Veteran model of preventing community-acquired pressure injuries associated with spinal cord injury: A qualitative descriptive study

Context/Objective Pressure injuries (PrIs) are the second leading cause of hospitalization in people with spinal cord injury (SCI). The majority of PrIs occur in the community, but there is little known about prevention of community acquired PrI (CAPrI). The purpose of this study was to better understand risks, resources, and actions associated with CAPrI prevention from the perspective of veterans living with SCI in the community. Methods A qualitative descriptive design using photovoice (n = 30) with or without guided tours (n = 15) was conducted with Veterans living with SCI at 3 sites across the United States to determine environmental/lifestyle risks at home, prevention activities, resources used, and challenges in CAPrI prevention. Interviews were audio-recorded, transcribed and analyzed using thematic analysis, followed by inductive thematic synthesis. Results Qualitative analyses revealed a model describing veteran's perspective of preventing CAPrIs associated with SCI. The model included 3 themes and 9 subthemes: Factors that Lead to Risk for Pressure Injury (Challenges and Barriers), Factors that Affect Chosen Actions (Veteran Motivators, Veteran Values, Veteran Satisfaction with Provider Relationships, and Veteran Supports), and Preventive Activities within Context of Life (Physical Care, Coping, Advocacy). Conclusion Incorporating the veteran model of prevention within the context of life into clinical care could support provider-veteran collaboration to identify and integrate successful strategies that prevent CAPrIs while also improving veteran quality of life.