Self-management interventions to improve skin care for pressure ulcer prevention in people with spinal cord injuries: a systematic review protocol.
Pressure ulcers are a serious, common, lifelong, and costly secondary complication of spinal cord injury (SCI). Community-dwelling people with a SCI can prevent them with appropriate skin care (i.e. pressure relieving activities, skin checks). Adherence to skin care remains suboptimal however, and self-management interventions that focus on improving this have been designed. Little is known on their content, effectiveness, or theoretical basis. The aim of the proposed systematic review is to synthesize the literature on self-management interventions to improve skin care in people with a SCI. Specific objectives are to describe these interventions in relation to their content, effectiveness, theory base, and adherence to reporting guidelines for intervention description.



The search strategy will combine an electronic search of nine bibliographic databases (MEDLINE, Embase, PsycInfo, CENTRAL, CINAHL, Rehabdata, CIRRIE, PEDro, ERIC) and two trial registers with a manual search of relevant reference lists. Predefined eligibility criteria will be applied in a two-phase selection process involving title and abstract screening, followed by full-text screening. A data extraction spreadsheet will be applied to included papers. Intervention content will be coded using two taxonomies (behaviour change taxonomy; PRISMS self-management support taxonomy). A validated tool (Theory Coding Scheme) and the Template for Intervention Description and Replication (TIDieR) will be used to examine theoretical basis and assess adherence to reporting guidelines for intervention description. A small number of heterogeneous studies are likely to be included in this review therefore a narrative synthesis is planned.



This systematic review will help identify the gaps and priorities to guide future research activities in this area.



PROSPERO CRD42016033191.
Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada. jbaron@ohri.ca.|Department of Medicine, University of Ottawa, Ottawa, ON, Canada. jbaron@ohri.ca.
Justine
0000-0003-2782-079X
J
Baron
School of Surgery, University of Western Australia, Perth, Australia.|Institute for Health Research, University of Notre Dame Australia, Fremantle, Australia.
Jillian
J
Swaine
Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.|Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
J
J
Presseau
Rick Hansen Institute, Vancouver, BC, Canada.|Vancouver General Hospital, Vancouver, BC, Canada.
Arlene
A
Aspinall
Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.|Toronto Rehabilitation Institute, Toronto, ON, Canada.
Susan
S
Jaglal
Rick Hansen Institute, Vancouver, BC, Canada.
Barry
B
White
Parkwood Institute Research, Lawson Health Research Institute, London, ON, Canada.|University of Western Ontario, London, ON, Canada.
Dalton
D
Wolfe
Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.|Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
Jeremy
J
Grimshaw
D006801:Humans; D003668:Pressure Ulcer / Q000628:therapy*; D000073278:Self-Management; D017592:Skin Care / Q000379:methods*; D013119:Spinal Cord Injuries / Q000150:complications*; D000078202:Systematic Reviews as Topic
Bed sores; Pressure ulcers; Self-care; Self-management; Skin; Spinal cord injury