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Do clients with spinal cord injuries know what they need to know about pressure ulcers? A descriptive study on the knowledge, beliefs and practices about pressure ulcers

dc.contributor.advisorVisagie, Suronaen_ZA
dc.contributor.advisorHendry, Jennyen_ZA
dc.contributor.authorVisser, Adri Maricaen_ZA
dc.contributor.otherStellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.en_ZA
dc.date.accessioned2016-12-22T13:20:22Z
dc.date.available2016-12-22T13:20:22Z
dc.date.issued2016-12
dc.identifier.urihttp://hdl.handle.net/10019.1/100146
dc.descriptionThesis (MHumanRehabSt)--Stellenbosch University, 2016.
dc.description.abstractENGLISH SUMMARY : 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. Aim: To describe the knowledge, beliefs and practices about pressure ulcers of clients with SCI who received rehabilitation at a Cape Town rehabilitation center. 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 was done. To determine if any relationship existed between the variables, the Fisher’s exact test and Kruskal-Wallis test were applied. 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. While having a similar knowledge score as in-patients, personal experience of life with SCI and contact with others might have influenced the beliefs of out-patients over time as more of them saw themselves as likely to develop pressure ulcers, and a higher percentage believed PU would seriously impact their activities. Peer supporters had a higher mean knowledge score than the other two groups. Despite their higher mean knowledge score, their scores might be too low to effectively teach others PU prevention practices. 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 practiced correctly by 51% of participants, while 39% did not perform skin inspection correctly and 38% of participants smoked. Inferential statistics showed that most of the variables did not have a statistically significant relationship. An increase in time since injury had a significant impact on the belief that pressure ulcers would interfere with ADL (p=0.024), and increased knowledge scores impacted significantly on correct pressure relief practices (p=0.001). Conclusion: 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 realized pressure ulcers were serious and would impact their lives negatively. The study findings can be used to assist with the development of a contextually relevant training programme on pressure care.en_ZA
dc.description.abstractAFRIKAANSE OPSOMMING : Agtergrond: Druksere is ’n ernstige, maar voorkombare, sekondêre komplikasie van spinaalkoord beserings (SKB). Druksere maak dit moeilik vir pasiënte om weer deel van hulle gemeenskappe te raak, en dit kan lewensgevaarlik wees. Dit plaas ook groter finansiele druk en ’n onnodige sorglas op ons gesondheidsorgsisteem. Druksere kan voorkom word deur ’n goeie velsorgroetine en drukseervoorkomingsprogramme. ’n Persoon se kennis en sienings het ’n invloed op hoe doeldreffend hulle drukseervoorkomingspraktyke navolg. Doelwit: Die beskrywing van die kennis, sienings en praktyke rondom druksere van kliënte met spinaalkoord beserings by die Wes-Kaapse Rehabilitasiesentrum. Metodes: ’n Kwantitatiewe, beskrywende studie is gedoen met opeenvolgende proefsteke. Deelnemers sluit in binne-pasiënte (n=30), buite-pasiënte (n =33) en portuurondersteuners (n = 8). Die data is bymekaar gemaak in Maart en April 2015 met ’n vraelys. Die vraelys is ontwikkel deur bestaande vraelyste saam te voeg en aan te pas binne die studiekonteks. Beskrywende en inferensiële analises is gedoen van die data. Fisher se toets en die Kruskal-Wallis-toets is toegepas om te bepaal of daar enige statisties beduidende verhouding bestaan tussen die veranderlikes. ’n P-waarde van <0.05 is beskou as statistiesbeduidend. Resultate: Die gemiddelde ouderdom van die deelnemers was 36.3 en 86% was manlik. Slegs 31% van deelnemers het skool voltooi en 77% was werkloos, en 43% van die deelnemers het op een of ander stadium ’n drukseer gehad. Die gemiddelde saamgestelde kennistelling was 23.9 uit ’n moontlike 56 (42.7%). Die binne- en buite-pasiënte het soortgelyke tellings gehad (40.4% and 39.4% onderskeidelik). Kennisgebiede wat veral uitdagend was, sluit in voeding om druksere te voorkom, die stadiums van druksere, hoe lank dit neem vir ’n drukseer om te ontwikkel en die risikofaktore vir drukseerontwikkeling. Buite-pasiënte het soortgelyke tellings gekry as binne-pasiënte, maar persoonlike ervaring van SKB en kontak met ander kon die sienings van buite-pasiënte oor tyd beinvloed. Meer buite-pasiënte het aangedui hulle gaan waarskynlik druksere ontwikkel, en ’n hoër persentasie het geglo dit gaan ’n ernstige impak op hulle aktiwiteite hê. Portuurondersteuners het ’n hoër gemiddelde kennistelling gehad as die ander twee groepe. Steeds was hulle tellings te laag om ander doeltreffend te leer van drukseervoorkomingspraktyke. Die meerderheid van die deelnemers (88.7%) glo druksere is ernstig en 45% glo hulle kanse is goed om ’n drukseer te ontwikkel. Hulle glo daaglikse velkontrole (80.3%), gewigverskuiwing (86%) en beperkte sittyd (80.3%) kan die ontwikkeling van druksere verhoed. Drukverligting is nie reg toegepas deur 51% van die deelnemers nie terwyl 39% nie vel-inspeksies gedoen het nie en 38% rook. Inferensie-statistiek dui aan dat die meeste van die veranderlikes nie ’n statistiesbeduidende verhouding het nie. Die tydsduur sedert die besering het ’n beduidende impak gehad op die siening dat druksere sal inmeng met daaglikse aktiwiteite (p=0.024), en hoër kennistellings oor drukverligingpraktyke het ’n beduidende impak gehad op die regte drukverligtingpraktyke (p=0.001). Bevinding: Deelnemers toon ’n gebrek aan kennis, wat moontlik hulle sienings en drukseervoorkomingspraktyke negatief beinvloed het. Dit lyk asof die deelnemers nie toegerus is met genoegsame kennis om drukseervoorkomingspraktyke na te kom nie, selfs al besef hulle druksere is ernstig en het ’n negatiewe impak op hulle lewe. Die bevindings kan gebruik word vir die ontwikkeling van ’n kontekstueel relevante druksorg-opleidingsprogram oor.af_ZA
dc.format.extentxv, 106 pages ; illustrations, includes annexures
dc.language.isoen_ZAen_ZA
dc.publisherStellenbosch : Stellenbosch University
dc.subjectSpinal cord -- Wounds and injuries -- Patients -- Rehabilitationen_ZA
dc.subjectBedsoresen_ZA
dc.subjectPatient educationen_ZA
dc.subjectUCTD
dc.titleDo clients with spinal cord injuries know what they need to know about pressure ulcers? A descriptive study on the knowledge, beliefs and practices about pressure ulcersen_ZA
dc.typeThesisen_ZA
dc.rights.holderStellenbosch University


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