Factors influencing Patient engagement in preventing pressure injuries: A cross-sectional study in Orthopedic inpatients

Aim

This study aimed to explore the level of patients’ engagement behaviours in preventing pressure injury (PI) and the influencing factors related to it.

Background

The importance of “Patient and Family Engagement” was recognized as one of the key components in the outline of the 2023 Global Patient Safety Report. PIs were common and concerning patient safety events in Orthopaedics department. Active patient participation behaviour can effectively prevent the occurrence of PIs.

Method

This was a cross-sectional study involving 366 participants from Orthopaedics in China who has high level of risk in PI. The behavioural level of patients' participation in PI prevention was measured using a research tool designed by the research team. Based on the theory of planned behaviour, the possible influencing factors were determined, and the corresponding research tools were selected for evaluation. Univariate analysis, correlation analysis and multiple stepwise regression were used to determine the influencing factors of patients’ participation behaviour with SPSS 25.0.

Results

The total score of orthopaedic inpatients participating in PI preventive behaviour was 89.45 ± 10.64, with a scoring rate of 85.19 % (actual score/maximum possible score × 100 %), indicating relatively high adherence. Multiple regression analysis revealed that social support showed the strongest positive association (β = 0.291, P < 0.001), suggesting enhanced support networks facilitate engagement. Participation attitude (β = 0.211, P < 0.001) and health literacy (β = 0.233, P < 0.001) were key cognitive facilitators. Unexpectedly, cohabitation with children exhibited negative correlation (β = −0.141, P = 0.001), potentially indicating caregiving role transfer. Inter-hospital transfers (β = −0.120, P = 0.004) and medium-length stays (4–7 days, β = −0.089, P = 0.010) were inversely related, possibly reflecting care continuity challenges. Social Security recipients demonstrated greater participation (β = 0.108, P = 0.009), highlighting socioeconomic influences.

Conclusion

Our findings may guide clinical healthcare providers to develop more targeted interventions to promote patient engagement in self-care, including encouraging family members to involve in PI prevention with patients, improving patients’ attitude of participation, and supporting more health education of PI prevention. It was a potential suggestion for patient participation behaviour in medical services to prevent other types of adverse events as well.