A cross-sectional study on self-management of pressure ulcer prevention in paraplegic patients.
BACKGROUND
Little is known about health activation and self-management behavior in preventing pressure ulcers (PU) in paraplegic patients. Therefore this study aimed to describe the extent of health activation and self-management behavior in paraplegics to prevent PU's and associations between this behavior and patient characteristics. Furthermore, we aimed to find differences in health activation in paraplegics who never had a PU compared to paraplegics with a previous history of PU's or a new-onset PU's.


METHODS
A cross-sectional survey on health activation and self-management behavior was conducted among adult paraplegics recruited from two rehabilitation centers in the Netherlands. The Patient Activation Measure (PAM-score) was used to measure the extent of health activation. Patient statements on their level of self management behavior to prevent PU were evaluated.


RESULTS
The mean PAM-score (0-100) was 54 (±8.1; n = 162) indicating a low level of health activation. Two indicators turned out to be statistically significant associated with health activation: level of education (OR = 2.2, p = 0.017) and degree of paraplegia (OR = 2.8, p = 0.036). Evaluation of health activation levels amongst paraplegics with or without a PU- history showed no significant difference. Analysis of patients statements demonstrated a large discrepancy between intended and actual behavior to prevent pressure ulcers.


CONCLUSIONS
Level of education and level of paraplegia are significantly associated with health activation. A positive PU-history is not associated with future responsible behavior nor for compliant behavior in terms of health management.
Radboud University Medical Center Nijmegen, Department of Plastic Surgery, Netherlands. Electronic address: erik.delaat@radboudumc.nl.
H E W
HE
de Laat
Radboud University Medical Center Nijmegen, Department of Plastic Surgery, Netherlands; University of Utrecht, Department of Clinical Health Science, Netherlands.
A C
AC
de Munter
Sint Maartenskliniek Nijmegen, Rehabilitation Centre, Netherlands.
M J
MJ
van der Burg
Radboud University Medical Center Nijmegen, Department of Plastic Surgery, Netherlands.
D J O
DJ
Ulrich
Radboud University Medical Center Nijmegen, Department of Plastic Surgery, Netherlands.
O
O
Kloeters
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000150:complications / Q000523:psychology*; D010358:Patient Participation / Q000523:psychology* / Q000706:statistics & numerical data; D003668:Pressure Ulcer / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D057566:Self Report; D000073278:Self-Management / Q000523:psychology*; D017592:Skin Care
Health activation; Paraplegics; Pressure ulcers; Prevention; Self management