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The Evaluation of a Pressure Ulcer Prevention Programme (SPUPP) for Older Persons at Risk of Pressure Ulceration, Living in the Community Setting

posted on 22.11.2019 by Emer Shanley

Background: There is a potential for increase in the incidence of pressure ulcers (PU) in the older population due to the relationship between ageing and reduced mobility. Prevention of PU’s is a key issue for enhancing health, and education is a means to empower people to take an active role in health promotion. This study set out to develop, validate and evaluate the impact of the Shanley Pressure Ulcer Prevention Programme on older persons’ knowledge of, and attitudes and behaviours towards, PU prevention.

Methods: SPUPP is a structured pressure ulcer prevention education programme developed to address the key tenets of PU prevention. The study comprised three phases; phase 1 was the development of SPUPP, phase 2 was the development and psychometric evaluation of the Patient Knowledge of Pressure Ulcer Prevention (KPUP) tool, phase 3 was the evaluation of the SPUPP pre- and post-intervention, using a randomised controlled trial design. Following ethical approval 64 older adults participated in the intervention and completed the KPUP tool pre and post intervention. Knowledge was scored from 0-20. Descriptive analysis was used to summarise, describe and explain the data. Inferential statistics were used to test for possible associations between variables.

Results: The participants ranged in age from 70-96 years. Pre intervention mean knowledge scores were 11.68 (SD: 3.09, intervention group) and 11.68 (SD: 3.60, control group). Post intervention the mean knowledge score in the intervention group was 16.87 (SD: 1.87), and control group was 12.40 (SD: 3.2) MD: 4.47 (95% CI: 3.19-5.75; p=0.00001). Positive changes were also noted in the intervention group regarding self-reported health behaviours and attitudes towards PU prevention.

Conclusion: The SPUPP impacted positively on knowledge scores, and also positively influenced attitudes and behaviours towards PU prevention. Thus, this research provides useful information regarding the potential to enhance patient involvement in PU prevention.


School of Nursing and Midwifery, Royal College of Surgeons in Ireland


First Supervisor

Professor Zena Moore

Second Supervisor

Dr Declan Patton


A thesis submitted for the degree of Doctor of Philosophy from the Royal College of Surgeons in Ireland in 2018.

Published Citation

Shanley E. The Evaluation of a Pressure Ulcer Prevention Programme (SPUPP) for Older Persons at Risk of Pressure Ulceration, Living in the Community Setting [PhD Thesis]. Dublin: Royal College of Surgeons in Ireland; 2018.

Degree Name

Doctor of Philosophy (PhD)

Date of award



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