Determination of knowledge, attitudes and obstacles of palliative care nurses towards preventing pressure ulcers

Palliative care patients are at high risk of developing pressure ulcers. Nursing care and the challenges encountered during this care have an important role in the prevention and management of pressure ulcers. This study was conducted to determine the knowledge, attitudes and barriers faced by palliative care nurses towards pressure ulcer prevention. The study was conducted between June 2023 and June 2024 as a descriptive mixed model design. The study included 156 nurses (quantitative: 142; qualitative: 14). Online questionnaire and in-depth individual interview methods were used in the study. Nurse Descriptive Characteristics Form, Modified Pieper Pressure Ulcer Knowledge Test, Attitude Scale for the Prevention of Pressure Ulcers, and Nurse Interview Forms were used to collect the data. Pearson and Spearman Correlation, Mann Whitney U, Anova, Kruskal Wallis and t tests were used to analyze quantitative data. Qualitative data were analyzed using thematic content analysis with Atlas.ti software. The relationships between themes were visualized with Sankey diagrams and co-occurrence matrices. In the quantitative part of the study, it was determined that 71.8% of the nurses were female, the duration of nursing service was 62.74±54.95 months and the duration of working in palliative care was 25.66±23.02 months.The pressure ulcer knowledge test (PUKT) score of the nurses was found to be 27.71±6.08. The knowledge test scores of the nurses who had male gender, used standard care protocol, read the quick reference guide, received training on pressure ulcers and read articles were found to be statistically significantly higher (p<0.05). The nurses' attitude scale score towards prevention of pressure ulcers (APUP) was found to be 43.11±4.76. The attitude scale scores of nurses who had a higher frequency of pressure ulcer encounters and number of dressings, who worked in a public hospital, and who read articles/publications were found to be statistically significantly higher (p<0.05). In the qualitative part of the study, 57.14% of the participating nurses were female and 85.71% were undergraduate graduates. The most common obstacles encountered by nurses were inadequate materials and personnel, lack of training, negative attitudes of patient relatives and difficulties arising from the patient's condition. In conclusion, it is of great importance to understand how nurses' knowledge and attitudes about pressure ulcer prevention, as well as the barriers they face, affect their efforts to prevent pressure ulcers. These barriers should be taken into consideration in interventions to improve nurses' knowledge and attitudes.