Factors Protecting Against Pressure Injuries in Medically Underserved Adults With Spinal Cord Injury: A Qualitative Study

Top Spinal Cord Inj Rehabil, 2019 · DOI: 10.1310/sci2501-31 · Published: January 1, 2019

Spinal Cord Injury Research Methodology & Design Dermatology

Simple Explanation

This study looked at what helps people with spinal cord injuries (SCI) avoid serious pressure injuries, especially those who are poor and don't have good access to medical care. Researchers reviewed notes from a program that aimed to prevent pressure injuries. The study found eight main things that seemed to protect people from these injuries: having meaningful activities, wanting to stay healthy, having a stable life and resources, having the right equipment, being able to communicate well, certain personality traits, physical health, and good health habits. Some of these things, like personality, might be hard to change. But the study suggests that helping people get medical equipment and build healthy habits could prevent pressure injuries. Changes in policies are also needed to make sure everyone has access to things like housing and equipment.

Study Duration

12 Months

Participants

50 socioeconomically disadvantaged individuals with SCI

Evidence Level

Qualitative analysis

Key Findings

1
Eight types of potentially protective factors were identified: meaningful activity, motivation to prevent negative health outcomes, stability/resources, equipment, communication and self-advocacy skills, personal traits, physical factors, and behaviors/activities.
2
Some protective factors (eg, personal traits) may be inherent to certain individuals and nonmodifiable.
3
Future interventions for this population may benefit from a focus on acquisition of medical equipment and facilitation of sustainable, health-promoting habits and routines.

Research Summary

This study examined protective factors against pressure injuries in socioeconomically disadvantaged adults with SCI using a qualitative analysis of treatment notes from a pressure injury prevention intervention program. The analysis identified eight potentially protective factors, including meaningful activity, motivation to prevent negative health outcomes, stability/resources, equipment, communication/self-advocacy skills, personal traits, physical factors, and health-promoting behaviors/activities. The study suggests interventions should focus on equipment acquisition and health-promoting habits, while policy changes are needed to improve access to resources like housing and equipment for this population.

Practical Implications

Targeted Interventions

Healthcare practitioners can focus on helping patients acquire necessary medical equipment and develop sustainable, health-promoting habits and routines to prevent pressure injuries.

Policy Changes

Substantive policy changes are needed to improve access to adequate resources, particularly housing and equipment, for individuals with SCI, especially those from minority groups and with low socioeconomic status.

Further Research

More research is needed to understand the complex interplay of risk and protective factors for pressure injuries in adults with SCI, particularly among minority groups and those with low socioeconomic status, to justify resource allocation and inform healthcare approaches.

Study Limitations

1
The results of the current analysis apply to this unique population and are not necessarily generalizable.
2
Narrative case profiles were not checked by the original OT interveners, so progress notes may have been misinterpreted by the research team.
3
Unconscious bias may have been introduced during the interpretation of treatment notes by the intervention team

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