Controlling the pressure : an investigation of knowledge, locus of control, and value of pressure sore prevention in relation to prevalence
This is a quantitative and correlational analysis of how staff perceptions of locus of control of pressure sore prevention relate to knowledge and prevalence rates of pressure sores. Reference is made to value of pressure sore prevention. The survey population consisted of nursing and assistant nursing staff in both hospital and community settings of a rural Health Service Trust. Surveys were performed of: prevalence of sores; equipment for pressure relief; knowledge and opinions of aetiology, recommended use of equipment, and risk assessment. A scale was constucted to measure locus of control of life, health, and pressure sore prevention. The hypothesis that higher belief in personal control of pressure sore prevention would be correlated with higher knowledge of the subject, and lower prevalence rates, was not upheld. It is concluded that there are associations between prevalence, knowledge levels, value of pressure sore prevention, and locus of control. Significant differences exist between community and hospital staff, and between trained and support staff. Spearman correlations and Mann-Whitney tests were mainly used. Knowledge and equipment levels were considered satisfactory for adequate preventive measures to be taken. Key personnel, such as Sisters, were significantly associated with prevalence, in that the more they believed they controlled pressure sore prevention, the higher the prevalence rate. This has been explained using typology in terms of the priority and importance they attach to pressure sore prevention relative to other demands. Higher belief that fate controls pressure sore prevention also correlates with lower prevalence rates, perhaps because more effort is invested in trying to stave off the presumed inevitable. Domain-specific beliefs may be less important to prevention than generalized beliefs about control. Recommendations include the following: that methodology is replicated and refined; that the value of pressure sore prevention needs raising; that organisational lines of control need to be clear. Certain types of attitudes amongst staff may be unhelpful in a broader range of conditions and outcomes. Selection processes for nurses should take attitudes and beliefs into account, and there may be an need to change control expectations of groups of personnel.
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