The role of habit in recurrent pressure ulcers following spinal cord injury

Abstract

Background: Despite the existence of numerous prevention strategies, pressure ulcers remain highly prevalent in those with spinal cord injury (SCI). The concept of habit, broadly defined, may help understand the persistence of this problem and offer strategies for its mitigation by occupational therapy.

Aim: The aim of this paper is to describe the relationship between habits established prior to sustaining an SCI and post-injury habits that impacted on pressure ulcer risk.

Methods: Secondary analysis of qualitative data collected during an ethnographic study of community-dwelling adults with SCI.

Results: Participants’ habits appeared to substantially affect their risk of developing pressure ulcers. Habits established before incurring the SCI either facilitated or hindered the acquisition of new habits intended to prevent pressure ulcers.

Conclusions: An understanding of the individual’s pre-existing habits may be important when designing a rehabilitation programme intended to minimize risk of pressure ulcer development following SCI. Habit-change strategies could be used to supplement education in pressure ulcer prevention techniques.

Significance: Occupational therapists have a longstanding interest in habit. A more comprehensive understanding of this concept may provide important insights into the persistence and management of pressure ulcers following SCI.

Keywords:

• Health behaviour
• behaviour change
• treatment adherence

Acknowledgements

This work was supported by grants from the National Institutes on Disability and Rehabilitation Research, US Department of Education (award number H133G000062) and the National Center for Medical Rehabilitation Research (NCMRR) within the Eunice Kennedy Shriver National Institute of Child Health & Human Development, National Institutes of Health (award numbers R01HD056267 and K01HD076183).

Disclaimers

The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Department of Education.

Declaration of interest

The authors certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on them or on any organization with which they are associated and certify that all financial and material support for this research (e.g. NIH or NHS grants) and work are clearly identified on the title page of the manuscript.