Data-Based Models of How Pressure Ulcers Develop in Daily-Living Contexts of Adults With Spinal Cord Injury

Clark, Florence; Jackson, Jeanne; Scott, Michael D.; Carlson, Michael; Atkins, Michal; Uhles-Tanaka, Debra; Rubayi, Salah

doi:10.1016/j.apmr.2006.08.329

Cited by 62 publications

(67 citation statements)

References 18 publications

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“…Recent qualitative studies have examined how risk of developing PUs unfolds from everyday life situations. These studies examining the sequence of events leading to the development of PUs demonstrate that unexpected events (e.g., lengthy flight delay, change in care personnel) disrupt established prevention routines [26]. Decisions in daily activities, decay in adherence to prevention behaviors, lack of situational awareness, motivation, and access to needed services and supports are among the key principles pertaining to lifestyle that could increase the risk of developing PUs [11].…”

Section: Lifestyle and Psychosocial Factorsmentioning

confidence: 99%

“…However, it is recognized that the etiology of PUs is complicated and excess pressure is not the only factor leading to PU formation; tissue health, medical history, lifestyle, and psychosocial factors are identified as important contributing factors to the development of PUs [26][27].…”

Section: Section 1: Factors Associated With Self-managed Prevention Omentioning

confidence: 99%

“…We used the conceptual framework depicting the interactions between pressure forces and tissue tolerances devised by Defloor to summarize the key physiological factors related to PU development [25]. To assist technology developers in understanding the role of contextual factors in self-management practices, we used behavioral models described by Clark et al to summarize the lifestyle and contextual influences on PU management in daily life [26]. For section 2, focusing specifically on technologies for self-management, included studies were organized into four categories based on the technology applied: (1) education and behavioral interventions (2 studies), (2) interface pressure mapping (IPM) (5 studies), (3) electrical stimulation (ES) (3 studies), and (4) telemedicine (2 studies).…”

Section: Data Synthesismentioning

confidence: 99%

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Assistive technologies for self-managed pressure ulcer prevention in spinal cord injury: A scoping review

Tung

Stead²,

Mann³

et al. 2015

J Rehabil Res Dev

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Abstract-Pressure ulcers (PUs) in individuals with spinal cord injury (SCI) present a persistent and costly problem. Continuing effort in developing new technologies that support selfmanaged care is an important prevention strategy. Specifically, the aims of this scoping review are to review the key concepts and factors related to self-managed prevention of PUs in individuals with SCI and appraise the technologies available to assist patients in self-management of PU prevention practices. There is broad consensus that sustaining long-term adherence to prevention regimens is a major concern. Recent literature highlights the interactions between behavioral and physiological risk factors. We identify four technology categories that support self-management: computer-based educational technologies demonstrated improved short-term gains in knowledge (2 studies), interface pressure mapping technologies demonstrated improved adherence to pressure-relief schedules up to 3 mo (5 studies), electrical stimulation confirmed improvements in tissue tolerance after 8 wk of training (3 studies), and telemedicine programs demonstrated improvements in independence and reduced hospital visits over 6 mo (2 studies). Overall, self-management technologies demonstrated low-to-moderate effectiveness in addressing a subset of risk factors. However, the effectiveness of technologies in preventing PUs is limited due to a lack of incidence reporting. In light of the key findings, we recommend developing integrated technologies that address multiple risk factors.

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Section: Lifestyle and Psychosocial Factorsmentioning

confidence: 99%

Section: Section 1: Factors Associated With Self-managed Prevention Omentioning

confidence: 99%

Section: Data Synthesismentioning

confidence: 99%

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Assistive technologies for self-managed pressure ulcer prevention in spinal cord injury: A scoping review

Tung

Stead²,

Mann³

et al. 2015

J Rehabil Res Dev

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“…(p341) 20 Typical prevention recommendations made during rehabilitation include: examining skin daily to allow for early detection; minimizing moisture and incontinence, and keeping skin clean and dry; having an individually-prescribed wheelchair with a pressure redistribution cushion and regular pressure relief; ensuring that all equipment is functioning properly; decreasing or stopping smoking, and limiting alcohol consumption; and eating a well-balanced, nutritionally-complete diet, which includes monitoring of weight to detect undesirable trends. 1,21 Clark et al 22 suggested that, to promote sustainable outcomes, health care professionals must assist individuals with SCI to determine which preventative strategies are realistic for them to implement, based upon their life circumstances, and must help to identify ways to integrate these preventative strategies into their daily schedule.…”

Section: Introductionmentioning

confidence: 99%

A Systematic Review of Therapeutic Interventions for Pressure Ulcers After Spinal Cord Injury

Regan

Teasell

Wolfe

et al. 2009

Archives of Physical Medicine and Rehabilitation

154

108

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Objective-To systematically review evidence on the prevention and treatment of pressure ulcers in those with a spinal cord injury.Data Sources-For this evidence-based review, the following data sources were used: MEDLINE ® /PubMed, CINAHL ® , EMBASE ® and PsycINFO ® Study Selection-To be selected for inclusion in the current review, there had to have been an intervention, studies had to have 3 or more subjects, and 50% or more of the participating group had to have a spinal cord injury.Data Extraction-Data extracted included study design, subject demographics, inclusion and exclusion criteria, study type, sample size, outcome measures used, and study results.Data Synthesis-Articles selected for this review were organized into one of two categories: prevention or treatment. Within each broad category, several smaller ones were created and articles were grouped together according to the prevention (direct or indirect) or treatment intervention discussed.Conclusions-Of the 26 articles selected for inclusion in the systematic review, 7 were randomized control trials that dealt with treatment for pressure ulcers, and there was one RCT on prevention. Despite the cost effectiveness of prevention, little research exists on preventative interventions, and what does exist mostly is Level 4 evidence. More research is needed for both prevention and treatment, but especially the former.

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“…The threat of pressure ulcers represents a potential challenge for the ability of patients with SCI to experience a full and satisfying life. 8 This case study presents an individual with a T4-complete level injury who was 18 years out from his SCI. He was experiencing progressively adverse effects on his QOL due to difficulty in managing the spasticity and pressure ulcers associated with his SCI.…”

mentioning

confidence: 99%

Elective bilateral above the knee amputation in T4-complete spinal cord injury: a case report

Jaffe

2008

Spinal Cord

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Data-Based Models of How Pressure Ulcers Develop in Daily-Living Contexts of Adults With Spinal Cord Injury

Cited by 62 publications

References 18 publications

Assistive technologies for self-managed pressure ulcer prevention in spinal cord injury: A scoping review

Assistive technologies for self-managed pressure ulcer prevention in spinal cord injury: A scoping review

A Systematic Review of Therapeutic Interventions for Pressure Ulcers After Spinal Cord Injury

Elective bilateral above the knee amputation in T4-complete spinal cord injury: a case report

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