Predicting factors of pressure ulcers in older Thai stroke patients living in urban communities

AIM AND OBJECTIVE: To describe the contributing factors for pressure ulcer development in older Thai stroke patients in an urban community. BACKGROUND: Pressure ulcers are a common problem signifying a source of morbidity and mortality in older stroke patients. In the past, most studies have focused on the physiological factors affecting pressure ulcer development. However, studies related to effect of stroke severity and psychosocial factors in community-based setting have not found. DESIGN: Cross-sectional survey design. METHODS: One hundred and sixty-eight older stroke patients from urban communities in three districts in metropolitan Thailand were recruited for this cross sectional study. Data were collected from the Skin Assessment Tool, the Braden scale, the Canadian Neurological Scale, the Social Support Questionnaire and the Thai Geriatric Depression Scale for each patient. The results were analysed using multiple logistic regression and the chi-square test. RESULTS: Eighty older stroke patients who developed pressure ulcers (47·6%). The participants were aged between 60-93 years. Multiple logistic regression analysis was applied to calculate the odds ratio. The significant predicting factors for pressure ulcers were activity, moisture, nutrition, friction and shearing and depression. Sensory perception, mobility, severity of stroke and social support were not found to be significant predictors. CONCLUSIONS: Physiological factors and depression were found to be significant predicting factors for pressure ulcer development in older stroke patients living in an urban community. RELEVANCE TO CLINICAL PRACTICE: To help prevent pressure ulcers in older stroke patients, the findings suggest that healthcare providers assess activity, moisture, nutrition, friction and shearing, as well as psychological assessment for depression. The results indicate that models for pressure ulcer prevention merit further investigation.