Pressure injuries in Indonesian community-dwelling older adults: Prevalence, prevention and treatment by the (in)formal support system

This dissertation focused on the pressure injury (PI) problem among community-dwelling older adults in Bandung, West Java province, Indonesia. Studies in this dissertation investigated the prevalence of PIs, family caregivers’ knowledge, attitude and practice, community nurses’ knowledge and attitude, and community nurses’ perception of barriers and potential facilitators in PI prevention. Pressure injuries appeared to be a serious problem among Indonesian community-dwelling older adults, proven by the fact that the prevalence rate was 11%. This dissertation also showed that community nurses and family members lack knowledge and practice on PI prevention and treatment. Furthermore, community nurses experience several barriers in performing PI care, such as a heavy workload, staff shortages, a shortage of resources and equipment and insufficient training. Therefore, solutions are needed to address the problems, including strengthening the role of formal (i.e. community nurses) and informal caregivers (i.e. family caregivers and health care volunteers), and strengthening national regulations that make PI prevention a priority.