Caregiver Knowledge and Functional Status in Preventing Pressure Ulcers among Stroke Patients: A Cross-Sectional Study
DOI:
https://doi.org/10.55018/janh.v7i3.408Keywords:
Stroke, Pressure Ulcer, Caregivers, Functional Status, Nursing CareAbstract
Background: Stroke is a leading cause of death and disability, often reducing patients' quality of life and increasing caregiver burden. Immobility after stroke raises the risk of pressure ulcers, worsening outcomes, and prolonging hospital stays. Caregivers are crucial in prevention, as their knowledge and functional ability affect care effectiveness. However, few studies have explored the direct link between caregiver knowledge and functional status in pressure ulcer prevention, particularly in home or community settings. This study aims to examine that relationship.
Methods: This cross-sectional study (June–July 2025) in Indonesia involved 38 primary caregivers of stroke patients, selected via consecutive sampling. Eligible caregivers were ≥18 years old, had ≥1 month of caregiving experience, and consented; professional caregivers and those caring for acute-phase patients were excluded. Data were collected using bilingual questionnaires on caregiver knowledge (15 items, α = 0.739) and functional status (18 items, α = 0.878). Descriptive statistics summarized participant characteristics, and Pearson’s correlation analyzed the relationship between knowledge and functional status.
Results: Most caregivers were aged 46–55 (42.1%), female (76.3%), educated to junior/high school level (71.1%), and predominantly housewives (47.4%). A majority (76.3%) had no prior caregiving experience. The mean knowledge and functional status scores were 10.58 ± 1.605 and 61.95 ± 4.550, respectively. Pearson’s correlation revealed a strong, significant positive relationship between caregiver knowledge and functional status (r = 0.634; p < 0.001), suggesting that greater understanding of pressure ulcer prevention is associated with improved caregiving performance in stroke care.
Conclusion: Caregivers’ knowledge and functional status directly affect their effectiveness in stroke care. Better-informed caregivers more successfully prevent pressure ulcers, emphasizing the need for structured training programs that build skills and confidence, improve patient outcomes, and reduce complications.
Downloads
References
Afzali Borojeny, L., Albatineh, A. N., Hasanpour Dehkordi, A., & Ghanei Gheshlagh, R. (2020). The Incidence of Pressure Ulcers and its Associations in Different Wards of the Hospital: A Systematic Review and Meta-Analysis. International Journal of Preventive Medicine, 11(1). https://doi.org/10.4103/ijpvm.IJPVM_182_19
Alabdulhadi, A. A., Albrahim, M., Albshr, F. A., Al jaber, A. A., Al Sahaf, F. A., Aldrees, E. A., Althani, R. M., Alibrahem, T., & Alismail, A. N. (2024). Evaluating the Knowledge of Home Caregivers on Pressure Ulcer Signs and Prevention in Elderly Patients in Al Ahsa. Cureus, 16(11), e73199. https://doi.org/10.7759/cureus.73199
Amir, Y., Lohrmann, C., Halfens, R. J. G., & Schols, J. M. G. A. (2017). Pressure ulcers in four Indonesian hospitals: prevalence, patient characteristics, ulcer characteristics, prevention and treatment. International Wound Journal, 14(1). https://doi.org/10.1111/iwj.12580
Atiqoh M.N. (2017). Gambaran pengetahuan dan persepsi family caregiver tentang pencegahan dekubitus pada anggota keluarga yang berisiko dekubitus di wilayah kerja puskesmas pisangan dan Ciputat. http://repository.uinjkt.ac.id/dspace/handle/123456789/36397
Aulia Refriyani, P., Rahman, A., Erwin, T., Studi Keperawatan, P., Kesehatan, F., & Mitra Indonesia, U. (2025). Hubungan Tingkat Pengetahuan Keluarga Dengan Peran Kelurga Dalam Pencegahan Terjadinya Luka Tekan Pada Pasien Stroke Di Rsud Demang Sepulau Raya Kabupaten Lampung Tengah. In Jurnal Ilmu Kedokteran dan Kesehatan (Vol. 12, Issue 2). http://ejurnalmalahayati.ac.id/index.php/kesehatan
Bååth, C., Brent, L., Santy-Tomlinson, J., & Hommel, A. (2024). Pressure Ulcer Prevention. https://doi.org/10.1007/978-3-031-33484-9_9
Cejalvo, E., Martí-Vilar, M., Merino-Soto, C., & Aguirre-Morales, M. T. (2021). Caregiving role and psychosocial and individual factors: A systematic review. In Healthcare (Switzerland) (Vol. 9, Issue 12). https://doi.org/10.3390/healthcare9121690
Chen, Y., Cai, T., Le, P., Zhang, L., Chen, Y., Wu, L., Chen, K., Yuan, C., & Lu, Y. (2025). Family caregivers’ perceptions and challenges in the care of pressure injuries in daily life: a qualitative study. BMC Geriatrics, 25(1), 490. https://doi.org/10.1186/s12877-025-06114-1
Costa, A. da, Peristiwati, Y., Ellina, A. D., & Fajriah, A. S. (2022). LITERATURE REVIEW: FAMILY CARING METHOD TO PREVENT DECUBITUS IN STROKE PATIENTS. Journal of Public Health Research and Community Health Development, 6(1). https://doi.org/10.20473/jphrecode.v6i1.29534
Farzan, R., Yarali, M., Mollaei, A., Ghaderi, A., Takasi, P., Sarafi, M., Samidoust, P., Mahdiabadi, M. Z., Firooz, M., Hosseini, S. J., Vajargah, P. G., & Karkhah, S. (2023). A systematic review of caregivers’ knowledge and related factors towards pressure ulcer prevention. In International Wound Journal (Vol. 20, Issue 8). https://doi.org/10.1111/iwj.14168
Feigin, V. L., Brainin, M., Norrving, B., Martins, S., Sacco, R. L., Hacke, W., Fisher, M., Pandian, J., & Lindsay, P. (2021). International Journal of Stroke X(X)Editorial World Stroke Organization (WSO): Global Stroke Fact Sheet 2022 Waste Management & Research, 0(0). International Journal of Stroke, 17(1).
Hartati J. (2015). Hubungan Tingkat Pengetahuan dengan Perilaku Family Caregiver Dalam Merawat Penderita Paska Stroke di Rumah Tahun 2012. https://repository.uinjkt.ac.id/dspace/handle/123456789/25560
Jammal, M., Liu, K. P. Y., George, E. S., & Kolt, G. S. (2025). The impact of providing care for stroke survivors on caregiver health and wellbeing: Developing stronger support mechanisms. Disability and Health Journal, 101912. https://doi.org/https://doi.org/10.1016/j.dhjo.2025.101912
Kebijakan Pembangunan, B., Kementerian, K., & Ri, K. (2024). DALAM ANGKA TIM PENYUSUN SKI 2023 DALAM ANGKA KEMENTERIAN KESEHATAN REPUBLIK INDONESIA.
Lauritano, E. C., Sepe, F. N., Mascolo, M. C., Boverio, R., & Ruiz, L. (2022). Diagnosis and Acute Treatment of Ischemic Stroke. Reviews on Recent Clinical Trials, 17. https://doi.org/10.2174/1574887117666220617103114
Lee, J.-H., & Jung, M. (2023). Factors Influencing the Quality of Life of Family Caregivers of Stroke Patients: A Cross-Sectional Survey. Journal of Korean Academy of Fundamentals of Nursing. https://doi.org/10.7739/jkafn.2023.30.4.479
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(1). https://doi.org/10.1186/s12877-022-03702-3
Mervis, J. S., & Phillips, T. J. (2019). Pressure ulcers: Prevention and management. Journal of the American Academy of Dermatology, 81(4), 893–902. https://doi.org/https://doi.org/10.1016/j.jaad.2018.12.068
Murphy, S. J., & Werring, D. J. (2023). Stroke: causes and clinical features. In Medicine (United Kingdom) (Vol. 51, Issue 9). https://doi.org/10.1016/j.mpmed.2023.06.003
Platz, T. (2021). Clinical pathways in stroke rehabilitation: Evidence-based clinical practice recommendations. In Clinical Pathways in Stroke Rehabilitation: Evidence-based Clinical Practice Recommendations. https://doi.org/10.1007/978-3-030-58505-1
Roussou, E., Fasoi, G., Stavropoulou, A., Kelesi, M., Vasilopoulos, G., Gerogianni, G., & Alikari, V. (2023). Quality of life of patients with pressure ulcers: a systematic review. In Medicine and Pharmacy Reports (Vol. 96, Issue 2). https://doi.org/10.15386/mpr-2531
Sanjuán, M., Navarro, E., & Calero, M. D. (2023). Caregiver training: Evidence of its effectiveness for cognitive and functional improvement in older adults. Journal of Clinical Nursing, 32(5–6). https://doi.org/10.1111/jocn.16301
Sari, S. P., Everink, I. H. J., Lohrmann, C., Amir, Y., Sari, E. A., Halfens, R. J. G., & Schols, J. M. G. A. (2025). Knowledge, attitude and practice of family caregivers on pressure injury prevention for community-dwelling older adults: a cross-sectional study in an Indonesia City. BMC Nursing, 24(1), 24. https://doi.org/10.1186/s12912-024-02662-w
Sen, H., & Kilic, M. (2024). Determination of the family caregivers’level of knowledge on pressure injury prevention. Journal of Tissue Viability, 33(4), 625–630. https://doi.org/https://doi.org/10.1016/j.jtv.2024.06.003
Swanson, K. M. (2018). Empirical Development of a Middle Range Theory of Caring. In Caring in Nursing Classics. https://doi.org/10.1891/9780826171122.0013
Tarihoran, Y. (2023). Hubungan Pengetahuan Dan Peran Keluarga Terhadap Pencegahan Luka Dekubitus Pada Penderita Stroke Di Desa Bakaran Batu Tahun 2022.
Theng, B., Tran, J. T., Serag, H., Raji, M., Tzeng, H.-M., Shih, M., & Lee, W.-C. (Miso). (2023). Understanding Caregiver Challenges: A Comprehensive Exploration of Available Resources to Alleviate Caregiving Burdens. Cureus. https://doi.org/10.7759/cureus.43052
Tuncer, Ö., Yılmaz, M. B., & Mert, A. (2024). Effectiveness of a Training Program for the Prevention of Pressure Ulcers on Caregivers of Elderly Patients. Risk Management and Healthcare Policy, 17, 2717–2728. https://doi.org/10.2147/RMHP.S481204
Wang, T. J. (2004). Concept analysis of functional status. International Journal of Nursing Studies, 41(4). https://doi.org/10.1016/j.ijnurstu.2003.09.004
World Health Organization. (2021). Global health estimates: Life expectancy and leading causes of death and disability. https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates
Yang, K. L., Chen, L., Kang, Y. Y., Xing, L. N., Li, H. L., Cheng, P., & Song, Z. H. (2020). Identification of risk factors of developing pressure injuries among immobile patient, and a risk prediction model establishment: A protocol for systematic review. In Medicine (United States) (Vol. 99, Issue 52). https://doi.org/10.1097/MD.0000000000023640
Zaidi SRH, S. S. (2025, January). Pressure Ulcer. [Updated 2024 Jan 3]. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK553107/
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 chrisyen Damanik, Salwa Setya Anggun Pratama

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.














