Self-management in prevention of pressure ulcers in persons with spinal cord injury: a descriptive cross-sectional study

Abstract

Background Persons with spinal cord injury (SCI) perform daily activities to prevent pressure ulcers (PUs). Increasing self-management behavior can decrease the impact of a chronic condition on a person’s health status. Self-management interventions to prevent PUs should be implemented into chronic SCI care. In order to do so, information is needed on self-management behavior in the SCI population.

Aim This study explored which personal, SCI related and health related factors influence self-management behavior in persons with SCI. With this knowledge nurses can focus on these main influencing factors to increase the person’s extent of self-management behavior. Research question: What is the nature and extent of self-management behavior in PU-prevention in persons with SCI?

Method The extent of self-management was measured using the PAM 13-Dutch. A 30-item questionnaire was completed by 165 persons with a SCI from two rehabilitation centers in the Netherlands. Correlations and a logistic regression model were used to measure associations between self-management and assumed influencing factors.

Results Significant correlations were found between the PAM 13-Dutch and the number of PU-prevention behavior, time since injury, self-reported health, education, usual activity (EQ 5D-3L), complete SCI and comorbidity. Completeness of SCI was the main influencing factors on the extent of self-management behavior.

Conclusion Increased PU-prevention behavior correlates with higher self-management behavior. Complete SCI has most impact on a higher extent of self-management behavior. Recommendations: Nurses who provide SCI and PU-prevention care should consider the characteristics of the person versus the potential influencing factors in their efforts to increase the patient’s self-management behavior. Self-management education and instruction should be tailored to the individual with SCI.