Samruddhi Ghaisas, Elizabeth A. Pyatak, Erna Blanche, Jeanine Blanchard, Florence Clark, PUPS II Study Group; Lifestyle Changes and Pressure Ulcer Prevention in Adults With Spinal Cord Injury in the Pressure Ulcer Prevention Study Lifestyle Intervention. Am J Occup Ther 2014;69(1):6901290020p1-6901290020p10. doi: 10.5014/ajot.2015.012021.
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© 2019 American Occupational Therapy Association
Pressure ulcers (PrUs) are a major burden to patients with spinal cord injury (SCI), affecting their psychological, physical, and social well-being. Lifestyle choices are thought to contribute to the risk of developing PrUs. This article focuses on the interaction between lifestyle choices and the development of PrUs in community settings among participants in the University of Southern California–Rancho Los Amigos National Rehabilitation Center Pressure Ulcer Prevention Study (PUPS II), a randomized controlled trial of a lifestyle intervention for adults with SCI. We conducted a secondary cross-case analysis of treatment notes of 47 PUPS II participants and identified four patterns relating PrU development to lifestyle changes: positive PrU changes (e.g., healing PrUs) with positive lifestyle changes, negative or no PrU changes with positive lifestyle changes, positive PrU changes with minor lifestyle changes, and negative or no PrU changes with no lifestyle changes. We present case studies exemplifying each pattern.
Positive PrU changes (e.g., healing and closing PrUs) accompanied by positive lifestyle and behavior changes
Negative or no PrU changes accompanied by positive lifestyle and behavior changes
Positive PrU changes accompanied by minor or no lifestyle or behavior changes
Negative or no PrU changes accompanied by minor or no lifestyle or behavior changes.
Lifestyle factors and PrU development are interrelated; four patterns of relationships between the two emerged from this study.
The four patterns were not absolute, demonstrating the complexity of the relationships.
Additional factors, such as medical complications and unanticipated life circumstances, affect PrU development and lifestyle change.
Community-based practice offers a valuable opportunity to comprehensively address lifestyle and environmental factors during intervention with people at risk for PrU development.
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