Abstract
Objective: To co-design a theoretically underpinned, healthcare practitioner (HCP) mediated, tailored intervention to support housebound older patients and their lay carers to adopt pressure ulcer prevention behaviours.
Design: Theoretical Domains Framework informed co-design
Setting: One geographical area in the United Kingdom, spanning several community National Health Service Trusts.
Participants: Community dwelling older patients at risk of pressure ulcer development and
their lay carers (n=4) and health practitioners (n=6) providing related care.
Results: Co-designers addressed five identified barriers to pressure ulcer prevention, knowledge and beliefs about consequences, social or professional role and influence, motivation and priorities, emotion and environment. Prioritised intervention components were: i) making every contact count, all health and social care workers to be conversant with basic prevention behaviours and to support and reiterate these at every visit (9.1/10), ii) signposting of existing support groups and sitting services (8.4/10), iii) accessible, timely, trustable and relatable written information including role of patients, carers and staff in prevention and links to other resources (7.7/10) and iv) supporting close family involvement in some of the practical elements of care (5.6/10).
Conclusions: Our study sought to co-design a practitioner mediated, tailored intervention to support housebound older patients and their lay carers to adopt pressure ulcer prevention behaviours. The process of barrier identification and selection of behaviour change techniques for intervention components was theoretically informed. However, further development will be needed to refine the prototype intervention to take into account the complexity of multiple health needs and priorities of patients. The principles of this study are likely to be transferable to similar national and international contexts.
Design: Theoretical Domains Framework informed co-design
Setting: One geographical area in the United Kingdom, spanning several community National Health Service Trusts.
Participants: Community dwelling older patients at risk of pressure ulcer development and
their lay carers (n=4) and health practitioners (n=6) providing related care.
Results: Co-designers addressed five identified barriers to pressure ulcer prevention, knowledge and beliefs about consequences, social or professional role and influence, motivation and priorities, emotion and environment. Prioritised intervention components were: i) making every contact count, all health and social care workers to be conversant with basic prevention behaviours and to support and reiterate these at every visit (9.1/10), ii) signposting of existing support groups and sitting services (8.4/10), iii) accessible, timely, trustable and relatable written information including role of patients, carers and staff in prevention and links to other resources (7.7/10) and iv) supporting close family involvement in some of the practical elements of care (5.6/10).
Conclusions: Our study sought to co-design a practitioner mediated, tailored intervention to support housebound older patients and their lay carers to adopt pressure ulcer prevention behaviours. The process of barrier identification and selection of behaviour change techniques for intervention components was theoretically informed. However, further development will be needed to refine the prototype intervention to take into account the complexity of multiple health needs and priorities of patients. The principles of this study are likely to be transferable to similar national and international contexts.
Original language | English |
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Journal | BMJ Open |
Publication status | Accepted/In press (AAM) - 14 Oct 2024 |