Background

Pressure ulcers are a common complication with a high impact on well-being and quality of life in people with impaired mobility and/or dysfunctional pain sensations. Prevention is therefore crucial. However, persons at risk seem to experience difficulties in adhering to self-management regimens that can help to prevent or diminish the development of pressure ulcers. Self-management support interventions might help to improve their self-management skills.

Objectives

To review the content, components and effectiveness of self-management support interventions on clinical and behavioral outcomes for people at risk of pressure ulcers.

Methods

A systematic literature search for the period of January 2000 to February 2020 was conducted in five databases (CINAHL, Cochrane, PsycINFO, PubMed, and Web of Science). Inclusion criteria were: (1) studies including persons at a high risk of pressure ulcers; (2) studies investigating interventions focused on self-management support; (3) studies describing clinical and behavioral outcomes related to prevention and care of pressure ulcers. All studies were independently screened on title, abstracts and full text by two researchers. The PRISMS taxonomy of 14 components was used to code intervention content.

Results

The search yielded 5297 papers, which resulted in the inclusion of 16 papers on self-management support interventions for persons at risk of pressure ulcers. Interventions focused mostly on ‘Information about condition and/or management’ (13 interventions), ‘Training in practical self-management activities’ (7 interventions), and ‘Training in psychological strategies’ (6 interventions). ‘Provision of equipment’ was not investigated. The intensity of the interventions varied in delivery mode, frequency and duration. Improvements were found in clinical outcomes in four studies and in behavioral outcomes in ten studies. Four studies showed improvements in clinical outcomes and ten studies in behavioral outcomes. Knowledge was positively influenced in eight studies.

Conclusion

Self-management support interventions show potential. The extensiveness and intensity of the interventions seem to be predictive for the effectiveness, but specific content components cannot be recommended. This review revealed recommendations for future research and international consensus should be reached about patient-relevant outcomes.

中文翻译：

---

对有压疮风险的人进行自我管理支持干预的内容和有效性：系统评价

背景

压疮是一种常见的并发症，对行动不便和/或痛觉失调的人的健康和生活质量有很大影响。因此，预防至​​关重要。然而，处于危险中的人似乎在遵守有助于预防或减少压疮发展的自我管理方案方面遇到困难。自我管理支持干预可能有助于提高他们的自我管理技能。

目标

审查自我管理支持干预对有压疮风险的人的临床和行为结果的内容、组成部分和有效性。

方法

在五个数据库（CINAHL、Cochrane、PsycINFO、PubMed 和 Web of Science）中对 2000 年 1 月至 2020 年 2 月期间的文献进行了系统检索。纳入标准是：（1）研究包括压疮高危人群；(2) 调查侧重于自我管理支持的干预措施的研究；(3) 描述与压疮预防和护理相关的临床和行为结果的研究。所有研究均由两名研究人员独立筛选标题、摘要和全文。使用 14 个组件的 PRISMS 分类法对干预内容进行编码。

结果

搜索产生了 5297 篇论文，其中包括 16 篇关于对有压疮风险的人进行自我管理支持干预的论文。干预措施主要集中在“关于病情和/或管理的信息”（13 项干预措施）、“实际自我管理活动培训”（7 项干预措施）和“心理策略培训”（6 项干预措施）。没有调查“提供设备”。干预的强度因交付方式、频率和持续时间而异。四项研究的临床结果和十项研究的行为结果均有所改善。四项研究显示临床结果有所改善，十项研究显示行为结果有所改善。八项研究对知识产生了积极影响。

结论

自我管理支持干预显示出潜力。干预的广泛性和强度似乎可以预测有效性，但不能推荐特定的内容组成部分。该综述揭示了对未来研究的建议，并应就患者相关结果达成国际共识。