Pressure ulcer risk assessment: risk factors and risk screening in older persons – a validation study
Background: Mobility is acknowledged in the literature as the highest predictor
of pressure ulcer development, however most of clinical studies assess mobility
subjectively. The few studies that have analysed mobility objectively using
technology have the limitation of not measuring small postural changes, which
are important for pressure relief. A more comprehensive analysis of mobility,
including all types of movement is needed to better understand mobility and
pressure ulcer development, and to further correlate it with other risk factors.
Therefore, a quantitative, prospective, non-experimental study among the elderly
population was undertaken.
Aim: The primary objective of the study was to explore how activity and mobility,
along with other risk factors lead to pressure ulcer development in older persons
cared for in long-term facilities. The secondary objectives of the study were firstly
to report pressure ulcer incidence among the study participants using visual skin
assessment and sub-epidermal moisture (SEM) measurement. Secondly, to
explore mobility in healthy volunteers using a mobility sensor in order to compare
to mobility levels of older people cared for in long-term settings.
Methods: Ethical approval was received. The chosen explanatory variables were
included as they are common to the three most widely used risk assessment tools
(Waterlow, Norton and Braden), namely, mobility, activity, nutritional status and
incontinence. Following statistical advice and after the results of the pilot study of
48 participants, the sample size was recalculated based on the two causal factors
that varied over the 20-day follow-up, namely mobility and activity. Therefore, a
total of 150 participants were included. The pilot study also identified the need to
include healthy participants to better determine mobility among a healthy
population, in order to enhance the understanding of the older participants’
movements. Following ethical approval, a total of 22 healthy participants were
included and their mobility were assessed over a 2-night period, using the same
motion sensor employed within the main study.
First SupervisorProfessor Zena Moore
Second SupervisorDoctor Declan Patton
CommentsA thesis submitted for the degree of Doctor of Philosophy from the Royal College of Surgeons in Ireland in 2019
Published CitationModa Vitoriano Budri A. Pressure ulcer risk assessment: risk factors and risk screening in older persons – a validation study. [PhD Thesis]. Dublin: Royal College of Surgeons in Ireland; 2019.
Degree NameDoctor of Philosophy (PhD)
Date of award30/06/2019
- Doctor of Philosophy (PhD)