Wales Descriptive, Qualitative Sample: Six clinical nurses, three student nurses, six nurse managers, and one nurse lecturer Setting: Nonacute units in three hospitals Instrument: Interviews Themes: High value of PU prevention Environmental factors and lack of time hinder PU prevention. Prevention delegated to students and NAs. Values influence performance of PU prevention. Quantitative Studies Källman and Suserud (2009). RNs’ and NAs’ attitudes, knowledge, performance of prevention, perceived possibilties/barriers, competence in PU prevention. Sweden Descriptive Cross-Sectional Sample: 77 RNs and 77 NAs Setting: Six hospitals and six clinics Instrument: 47-item questionnaire (included 11-item attitude scale from Moore & Price, 2004) Positive attitude toward PU prevention Knowledge was adequate. Performance of prevention interventions was inadequate. Perceived possibilities included access to facilities, knowledge, routines, teamwork. Perceived barriers included lack of time, patient’s condition, lack of resources/equipment, lack of knowledge. Beeckman, Defloor et al. (2010). Development and evaluation of the Attitude toward Pressure Ulcer Prevention Instrument (APup). Belgium and Netherlands Psychometric Evaluation Sample: 258 nurses, 291 nursing students Setting: Two general hospitals and one psychiatric hospital Instrument: 13-item, 4-point Likert (APuP) Support for the reliability and validity of a new instrument to assess nurses’ attitudes toward PU prevention. Beeckman et al. (2011). Relationships between nurses’ knowledge of, attitudes toward, and performance of PU prevention. Belgium Cross-Sectional Sample: 553 nurses, 2,105 patients (of which 625 were at risk for PUs) Setting: 14 hospitals Instrument: Knowledge by 26-item multiple choice, attitude by 13-item APuP, and performance by observation Knowledge was insufficient. Education increased knowledge. Knowledge was not correlated with performance. Attitude had positive correlation with knowledge and performance. Prevention interventions were inadequate. continued on next page Research for Practice
September-October 2014 • Vol. 23/No. 5 353 Findings Qualitative Studies A phenomenological qualitative study using in-depth individual interviews was conducted in Sweden to describe hospital and community registered nurses’ ( n =30) perceptions of variables affecting PU prevention and care (Athlin et al., 2009). Inclusion criteria were working as a registered nurse (RN) for at least 5 years and having cared for patients with PUs in the last 6 months. Nurse managers recruited participants in the convenience sample. Research - ers audio-recorded semi-structured interviews that consisted of open- ended questions addressing the dis- charge process, progression or regression of PUs, and barriers in providing PU care. Findings includ- ed three main categories and nine subcategories that affect PU care and prevention: (a) the individual patient (physical, psychological, and place of care); (b) health care personnel (views and values, responsibility and commitment, knowledge and competence, and cooperation and communication); and (c) health care structure (orga-
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