Primary home caregiver training and pressure injury prevention knowledge after patient discharge from a Level 5 Hospital in Kenya

Stanley Kiarie Njau, Lucy Kawira Gitonga, Anna Kagure Karani, Henry M Nyamu



Pressure injuries are wounds on the skin, after hours of sitting, or lying in the same position. The global incidence of home acquired pressure injuries could be as high as 80%, yet home caregivers’ pressure injury prevention knowledge is not clearly known. The specific objectives of this study were to assess the socio-demographic characteristics of primary home care givers, and patients at risk of pressure injuries, and to evaluate the effect of primary home caregiver training, on pressure injury prevention knowledge, after their bedridden patients were discharged from hospital.


This was part of a randomized controlled trial, whose broad objective was to assess the impact of a home caregiver training program, on prevention of pressure injuries among patients discharged from Embu Level Five Teaching and Referral Hospital, Kenya. The overall sample size was 34 primary home caregivers whereby, 17 of them were randomly assigned into experimental group, and 17 were assigned into the control group. Research permit was obtained from NACOSTI (Licence No: NACOSTI/P/22/21760). Data was collected using a researcher administered questionnaire, developed based on national and international pressure injury prevention guidelines. The pre training and post training pressure injury prevention knowledge mean scores, in the experimental group, were compared.  Data was analyzed using SPSS version 27.


Majority (88.2%) of the primary home caregivers were female, with a mean age of 37.06±11.5SD years, while majority of the patients (76.5%) were female, with a mean age of 78.4±18.7 years. The pre training pressure injury prevention knowledge mean score was 11.11±11.11SD, while the post training pressure injury prevention knowledge mean score was 37.3±10.4. These two knowledge mean scores were significantly different, at 95% confidence level (t=10.376, df=16, p<0.001).

Conclusions and recommendations

Most of the primary home care givers were youthful females, while most of the patients were old females. Primary home caregiver training significantly improved the knowledge on pressure injury prevention, and more resources should be geared towards capacity building of these primary home caregivers, in readiness for home based care of patients at risk of pressure injuries.




Home caregiver, training, pressure injury, prevention, knowledge, patient

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Chan, Y. (2003). Randomized Controlled Trials (RCTs)-Sample Size: The Magic Number? Singapore Medical Journal, 44(4), 172–174.

Chen, H.-L., Cai, J.-Y., Du, L., Shen, H.-W., Yu, H.-R., Song, Y.-P., & Zha, M.-L. (2020). Incidence of Pressure Injury in Individuals With Spinal Cord Injury: A Systematic Review and Meta-analysis. Journal of Wound Ostomy Continence Nursing, 47(3), 215–223.

Chong, C. (2017). Pressure ulcer prevention & management: Evaluation of a home-based education program for caregivers of elderly: A pilot study. Presentation F8.1. HA Convention.

Eljedi, A., El-Daharja, T., & Dukhan, N. (2015). Effect of an educational program on a family caregiver’s prevention and management of pressure ulcers in bedridden patients after discharge from hospitals in Palestine. International Journal of Medical Science and Public Health, 4(5), 600–606.

García-Sánchez, F. J., Martínez-Vizcaíno, V., & Rodríguez-Martín, B. (2019). Barriers and facilitators for caregiver involvement in the home care of people with pressure injuries: A qualitative study. Plos One, 14(12), 1–13. 10.1371/journal.pone.0226359

Getanda, A., Chirchir, V., Omune, F., Tanui, C., Kosgei, A., & Ayumba, R. (2016). Awareness of Risk Assessment and Prevention of Pressure Ulcers amongst Nurses Working in Surgical and Orthopedic Wards of a Kenyan National Hospital. Kenyan Journal of Nursing and Midwifery, 1(1), 1–10.

Hinkle, J., & Cheever, K. (2017). Textbook of Medical Surgical Nursing (13th Edition). Lippincott Williams and Wilkins.

Hossein, R., Zohreh, V., Mohammadi, E., & Hosseinzadeh, K. (2021). The Role of Family Caregivers in Pressure Injury Prevention Guidelines: A Scoping Review. Home Healthcare Now, 39(5).

Jaul, E., Barron, J., Rosenzweig, J., & Menczel, J. (2018). An overview of co-morbidities and the development of pressure ulcers among older adults. BMC Geriatrics, 18(1), 305.

Karimi, F., Yaghoubinia, F., Keykhah, A., & Askari, H. (2018). Investigating the Effect of Home-Based Training for Family Caregivers on the Incidence of Bedsore in Patients with Stroke in Ali Ebne Abitaleb Hospital, Zahedan, Iran: A Clinical Trial Study. Medical Surgical Nursing Journal, 7(3).

Kaur, S., Singh, A., & Kaur, T. (2018). Comparison of Two Intervention Strategies on Prevention of Bedsores among the Bedridden Patients: A Quasi Experimental Community-based Trial. Indian Journal of Palliative Care, 24(1), 28–34.

Lee, S.-B., & Lee, H.-Y. (2022). Impact of pressure ulcer prevention knowledge and attitude on the care performance of long‑term care facility care workers: A cross‑sectional multicenter study. BMC Geriatrics, 22(988), 1–12.

Matos, S., Dinizz, I., Lucena, A., Andrade, S., Brito, K., Aguiar, E., Santana, E., Sousa, M., Souza, A., Coelho, H., Silva, M., & Costa, M. (2017). Pressure Ulcers in Institutionalized Elderly People: Association of Sociodemographic and Clinical Characteristics and Risk Factors. Open Journal of Nursing, 7(1), 111–122.

Nangole, F. (2010). Pressure ulcers presentations and management at Kenyatta National Hospital and Spinal Injury Hospital. East African Medical Journal, 12.

NPUAP, EPUAP, & PPPIA. (2019). Prevention and Treatment of Pressure Ulcers: Quick Reference Guide.

Padula, W. V., & Delarmente, B. A. (2019). The national cost of hospital-acquired pressure injuries in the United States. International Wound Journal, 16(3), 634–640.

Taber, K. (2018). The Use of Cronbach’s Alpha When Developing and Reporting Research Instruments in Science Education. Research in Science Education, 48(1), 1273–1296.

Tharu, N., Alam, M., Bajracharya, S., & Kabir, M. (2018). Knowledge, Attitude and Practice Among Caregivers Towards Pressure Ulcer in Spinal Cord Injury at Rehabilitation Center in Bangladesh [The Hong Kong Polytechnic University].


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