SCIENCE, PRACTICE AND EDUCATION DOI: 10.35279/jowm202110.08 A community-based approach to the prevention of pressure injuries: A study supported by the European Wound Management Association Research Grant Vildan Çakar , RN, MSc, PhD Student in Nursing, Research Assistant, Koç University, Graduate School of Health Sciences, Koç University Health Sciences Campus, Davutpasa Str. Topkapı, Istanbul, Turkey Ayişe Karadağ , RN, ET/WOCN, PhD, Professor in Nursing, Advisor, Koç University, School of Nursing, Koç University Health Sciences Campus, Davutpasa Str. Topkapı, Istanbul, Turkey Correspondence: vcakar18@ku.edu.tr · Conflicts of interest: None Keywords: Digital gamification, education, pressure injuries, pressure ulcers, prevention ABSTRACT Pressure injuries (PIs) are important health problems all over the world because of their serious effects. Awareness of PIs and their effects has increased in recent years. Since patients’ relatives are part of the care team, they have an important role to play in the prevention of PIs. The most crucial aspect of the prevention of PIs is the education of healthcare professionals, patients and patients’ relatives and caregivers. This study aimed to educate caregivers on the prevention of PIs through the development of a digital game. With this purpose, we developed and used a technological education approach —a digital game— that employs gamification methods. INTRODUCTION A pressure injury (PI) is defined as localised damage to the skin and/or underlying tissues, usually over a bony prominence or related to a medical device and/ or other devices, due to intense and/or prolonged pressure or pressure in combination with shear. This damage can present as intact skin or appear I the form an open wound. Soft tissue tolerance to pressure and shearing forces are affected by microclimate, perfu- sion, age, nutrition, acute or chronic health status, comorbidities, soft tissue conditions and a number of contributing or confounding factors associated with PIs, the most important of which is impaired mobil- ity. Patients with limited mobility and those patients confined to bed are at a risk of developing PI. 1 The prevalence of PI varies by country and clinical setting (acute care, long-term care, community health care, etc.). 1 The overall prevalence of PIs has been de- termined to be 15.0% in the United States 2,3 , 10.8% in European countries 4 , 26.0% in Canada 5 and 7.9% in Australia. 6 In a point prevalence study on acute care with the largest sample, in which patients from 12 centres from different provinces of Turkey were included (n=5,088), the overall prevalence of PIs was found to be 9.5%. 7 In acute care, a systematic review (n=42) by Li et al. (2020) reported that the pooled prevalence and incidence rates of PIs were 12.8% and 5.4% per 10,000 patient-days, respectively.8 In stud- ies on home care conducted in Australia, Belgium and England, the prevalence of PIs was determined to be between 6.8 and 13.0%. 6,9,10,11 In a cross-sectional descriptive study that included patients (n=786) re- ceiving services from the home care unit of a training and research hospital in Turkey, the rate of PIs was found to be quite high, 29.8%. 12 PIs are considered a major public health problem due to their undesirable effects, such as increased JOURNAL OF WOUND MANAGEMENT OFFICIAL JOURNAL OF THE EUROPEAN WOUND MANAGEMENT ASSOCIATION 61
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