: Pressure ulcers are a serious, but preventable, secondary complication of spinal cord injury (SCI). Pressure ulcers limit community integration, and are potentially life-threatening. They also put an increased financial and care burden on health systems. Pressure ulcers can be prevented by following the guidelines for good skin care and pressure-ulcer prevention programmes. Adherence to pressure-ulcer prevention practices is influenced by a person`s knowledge and beliefs. Aim: To describe the knowledge, beliefs and practices about pressure ulcers of clients with SCI who received rehabilitation at a Cape Town rehabilitation center. Methods: A quantitative, descriptive study, that employed consecutive sampling, was done. Participants included in-patients (n=30), out-patients (n =33) and peer supporters (n = 8). Data was collected during April and March 2015 with a questionnaire developed through collating existing questionnaires and adapting them for the study context. Descriptive and inferential analyses of data was done. To determine if any relationship existed between the variables, the Fisher’s exact test and Kruskal-Wallis test were applied. A P-value of <0.05 was considered statistically significant. Results: The mean age of participants was 36.3 years with 86% being male. Only 31% of participants finished school and 77% were unemployed. Of all the participants, 43% had developed a pressure ulcer at some stage. The mean combined knowledge score was 23.9 out of a possible 56 (42.7%). The in-patients and out-patients had similar scores (40.4% and 39.4% respectively). Areas of knowledge that were particularly challenged, included nutrition to prevent pressure ulcers, the staging of pressure ulcers, the time it takes for a pressure ulcer to develop and the risk factors for pressure ulcer development. While having a similar knowledge score as in-patients, personal experience of life with SCI and contact with others might have influenced the beliefs of out-patients over time as more of them saw themselves as likely to develop pressure ulcers, and a higher percentage believed PU would seriously impact their activities. Peer supporters had a higher mean knowledge score than the other two groups. Despite their higher mean knowledge score, their scores might be too low to effectively teach others PU prevention practices. The majority of participants (88.7%) believed pressure ulcers to be serious and 45% thought they were likely to develop a PU. They believed daily skin checks (80.3%), weight shifting (86%) and limiting sitting time (80.3%) could prevent PU development. Pressure relief was not practiced correctly by 51% of participants, while 39% did not perform skin inspection correctly and 38% of participants smoked. Inferential statistics showed that most of the variables did not have a statistically significant relationship. An increase in time since injury had a significant impact on the belief that pressure ulcers would interfere with ADL (p=0.024), and increased knowledge scores impacted significantly on correct pressure relief practices (p=0.001). Conclusion: Participants showed a lack of knowledge which might have impacted their beliefs and pressure-ulcer prevention practices negatively. It seems as if participants were not equipped with sufficient knowledge to assist them in adhering to pressure-ulcer prevention practices, even though they realized pressure ulcers were serious and would impact their lives negatively. The study findings can be used to assist with the development of a contextually relevant training programme on pressure care.