Title

Response Factors Surrounding Progression of Pressure Ulcers in Community-Residing Adults with Spinal Cord Injury

Start Time

27-10-2007 5:00 PM

End Time

27-10-2007 6:00 PM

Abstract

Adults with spinal cord injury (SCI) are at high risk of developing medically serious pressure ulcers due to decreased mobility and reductions in skin sensitivity (Correa et al., 2006; Garber, Rintala, Hart, & Furhrer, 2000; Maklebust, 2005). Many ulcers exacerbate to require surgical repair resulting in extensive, occupationally debilitating hospitalization. Beyond their medical consequences, pressure ulcers impact functional ability to pursue occupations that contribute to a person’s sense of independence, control, productivity, and quality of life (Tate & Forchheimer, 2002).Currently there is little occupational science literature conceptualizing how occupational opportunities and obstacles affect responses to low grade ulcers. This qualitative study is a secondary analysis (Clark et al., 2006) that aims to offer deeper insight into the ulcer response process and draws attention to that critical window of time following the onset of early skin breakdown. Action taken during this crucial period often determines ulcer progression. This presentation explores how occupational lifestyle issues affected pressure ulcer risk in adults with SCI who responded to an early ulcer that progressed to a medically serious level. Through analysis of individualized profiles developed in the parent study from participant observation field notes and in-depth interviews, emergent occupational patterns were identified. A typological framework of responses was then created to elucidate the complex interplay between occupational decision-making and the associated health consequences. Results revealed the most common emergent response to be Distraction, the decision to engage in everyday occupation or a pressing life event versus attending to healing a newly discovered ulcer. This confirms that individual daily life occupations and contexts are not only inextricably intertwined but oftentimes at odds with health-related actions. Discussion topics stimulated by these findings include:1) how occupational science might conceptualize negotiating engagement in meaningful occupation versus a prescribed risk-reducing regime that challenges full participation in daily life; 2) how occupation has the potential to affect participants‚ responses to potentially debilitating health risks; and 3) the importance of a preventive occupation-based approach to structured follow-up interventions within one’s everyday life setting.

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Oct 27th, 5:00 PM Oct 27th, 6:00 PM

Response Factors Surrounding Progression of Pressure Ulcers in Community-Residing Adults with Spinal Cord Injury

Adults with spinal cord injury (SCI) are at high risk of developing medically serious pressure ulcers due to decreased mobility and reductions in skin sensitivity (Correa et al., 2006; Garber, Rintala, Hart, & Furhrer, 2000; Maklebust, 2005). Many ulcers exacerbate to require surgical repair resulting in extensive, occupationally debilitating hospitalization. Beyond their medical consequences, pressure ulcers impact functional ability to pursue occupations that contribute to a person’s sense of independence, control, productivity, and quality of life (Tate & Forchheimer, 2002).Currently there is little occupational science literature conceptualizing how occupational opportunities and obstacles affect responses to low grade ulcers. This qualitative study is a secondary analysis (Clark et al., 2006) that aims to offer deeper insight into the ulcer response process and draws attention to that critical window of time following the onset of early skin breakdown. Action taken during this crucial period often determines ulcer progression. This presentation explores how occupational lifestyle issues affected pressure ulcer risk in adults with SCI who responded to an early ulcer that progressed to a medically serious level. Through analysis of individualized profiles developed in the parent study from participant observation field notes and in-depth interviews, emergent occupational patterns were identified. A typological framework of responses was then created to elucidate the complex interplay between occupational decision-making and the associated health consequences. Results revealed the most common emergent response to be Distraction, the decision to engage in everyday occupation or a pressing life event versus attending to healing a newly discovered ulcer. This confirms that individual daily life occupations and contexts are not only inextricably intertwined but oftentimes at odds with health-related actions. Discussion topics stimulated by these findings include:1) how occupational science might conceptualize negotiating engagement in meaningful occupation versus a prescribed risk-reducing regime that challenges full participation in daily life; 2) how occupation has the potential to affect participants‚ responses to potentially debilitating health risks; and 3) the importance of a preventive occupation-based approach to structured follow-up interventions within one’s everyday life setting.