Coleman S, Nixon J, Keen J, Wilson L, McGinnis E, Dealey C, Stubbs N, Farrin A, Dowding D, Schols JM, Cuddigan J, Berlowitz D, Jude E, Vowden P, Schoonhoven L, Bader DL, Gefen A, Oomens CW, Nelson EA, et al.
Journal of advanced nursing. Date of publication 2014 Oct 1;volume 70(10):2222-34.
1. J Adv Nurs. 2014 Oct;70(10):2222-34. doi: 10.1111/jan.12405. Epub 2014 Mar 31.
A new pressure ulcer conceptual framework.
Coleman S(1), Nixon J, Keen J, Wilson L, McGinnis E, Dealey C, Stubbs N, Farrin
A, Dowding D, Schols JM, Cuddigan J, Berlowitz D, Jude E, Vowden P, Schoonhoven
L, Bader DL, Gefen A, Oomens CW, Nelson EA.
Author information:
(1)Leeds Institute of Clinical Trials Research, University of Leeds, UK.
AIM: This paper discusses the critical determinants of pressure ulcer development
and proposes a new pressure ulcer conceptual framework.
BACKGROUND: Recent work to develop and validate a new evidence-based pressure
ulcer risk assessment framework was undertaken. This formed part of a Pressure
UlceR Programme Of reSEarch (RP-PG-0407-10056), funded by the National Institute
for Health Research. The foundation for the risk assessment component
incorporated a systematic review and a consensus study that highlighted the need
to propose a new conceptual framework.
DESIGN: Discussion Paper.
DATA SOURCES: The new conceptual framework links evidence from biomechanical,
physiological and epidemiological evidence, through use of data from a systematic
review (search conducted March 2010), a consensus study (conducted December
2010-2011) and an international expert group meeting (conducted December 2011).
IMPLICATIONS FOR NURSING: A new pressure ulcer conceptual framework incorporating
key physiological and biomechanical components and their impact on internal
strains, stresses and damage thresholds is proposed. Direct and key indirect
causal factors suggested in a theoretical causal pathway are mapped to the
physiological and biomechanical components of the framework. The new proposed
conceptual framework provides the basis for understanding the critical
determinants of pressure ulcer development and has the potential to influence
risk assessment guidance and practice. It could also be used to underpin future
research to explore the role of individual risk factors conceptually and
operationally.
CONCLUSION: By integrating existing knowledge from epidemiological, physiological
and biomechanical evidence, a theoretical causal pathway and new conceptual
framework are proposed with potential implications for practice and research.
© 2014 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons
Ltd.
DOI: 10.1111/jan.12405
PMCID: PMC4263098
PMID: 24684197 [Indexed for MEDLINE]
