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.

Keywords:

• Self-management
• Facilitators
• Complications
• Bedsores
• Semi-structured interviews
• Thematic analysis

Acknowledgements

The authors would like to thank the Suva, the Swiss Accident Insurance Fund, for the funding of the project at the basis of this paper. The authors would also like to thank all the participants for their precious insight and collaboration.

Disclosure statements

Conflicts of interest The authors report no conflicts of interest.

Funding This project was funded by the Suva, the Swiss Accident Insurance.

ORCID

Claudia Zanini http://orcid.org/0000-0002-3863-061X

Hans Georg Koch http://orcid.org/0000-0003-3790-7039