Qualitative exploratory study.
Pressure injuries (PIs) are a major secondary condition occurring after spinal cord injuries (SCI). Optimization of outpatient and community care may be a promising approach to better support community-dwelling individuals with SCI in preventing PIs. The aim of this study was to examine the experiences of individuals with SCI, family caregivers and health professionals (HPs) in using or providing outpatient and community services for early treatment and prevention of PIs in SCI.
Semi-structured interviews with a sample of Swiss residents community-dwelling individuals with SCI (n = 20), family caregivers (n = 5) and HPs (n = 22) were analysed using thematic analysis.
General practitioners (GPs), home care providers, SCI-specialized outpatient clinics and an SCI-specialized nursing service are involved in the prevention and early treatment of PIs. Our findings show that the needs of individuals with SCI are not fully met: outpatient and community care is often fragmented, mono-professional and non-specialized, while persons with SCI and HPs prefer coordinated, inter-professional and specialized services for preventing and treating PIs. Our findings also highlight the challenges faced by HPs in providing care to individuals with SCI in the community.
Although there seems to be a gap in service provision, there is the potential for improvement by better integrating the different providers in a network and structuring their collaborations. Concrete suggestions are: systematizing knowledge transfer to home care providers and GPs; redefining the role of involved HPs and individuals with SCI and reinforcing the role of the SCI-specialized nursing service.
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The transcripts of the interviews analysed in the current study are available from the corresponding author on request. Transcripts will be provided in the original language (mostly German).
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The authors would like to express their gratitude to the participants for their time and engagement. We also thank Nadja Münzel for her comments on an earlier version of the paper, and Hans Georg Koch for his assistance in the recruitment of study participants. Thank you also to Lisa Adey, who carefully checked the translation of all quotes from the interviews.
This project was supported by the Suva, the Swiss National Accident Insurance Fund.
Conflict of interest
The authors declare that they have no conflict of interest.
We certify that all applicable institutional and governmental regulations concerning the ethical treatment of human volunteers were followed throughout the study. The study obtained ethical approval from the regional committee of north-western and central Switzerland (Ethikkommission Nordwest- und Zentralschweiz, reference number EKNZ 2015-311).
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Zanini, C., Lustenberger, N., Essig, S. et al. Outpatient and community care for preventing pressure injuries in spinal cord injury. A qualitative study of service users’ and providers’ experience. Spinal Cord 58, 882–891 (2020). https://doi.org/10.1038/s41393-020-0444-4