Pressure ulcer knowledge, beliefs and practices in a group of South Africans with spinal cord injury

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Study design

A quantitative, descriptive study using a cross-sectional survey.


To describe the pressure ulcer knowledge, beliefs and practices amongst persons with SCI, who received rehabilitation at a Cape Town rehabilitation centre.


A rehabilitation centre for clients with physical disabilities in Cape Town, South Africa.


A quantitative, descriptive study, that employed consecutive sampling, was done. Participants included inpatients (n = 30), outpatients (n = 33) and peer supporters (n = 8). Data were collected during April and March 2015 with a questionnaire developed through collating existing questionnaires and adapting it for the study context. This rendered a knowledge score and data on beliefs and practices. The Fisher’s exact test was used for comparative analysis (p < 0.05).


The mean combined knowledge score was 42.7%. The majority of participants (88.7%) believed pressure ulcers to be serious and 45% thought they were likely to develop a PU. They believed daily skin checks (80.3%), weight shifting (86%) and limiting sitting time (80.3%) could prevent PU development. Study participants indicated that they did not regularly follow guideline recommended practices like regular pressure relief (51%) (36 participants) or daily skin inspection (38%) (27 participants) and 37% (26 participants) reported being current smokers.


Participants showed a lack of knowledge, which might have affected their pressure ulcer prevention practices negatively. The study findings can be used to assist with the development of a contextually relevant training programme on pressure care.

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This manuscript is based on a research assignment for a master’s degree submitted to Stellenbosch University in 2015 [29].

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Correspondence to Adri Marica Visser.

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Conflict of interest

The researcher and research assistant were employed at the study centre. This could have impacted data collection and participants’ answers. To try and eliminate this, the questionnaire was very structured with specific prompts that were used in the same way, for all clients. A thorough explanation of the purpose of the study was given to ensure that participants understood the importance of answering the questions truthfully.

Statement of ethics

The study was approved and registered with the University of Stellenbosch, Human Research Ethics Committee (S14/10/213). Permission to perform the study was also received from the relevant authorities. Participation in the study was voluntary and written informed consent was obtained before data collection commenced. All data are treated confidential.

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Visser, A.M., Visagie, S. Pressure ulcer knowledge, beliefs and practices in a group of South Africans with spinal cord injury. Spinal Cord Ser Cases 5, 83 (2019) doi:10.1038/s41394-019-0226-4

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