Compliance with pressure ulcer prevention measures in older adults, according to Dorothea Orem’s Theory

Abstract

Pressure ulcers are a frequent complication in older adults, especially in those with reduced mobility and chronic diseases. These injuries affect quality of life, increase the risk of complications, prolong hospital stays, and raise healthcare costs. Additionally, they are considered an indicator of the quality of nursing care; therefore, their prevention remains a challenge in hospitals and long-term care institutions. The objective of this study was to analyze compliance with pressure ulcer prevention measures in older adults, based on Dorothea Orem’s self-care theory. A qualitative systematic review of scientific literature published between 2020 and 2025 was conducted. The search was carried out in Google Scholar, PubMed, SciELO, Redalyc, Scopus, and Medline. The selection process followed PRISMA guidelines, identifying 20 studies for analysis. The results showed that non-compliance with preventive measures was associated with intrinsic factors (advanced age, immobility, malnutrition, and cognitive impairment) and extrinsic factors (institutional deficiencies, workload overload, and limited training). The most effective interventions included risk assessment using tools such as the Braden and Norton scales, scheduled repositioning, comprehensive skin care, nutritional support, and caregiver education. From Orem’s perspective, patients presented a self-care deficit, requiring compensatory and supportive-educative nursing systems. It is concluded that the comprehensive implementation of these measures reduces the incidence of pressure ulcers and improves the quality of care in this vulnerable population.