Impact of pressure ulcer prevention knowledge and attitude on the care performance of long-term care facility care workers: a cross-sectional multicenter study

Background: The Long-Term Care Insurance Act in the Republic of Korea has enabled the elderly population to receive benefits through the long-term care system since July 2008. Because one nurse or nursing assistant is assigned to 25 elderly persons and one care worker is assigned to 2.5 elderly persons in long-term care facilities, registered nurses should educate care workers to participate in pressure ulcer prevention activities. This descriptive study investigated the effect of the knowledge and attitude related to pressure ulcer prevention on care performance. Methods: Data were collected from February 20 to December 15, 2021 using a structured questionnaire targeting 165 care workers in four long-term care facilities located in I-city and Y-gun, Gyeongsangbuk-do. The questionnaires of the knowledge, attitude, and care performance developed for nurses were modified to survey the care workers. The content validity was verified on a 4-point scale by 10 clinical experts. A preliminary survey was conducted for 30 care workers, and the contents of the modified questionnaire were further revised. Data analyses were performed by t-test, one-way ANOVA, Scheffe test, Pearson's correlation coefficient, and a multiple linear regression modeling using the SPSS/WIN 25.0 program. Results: Care performance on pressure ulcer prevention had a significant positive correlation with knowledge (r = 0.692, p < .001), attitude (r = 0.426, p < .001), work experience (r = 0.760, p < .001), amount of experience (r = 0.712, p < .001), and the number of training sessions received (r = 0.551, p < .001). In multiple regression modeling, work experience (beta [standardized coefficient beta] = 0.534, p = .000), knowledge (beta = 0.323, p = .000), and attitude (beta = 0.103, p = .049) related to pressure ulcer prevention were identified as variables significantly affecting care performance. The regression model explained 65.4% with 5 independent variables. Conclusion: To prevent bedsores in long-term care facilities, it is necessary to educate care workers regularly about pressure ulcer prevention. In addition, clinical guidelines could help standardize the pressure ulcer prevention work of caregivers, strongly regulating their practice in all long-term care facilities and monitoring bedsore prevention regularly.