Determinant Factors of Self‐Care Deficit in People With Chronic Wounds: A Scoping Review

ABSTRACT

Aims

To identify and synthesise the scientific evidence on determinants of self-care deficits in people with chronic wounds.

Design

Scoping review based on the Joanna Briggs Institute guidelines.

Methods

This scoping review was conducted by a review team responsible for study screening, data extraction and synthesis. The categorisation of findings was grounded in Orem's Self-Care Deficit Theory and operationalised using the COM-B model and the Theoretical Domains Framework.

Data Sources

A comprehensive search, without date or language restrictions, was conducted in Web of Science, MEDLINE (PubMed), Cochrane Library, Scopus (Elsevier), SciELO, Ovid and EMBASE (Elsevier), from November 2023 to April 2024.

Results

Of the 3076 records identified, 22 studies were included. Most were cross-sectional studies, with sample sizes ranging from seven to 1085 participants and a mean age of 61.45 years, predominantly involving people with venous leg ulcers and diabetic foot ulcers. Findings were synthesised into four categories: clinical, socioeconomic, behavioural and health system-related factors, indicating that multiple interrelated determinants influence engagement in self-care and contribute to persistent self-care deficits.

Conclusion

The findings demonstrate the vulnerability of people living with chronic wounds, arising from the complex interaction of clinical, psychosocial, socioeconomic and health service-related factors that determine self-care deficits. These deficits compromise wound healing, prolong treatment and negatively affect quality of life, underscoring the need for person-centred approaches to care.

Implications for the Profession and/or Patient Care

This study reinforces the need for integrated and sustainable models of care grounded in person-centred practice, aimed at strengthening self-care capacities, enhancing clinical practice and informing more equitable health policies.

Impact

This review highlights the multifactorial nature of self-care deficits in people with chronic wounds. Nursing plays a key role in identifying barriers and strengthening capacities through Orem's supportive–educative system. Person-centred interventions improve adherence and continuity of care.

Reporting Method

This review follows the PRISMA guidelines for reporting.

Patient or Public Contribution

This study did not include patient or public involvement in its design, conduct, or reporting.