Barriers and facilitators to pressure ulcer prevention behaviours by older people living in their own homes and their lay carers: a qualitative study

• Published in: BMJ open Vol. 14; no. 3; p. e080398
• Main Authors: Roddis, Jennifer, Dyson, Judith, Woodhouse, Marjolein, Devrell, Anne, Oakley, Karen, Cowdell, Fiona
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 18-03-2024; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Original research
• Subjects: Aged; Aging; Arthritis; Behavior; Caregivers; Caregivers - psychology; Community; Data analysis; Data collection; Females; Humans; Interviews; Mobility; Motivation; Nursing; Nursing Care; Older people; Paralysis; Patients; Pressure Ulcer - prevention & control; Pressure ulcers; Prevention; Primary Prevention; QUALITATIVE RESEARCH; Skin; State Medicine; Wheelchairs; Nursing Care; Aging; Primary Prevention; Patients; QUALITATIVE RESEARCH
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2023-080398

ObjectiveTo identify barriers and facilitators to pressure ulcer prevention behaviours in community-dwelling older people and their lay carers.DesignTheoretically informed qualitative interviews with two-phase, deductive then inductive, thematic analysis.SettingThe study was conducted in one geographical region in the UK, spanning several community National Health Service Trusts.ParticipantsCommunity-dwelling older patients at risk of pressure ulcer development (n=10) and their lay carers (n=10).ResultsSix themes and subthemes were identified: (1) knowledge and beliefs about consequences (nature, source, timing and taboo); (2) social and professional role and influences (who does what, conflicting advice and disagreements); (3) motivation and priorities (competing self-care needs and carer physical ability); (4) memory; (5) emotion (carer exhaustion and isolation, carergiver role conflict and patient feelings) and (6) environment (human resource shortage and equipment).ConclusionsThere is minimal research in pressure ulcer prevention in community-dwelling older people. This study has robustly applied the theoretical domains framework to understanding barriers and facilitators to pressure ulcer prevention behaviours. Our findings will support co-design of strategies to promote preventative behaviours and are likely to be transferable to comparable healthcare systems nationally and internationally.