City Research Online

Abstract

Aim
To explore barriers and enablers to providing pressure ulcer care experienced by family carers of older adults.

Design
Qualitative interview study informed by the Theoretical Domains Framework.

Methods
Semistructured interviews with a purposive sample of adult family carers of persons aged 65 years and above who had a Category 2 or above pressure ulcer. Participants were identified from district nursing caseloads in England. Data were analysed using the Framework Approach.

Results
Twenty-seven carers participated. Frequently performed pressure ulcer care behaviours included ensuring adequate nutrition and hydration; initiating, facilitating and coordinating professional care; managing incontinence/moisture; helping with repositioning and mobility; and keeping the wound clean/covered. Key influences on behaviour were reported in the domains of Knowledge, Environmental Context and Resources, Social/Professional Role and Identity, Beliefs about Consequences, Emotion and Beliefs about Capabilities and Skills. Carers recognised the importance of pressure ulcer care, felt committed to their relative’s welfare and saw the benefit of their input. Key barriers included a lack of information and training, difficulty accessing healthcare resources and the emotional impact of caregiving. Support from health professionals and from family and friends was an enabler of care.

Conclusion
Family carers play a significant role in pressure ulcer care but face challenges in doing so. We highlight the complexity of tasks they perform and identify a broad range of barriers and enablers to pressure ulcer care.

Publication Type:	Article
Additional Information:	Copyright © 2026 Shashivadan P. Hirani et al. Health & Social Care in the Community published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Publisher Keywords:	aged, barriers, community health nursing, enablers, family carer, interview, pressure injuries, pressure ulcers, qualitative research, theoretical domains framework, 1117 Public Health and Health Services, 1607 Social Work, Nursing, 4203 Health services and systems, 4206 Public health, 4409 Social work
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments:	School of Health & Medical Sciences School of Health & Medical Sciences > Department of Population Health & Policy
SWORD Depositor:	Symplectic Administrator

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