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Original article

Vol. 149 No. 2526 (2019)

Challenges to building and maintaining partnership in the prevention and treatment of pressure injuries in spinal cord injury: a qualitative study of health professionals’ views

  • Claudia Zanini
  • Sara Rubinelli
  • Nadia Lustenberger
  • Hans Georg Koch
  • Anke Scheel-Sailer
  • Mirjam Brach
Cite this as:
Swiss Med Wkly. 2019;149:w20086



The effective management of spinal cord injury (SCI) requires partnership between people with SCI and health professionals (HPs). This paper identifies HPs’ perceived challenges in building and maintaining this partnership, with a specific focus on how people with SCI and HPs collaborate in the prevention and treatment of pressure injuries in SCI.


This study has a qualitative and explorative design. Data were collected through semi-structured interviews and analysed following the principles of thematic analysis.


The study population consisted of a purposive sample of HPs (n = 26) working in inpatient and outpatient care in Switzerland with experience in the care of people with SCI.


The analysis identified three main challenges: defining responsibilities and expectations, negotiating priorities and establishing and strengthening trust and respect. The HPs argue that the prevention of pressure injuries and self-management are mainly the responsibility of the person with SCI. The HPs have, however, the responsibility to empower, guide, and support persons with SCI in self-management by educating and motivating them.


Building and maintaining a partnership with individuals with SCI to prevent and treat pressure injuries is crucial, but it is not an easy task for HPs. Specific communication skills can help HPs and patients find personalised solutions that take into account the patients’ expertise and preferences. Additionally, the healthcare system must develop solutions that go beyond personal partnership to better integrate the prevention and treatment of pressure injuries into the lifelong self-management of SCI. Assistive technologies, such as mobile technology, might help in this endeavour.


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