Lucía I Floríndez1, Mike E Carlson1, Elizabeth Pyatak1, Jeanine Blanchard1, Alison M Cogan1,2, Alix G Sleight1,3, Valerie Hill1,4, Jesus Diaz1, Erna Blanche1, Susan L Garber5, Florence A Clark1. 1. USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA. 2. Washington DC Veterans Affairs Medical Center, Washington, DC, USA. 3. National Cancer Institute, Rockville, MD, USA. 4. Department of Rehabilitation, Exercise, and Nutrition Sciences, Occupational Therapy Program, University of Cincinnati, Cincinnati, OH, USA. 5. Baylor College of Medicine, Houston, TX, USA.
Abstract
Purpose: Medically underserved adults with spinal cord injury (SCI) remain at high risk of incurring medically serious pressure injuries even after receiving education in prevention techniques. The purpose of this research is to identify circumstances leading to medically serious pressure injury development in medically underserved adults with SCI during a lifestyle-based pressure injury prevention program, and provide recommendations for future rehabilitation approaches and intervention design. Methods: This study entailed a qualitative secondary case analysis of treatment notes from a randomized controlled trial. Participants were 25 community-dwelling, medically underserved adults with SCI who developed medically serious pressure injuries during the course of the intervention of the RCT.Results and conclusions: Among the 25 participants, 40 unique medically serious pressure injuries were detected. The six themes related to medically serious pressure injury development were: (1) lack of rudimentary knowledge pertaining to wound care; (2) equipment and supply issues; (3) comorbidities; (4) non-adherence to prescribed bed rest; (5) inactivity; and (6) circumstances beyond the intervention's reach. Together, these factors may have undermined the effectiveness of the intervention program. Modifications, such as assessing health literacy levels of patients prior to providing care, providing tailored wound care education, and focusing on equipment needs, have potential for altering future rehabilitation programs and improving health outcomes.Implications for rehabilitationTo provide patients with spinal cord injury with the necessary information to prevent medically serious pressure injury development, health care providers need to understand their patient's unique personal contexts, including socio-economic status, language skills, and mental/cognitive functioning.When providing wound care information to patients with spinal cord injury who have developed a medically serious pressure injury, practitioners should take into account the level of health literacy of their patient in order to provide education that is appropriate and understandable.Practitioners should be aware of how to help their patient advocate for outside services and care that address their equipment needs, such as finding funding or grants to pay for expensive medical equipment.
Purpose: Medically underserved adults with spinal cord injury (SCI) remain at high risk of incurring medically serious pressure injuries even after receiving education in prevention techniques. The purpose of this research is to identify circumstances leading to medically serious pressure injury development in medically underserved adults with SCI during a lifestyle-based pressure injury prevention program, and provide recommendations for future rehabilitation approaches and intervention design. Methods: This study entailed a qualitative secondary case analysis of treatment notes from a randomized controlled trial. Participants were 25 community-dwelling, medically underserved adults with SCI who developed medically serious pressure injuries during the course of the intervention of the RCT.Results and conclusions: Among the 25 participants, 40 unique medically serious pressure injuries were detected. The six themes related to medically serious pressure injury development were: (1) lack of rudimentary knowledge pertaining to wound care; (2) equipment and supply issues; (3) comorbidities; (4) non-adherence to prescribed bed rest; (5) inactivity; and (6) circumstances beyond the intervention's reach. Together, these factors may have undermined the effectiveness of the intervention program. Modifications, such as assessing health literacy levels of patients prior to providing care, providing tailored wound care education, and focusing on equipment needs, have potential for altering future rehabilitation programs and improving health outcomes.Implications for rehabilitationTo provide patients with spinal cord injury with the necessary information to prevent medically serious pressure injury development, health care providers need to understand their patient's unique personal contexts, including socio-economic status, language skills, and mental/cognitive functioning.When providing wound care information to patients with spinal cord injury who have developed a medically serious pressure injury, practitioners should take into account the level of health literacy of their patient in order to provide education that is appropriate and understandable.Practitioners should be aware of how to help their patient advocate for outside services and care that address their equipment needs, such as finding funding or grants to pay for expensive medical equipment.
Entities:
Keywords:
Spinal cord injuries; cultural diversity; intervention; lifestyle; pressure injury
Authors: JoAnne Whitney; Linda Phillips; Rummana Aslam; Adrian Barbul; Finn Gottrup; Lisa Gould; Martin C Robson; George Rodeheaver; David Thomas; Nancy Stotts Journal: Wound Repair Regen Date: 2006 Nov-Dec Impact factor: 3.617
Authors: Mike Carlson; Cheryl L P Vigen; Salah Rubayi; Erna Imperatore Blanche; Jeanine Blanchard; Michal Atkins; Barbara Bates-Jensen; Susan L Garber; Elizabeth A Pyatak; Jesus Diaz; Lucia I Florindez; Joel W Hay; Trudy Mallinson; Jennifer B Unger; Stanley Paul Azen; Michael Scott; Alison Cogan; Florence Clark Journal: J Spinal Cord Med Date: 2017-04-17 Impact factor: 1.985
Authors: Mary Ann Regan; Robert W Teasell; Dalton L Wolfe; David Keast; William B Mortenson; Jo-Anne L Aubut Journal: Arch Phys Med Rehabil Date: 2009-02 Impact factor: 3.966
Authors: Alison M Cogan; Jeanine Blanchard; Susan L Garber; Cheryl Lp Vigen; Mike Carlson; Florence A Clark Journal: Clin Rehabil Date: 2016-07-20 Impact factor: 3.477
Authors: Alix G Sleight; Alison M Cogan; Valerie A Hill; Elizabeth A Pyatak; Jesus Díaz; Lucía I Floríndez; Jeanine Blanchard; Cheryl Vigen; Susan L Garber; Florence A Clark Journal: Top Spinal Cord Inj Rehabil Date: 2019
Authors: Lynn A Worobey; Allen W Heinemann; Kim D Anderson; Denise Fyffe; Trevor A Dyson-Hudson; Theresa Berner; Michael L Boninger Journal: Arch Phys Med Rehabil Date: 2021-04-09 Impact factor: 3.966