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Pressure injury (PI) is a remarkable problem among patients following stroke. The Neuman System Theory can be applied by nurses to manage PI in patients following stroke. The emphasis of this theory on prevention levels, especially primary and tertiary prevention, has made it compatible with standard PI guidelines.
Stroke was the cause of nearly 12% of deaths in the world in 2015. It is not only the second leading cause of death after cardiovascular diseases, but also the most common cause of disability in the United States (Benjamin et al., 2018). Studies in Iran, mostly conducted locally, also have found a high prevalence (Bahonar et al., 2017; Mohamadi et al., 2017; Saber et al., 2017). Of all patients discharged after stroke, 45% are moved directly to their homes and receive homebased care, 24% are referred to outpatient rehabilitation centers, and 31% are referred to specialized centers providing medical and nursing services (Aslani et al., 2016).
A common complication of stroke is the occurrence of pressure injury (PI) (Chitambira & Evans, 2018; Schott et al., 2018). The National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, and Pan Pacific Pressure Injury Alliance (2014) described PI (previously known as pressure ulcer, bedsore, or decubitus ulcer) as "a localized injury to the skin and/or underlying tissue, usually over a bony prominence, resulting from sustained pressure" (p. 19). PI can be described in six stages (see Table 1).
Although the attention to PI has increased in recent years, this clinical problem remains a major challenge for hospitals around the world (Zeb et al., 2015). PI can lead to further health concerns for affected patients. For example, patients with PI usually experience persistent pain. The occurrence of PI also reduces patient independence, negatively impacts patient privacy and dignity, and reduces the ability and willingness to engage in social activities (Jackson et al., 2018). Associated complications ultimately can affect the patient's quality of life (Young et al., 2018).
Ideally, nursing practice should be based on nursing theories (Alejandro, 2017). Betty Neuman System Theory is an appropriate theory for use in patients with chronic diseases, including patients who have experienced a stroke. Application of this theory encourages nurses in their provision of holistic patient care (Sultan, 2018). This theory emphasizes...