Clark FA, Jackson JM, Scott MD, Carlson ME, Atkins MS, Uhles-Tanaka D, Rubayi S, et al.
Archives of physical medicine and rehabilitation. Date of publication 2006 Nov 1;volume 87(11):1516-25.
1. Arch Phys Med Rehabil. 2006 Nov;87(11):1516-25.
Data-based models of how pressure ulcers develop in daily-living contexts of
adults with spinal cord injury.
Clark FA(1), Jackson JM, Scott MD, Carlson ME, Atkins MS, Uhles-Tanaka D, Rubayi
S.
Author information:
(1)Division of Occupational Science & Occupational Therapy, University of
Southern California, Los Angeles, CA 90089-9003, USA. fclark@usc.edu
OBJECTIVE: To examine the daily-lifestyle influences on the development of
pressure ulcers in adults with spinal cord injury (SCI).
DESIGN: Qualitative investigation using in-depth interviewing and participant
observation.
SETTING: Participants were studied in their homes and other naturalistic
contexts.
PARTICIPANTS: Twenty men and women of diverse ethnicities with paraplegia or
tetraplegia who were recruited at a pressure ulcer management clinic in a large
rehabilitation facility.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Detailed descriptive information pertaining to the
development of recurring pressure ulcers in relation to participants' daily
routine and activity, personal choices, motivating influences, lifestyle
challenges, and prevention techniques and strategies.
RESULTS: The daily-lifestyle influences on pressure ulcer development in adults
with SCI can be described through various models that vary in complexity,
depending on whether they incorporate individualization, interrelations among
modeled elements, situational specificity, and/or temporal comprehensiveness.
Ulcers are most likely to develop when a person with a relatively high-risk
background profile is exposed to an equilibrium-disrupting change event that
culminates in a specific pressure ulcer risk episode.
CONCLUSIONS: The results underscore the significant degree of complexity and
individualization that characterize the emergence of pressure ulcers in
daily-life contexts. Prevention efforts should therefore incorporate attention to
the unique constellation of circumstances that comprise a person's everyday life.
DOI: 10.1016/j.apmr.2006.08.329
PMID: 17084129 [Indexed for MEDLINE]