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A narrative review of patients' lived experience of having a pressure injury

22 February 2024
Volume 33 · Issue 4

Abstract

Aim:

To explore patients' experiences of living with pressure injuries.

Design:

A qualitative narrative review and thematic synthesis of qualitative research studies.

Data sources:

Six electronic databases were searched: Medline, CINAHL, Scopus, Web of Science, Embase, and Google Scholar (for grey literature). The search was conducted between October 2022 and April 2023. Setting: Acute, community and care home settings across the UK, France, Belgium and the US.

Review methods:

The PRISMA checklist for reporting systematic reviews was used. The included studies were evaluated for quality using the CASP tool. The Joanna Briggs Institute data extraction tool was used to extract data from the included studies. Thematic synthesis was used to identify themes to present a coherent and nuanced understanding of patients' experiences of living with pressure injuries.

Results:

Nine studies involving 244 participants, aged 21 to 101, with pressure injuries, met the inclusion criteria. Three key themes emerged using thematic analysis: physiological, emotional and psychological, and social effects. Within these themes, subthemes such as endless pain and discomfort, loss of mobility and independence, and social isolation were dominant in all aspects of the lives of patients living with pressure injuries.

Conclusions:

This narrative review gives clear and multifaceted insight into the impact of pressure injuries on individuals' lives, emphasising the necessity for patient-centred care and the integration of evidence-based tools for effective pain management and risk assessment. The impact of pain on emotional and psychological wellbeing was significant, and the financial implications are scarcely known. Future research is needed to explore the experiences of younger adults and the financial consequences of living with pressure injuries.

Pressure injuries are injuries to the skin or underlying tissues that occur over a bony prominence. They are caused by intrinsic factors (such as ageing and immobility) and extrinsic factors (such as pressure and shear) (National Pressure Injury Advisory Panel, 2016). Globally, pressure injuries are a leading cause of preventable patient harm, resulting in a significant increase in morbidity and mortality rates (Sardo et al, 2023). Evidence suggests that pressure injuries predominantly affect the ageing population due to frailty and increased risk of immobility (Awad and Hewi, 2020).

Pressure injuries are a significant health issue due to the economic impact (treatment and litigation costs, for example) and health burden on the healthcare sector and the individual (severe injuries can lead to sepsis, for example) (Hajhosseini et al, 2020). Despite various prevention strategies implemented worldwide to reduce the incidence and prevalence of pressure injuries, recent evidence indicates a substantial rise in pressure injury cases (Triantafyllou et al, 2021). In the UK, it is estimated that 700 000 people develop pressure injuries yearly at the cost to the NHS of £1.4 to £2.1 billion, which accounts for 4% of the total expenditure (NHS England, 2018). Similarly, in the US, about 2.5 million people are affected by pressure injuries, costing $11.6 billion annually (Geng et al, 2023).

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