exudates and Pressure-Ulcer

Focus group qualitative study.. To explore factors affecting adherence to behaviours appropriate for the prevention of pressure injuries (PIs) in people with spinal cord injury (SCI) in Malaysia.. University Hospital, Malaysia METHODS: Four sets of focus group interviews were conducted, each with 5-10 participants, totalling 30 people with SCI. A trained interviewer used structured interviews designed to explore participants' experiences of complying with recommended behaviours for the prevention of PIs. All interviews were digitally recorded, transcribed, and analysed utilising thematic analysis.. The factors that affected participants' adherence are classified into four main themes: (a) educational aspects, (b) internal drive, (c) social and environmental factors, and (d) post-SCI physiological changes.. This qualitative study provides initial exploratory evidence regarding the thoughts, experience, and opinions pertaining to PI preventive behaviours within the Malaysian SCI population. The emerging themes contribute to an in-depth understanding of the competency of the Malaysian healthcare system in PI prevention, personal and societal factors influenced by the socio-demographic backgrounds, and disease-related factors that influence the adherence to such preventive interventions.

Topics: Focus Groups; Humans; Malaysia; Pressure Ulcer; Qualitative Research; Spinal Cord Injuries

Managing neglected spinal cord injury (SCI) patients in a rural setting can be challenging due to a lack of resources and the unique personal and environmental contextual factors that may hinder rehabilitation. This article aims to identify the contextual factors and their impact on successful rehabilitation.. A middle-aged man from a rural area had suffered a neglected traumatic SCI and was first seen by the rehabilitation team 17 years post injury. He had a T7 AIS A paraplegia and was bedridden with multiple secondary complications. He was admitted with goals of optimizing his health, initiating basic spinal rehabilitation and improving his functional status. By 1 month, the patient made gradual improvement of his mobility and ADL but requested discharge despite not having achieved his rehab goals. We identified the factors that contributed to his poor motivation to be more functionally independent. Personal factors include poor educational level, his background personality and erratic health-seeking behaviour. Environmental factors included poor family and financial support, physical barriers, lack of work opportunities and facilities for people with disability, poor community support and acceptance and poor healthcare facilities and expertise.. The patient's personal and environmental factors affected the delivery of SCI management, spinal rehabilitation and management of secondary comorbidities. Awareness of early spinal rehabilitation among the rural community and healthcare authorities is crucial to promote better implementation of policies, services or programs to support people with SCI.

Topics: Accidental Falls; Activities of Daily Living; Economic Status; Educational Status; Health Services Accessibility; Humans; Malaysia; Male; Middle Aged; Motivation; Paraplegia; Patient Acceptance of Health Care; Pressure Ulcer; Renal Insufficiency, Chronic; Social Support; Spinal Cord Injuries; Thoracic Vertebrae

To describe nurses' perceptions of evidence-based recommendations to prevent complications in a Malaysian intensive care unit.. Ventilator-associated pneumonia, catheter-related blood stream infection and pressure ulcer are three frequent adverse events in the intensive care unit. Implementing evidenced-based practice is critical in prevention of these complications.. A qualitative focus group study.. Focus groups were conducted with nurses in the intensive care unit of a regional hospital in Malaysia following evidence-based interventions. Focus group transcripts were analysed using the method of thematic analyses.. Thirty-four nurses participated in eight focus groups. The main themes derived from the interviews: (1) nurses' knowledge impacts on the change process; (2) initial resistance, ambivalence and movement to acceptance; and (3) hierarchical organisational structure can hinder the change process.. Enhancing nurses' knowledge and attitudes of evidence-based practice, providing them with tools to monitor their clinical practice, and empowering them to change practice are likely to be important in influencing clinical outcomes. Increasing the emphasis on evidence-based practice in nursing curricula and engaging in cultural change processes in the workplace are necessary to improve clinical outcomes.. These findings provide valuable information for implementing clinical practice improvement interventions.

Topics: Adult; Focus Groups; Humans; Intensive Care Units; Malaysia; Nursing Assessment; Nursing Staff, Hospital; Pneumonia, Ventilator-Associated; Pressure Ulcer; Sepsis