Visser A.M.1,2, Visagie S.2, Hendry J.3
1Western Cape Rehabilitation Centre, Physiotherapy, Cape Town, South Africa, 2University of Stellenbosch, Centre for Rehabilitation Studies, Cape Town, South Africa, 3Western Cape Rehabilitation Centre, Cape Town, South Africa
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.
Purpose: To describe the knowledge, beliefs and practices about pressure ulcers of clients with SCI who received rehabilitation at a Cape Town rehabilitation centre.
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 were done. 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. Peer supporters had a higher mean knowledge score than the other two groups (65.2%).
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 practised correctly by 51% of participants, while 39% did not perform skin inspection correctly and 38% of participants smoked.
An increase in time since injury had a significant impact on the belief that PUs would interfere with ADL (p=0.024), and increased knowledge scores impacted significantly on correct pressure relief practices (p=0.001).
Conclusion(s): 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 realised pressure ulcers were serious and would impact their lives negatively.
Implications: The study findings can be used to assist with the development of a contextually relevant training programme on pressure care. Educating and training clients in pressure care could contribute to the role that physiotherapists play in preventative health. In a resource pour country, preventing the secondary complications associated with spinal cord injuries are important, not only for cost saving, but also to improve the quality of life of clients.
Funding acknowledgements: The Western Cape Department of Health, South Africa provided a bursary for class fees. All other funding was self-funded.
Topic: Disability & rehabilitation
Ethics approval: Approved by Stellenbosch University Health Ethics Research Committee (S14/10/213), South Africa
All authors, affiliations and abstracts have been published as submitted.
