Knaerke Soegaard, Martin Sollie, Dimitri Beeckman, Fin Biering-Sørensen, Jens Ahm-Sørensen, view paper on the JTV website.

This is a scoping review, which aims to assess the potential size and scope of available literature in a particular research area. This review looks at any studies that included an initiaitive, organisational components and/or stakeholders’ perspectives on pressure ulcer prevention for patients with a spinal cord injury transitioning from any healthcare setting into a home care environment. A total of 2886 papers were screened for eligibility, and 15 papers met their pre-defined inclusion criteria. There was no limitation in country of study, so the findings reflect a variety of different healthcare systems.

This review found that rehabilitation goals in patients with spinal cord injuries are individual to each patient, but independence and self management were described as being core concepts. Rehabilitation must focus on continuous tailored education and follow-up services. This will support the individual to live a life as close as possible to their desired goals, which can increase quality of life, level of social integration, mobility, self-esteem, and health activation. Furthermore, it can decrease pressure ulcer and rehospitalisation rates.

Several factors that can protect an individual from pressure ulcers were identified, including:

• Educational level
• Support from relatives
• Personal traits
• Motivation
• Self-advocacy skills
• Behaviour
• Activity
• Physical factors
• Level and severity of the injury
• Equipment
• Communication

These factors need to be taken into consideration when organising rehabilitation and educational activities, and will vary over time as the patient rehabilitates. Several challenges in transitional care were identified:

• Lack of adequate accommodation
• Lack of aids/equipment
• Continuity in community services
• Access to staff skilled in spinal cord injuries

It was found that there was a discrepancy between guidelines and stakeholders perspectives of the delivered healthcare services, which can lead to missed opportunities for individuals with spinal cord injuries to live with an optimal quality of life and lowest impact on secondary complications such as pressure ulcer development.

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