The Effect of Pressure Ulcer Management Program Applied With Jigsaw Technique

NCT06899282 | Completed

• 1 other identifier: 2025/03-13
• Study Type: interventional
• Target: 62
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to evaluate the effectiveness of the jigsaw method on pressure ulcer prevention in senior nursing students. In addition, the study will also examine student views on the jigsaw technique. Hypotheses of the study are as follows: Hypothesis 1: The pressure injury management program applied with the Jigsaw technique has an effect on the pressure ulcer knowledge scores of nursing students. Hypothesis 2: The pressure injury management program applied with the Jigsaw technique has an effect on the pressure ulcer prevention attitude of nursing students. Hypothesis 3: The pressure injury management program applied with the Jigsaw technique has an effect on nursing students' pressure ulcer management self-efficacy. The participant characteristics were being a 4th grade student of Kütahya University of Health Sciences, Faculty of Health Sciences, Department of Nursing and being enrolled in the Basic Principles and Practices in Nursing Practices Course. Nursing students who did not volunteer to participate in the study, those who did not participate in theoretical and clinical practices during the academic semester, and nursing students working as high school graduate nurses due to their past education will be excluded from the study. Intervention and measurements: Participants (N=70) will be randomly divided into intervention and control groups. The intervention group will study pressure ulcer management with the jigsaw technique. The control group will receive theoretical education with the traditional method. Students' pressure ulcer knowledge, attitude and self-efficacy levels will be assessed with standardized tools. Baseline assessment before the intervention, post-intervention and 6 weeks after the intervention will be done. Measurements will be made by students through self-reporting. However, a researcher blinded to the groups will administer the instruments and enter data. Data analysis will also be done by the researcher blinded to the groups. Thus, double blindness will be ensured. Statistical analysis will be based on significance tests.

Conditions

Pressure Ulcers; Nursing Students; Training Effectiveness; Randomized Controlled Trial

Keywords

jigsaw technique; nursing student; training effectiveness; randomized controlled trial; pressure ulcers

Outcome Measures

Primary Outcomes (3)

• Pressure Ulcer Knowledge Assessment Tool-Updated Version

  Pressure Ulcer Knowledge Assessment Tool-Updated is a tool that measures nurses' knowledge about pressure ulcers within the framework of evidence-based guidelines.It consists of 25 multiple-choice questions on six themes: Etiology, Classification and Observation, Risk Assessment, Nutrition, Prevention of Pressure Ulcers and Specific Patient Groups. In scoring, 1 point is given for each correct answer and 0 points for incorrect and "Don't know" answers. The total score ranges from 0 to 25. Cronbach's alpha value is 0.72.

  Baseline (Time 0), After 4 hours (Time 1), After 6 weeks (Time 2)

• Pressure Ulcer Prevention Attitude Scale

  Pressure Ulcer Prevention Attitude Scale The scale aims to assess attitudes towards pressure ulcer prevention. It consists of 13 items and 5 subscales including personal competence to prevent pressure ulcers (3 items), priority of pressure ulcer prevention (3 items), impact of pressure ulcers (3 items), personal responsibility in pressure ulcer prevention (2 items) and confidence in the effectiveness of prevention (2 items). Seven items (items 3, 5, 7, 8, 9, 10 and 13) are reverse scored as they are negative. The items are scored on a 4-point Likert scale (1 = strongly disagree, 4 = strongly agree) and score between 13 and 52 points. A higher score is interpreted as a more positive attitude. The Cronbach's alpha values of the original scale and the Turkish adaptation study are 0.79 and 0.71, respectively.

  Baseline (Time 0), After 4 hours (Time 1), After 6 weeks (Time 2)

• Pressure Ulcer Management Self-Efficacy Scale for Nurses

  The scale measures nurses' self-efficacy in managing pressure ulcers. The scale consists of a total of 10 items and four main subscales: Assessment, Planning, Supervision and Decision Making. Each item is scored from 1 (not at all competent) to 5 (completely competent). The scale does not include reverse items. The total score range is 0-100. The level of self-efficacy increases with the total score. The Cronbach Alpha value of the scale is 0.83.

  Baseline (Time 0), After 4 hours (Time 1), After 6 weeks (Time 2)

Other Outcomes (1)

• Jigsaw Opinion Scale

  After training (only intervention group after jigsaw technique)

Study Arms (2)

Intervention group: The group to be taught with jigsaw technique.

EXPERIMENTAL

Intervention Group: The lecture on pressure ulcer prevention and management to the intervention group will be conducted with the jigsaw technique. Pressure ulcer knowledge, attitude and prevention self-efficacy will be evaluated with standardized tools before, after the theoretical training and at the end of clinical practice. In addition, a standard student opinion questionnaire regarding the method will be applied.

Behavioral: Jigsaw method

Control Group: This is the group that will receive theoretical training with the traditional method.

ACTIVE COMPARATOR

Control group: Control group students will receive theoretical training prepared by the researchers. Pressure ulcer knowledge, attitude and prevention self-efficacy will be evaluated with standardized tools before, after the theoretical training and at the end of clinical practice.

Behavioral: The theoretical training

Interventions

Jigsaw method BEHAVIORAL

Jigsaw/puzzle method is one of the collaborative learning techniques. The Jigsaw technique requires each student to focus on a particular aspect of the topic, become an "expert" on that topic and teach it to their peers. Once the students have learned the topic in their expert group, they return to the original group and teach what they have learned back to them as if solving a jigsaw puzzle (Geiselman et al., 2024). For the application of the technique, the "Jigsaw Technique Application Directive" was prepared as a training material to be delivered to the students.

Intervention group: The group to be taught with jigsaw technique.

The theoretical training BEHAVIORAL

The theoretical training will be conducted in 2 sessions. The first session will cover the definition, prevalence and importance of pressure ulcers, etiology and classification, risk assessment and pressure ulcers in special patient groups. The second session will cover prevention and treatment of pressure ulcers.

Control Group: This is the group that will receive theoretical training with the traditional method.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• To be a 4th year student of the Department of Nursing, Faculty of Health Sciences, Kütahya University of Health Sciences
• To be enrolled in the Basic Principles and Practices in Nursing Course

You may not qualify if:

• Nursing students who did not volunteer to participate in the study
• Not participating in theoretical and clinical practices during the academic semester
• Graduated from health vocational high school and working with the title of nurse

Sponsors & Collaborators

• Kutahya Health Sciences University: lead

Study Sites (1)

Kütahya Health Science Univercity

Kütahya, Kütahya, 4300, Turkey (Türkiye)

Location

Related Publications (4)

• Turhan Damar H, Erkin O. The effect of case-supported concept map education on nursing students' knowledge of and attitudes toward pressure injury prevention. J Tissue Viability. 2025 Feb;34(1):100848. doi: 10.1016/j.jtv.2024.12.012. Epub 2024 Dec 9.

  PMID: 39665940 BACKGROUND

• Ozkan S, Uslusoy ECN. Outcomes of jigsaw technique in nurse education: A systematic review and meta-analysis. Nurse Educ Pract. 2024 Feb;75:103902. doi: 10.1016/j.nepr.2024.103902. Epub 2024 Jan 20.

  PMID: 38301377 BACKGROUND

• Dalli OE, Yildirim Y, Caliskan G, Girgin NK. Reliability and validity of the Turkish version of pressure ulcer knowledge assessment tool-updated version (PUKAT 2.0). J Tissue Viability. 2022 Feb;31(1):52-57. doi: 10.1016/j.jtv.2021.08.001. Epub 2021 Aug 11.

  PMID: 34429220 BACKGROUND

• Iseri O, Ursavas FE. The influence of the online education provided using the six thinking hat method on the knowledge and attitudes of nursing students regarding pressure injury prevention; a pilot study. J Tissue Viability. 2024 Aug;33(3):465-471. doi: 10.1016/j.jtv.2024.04.009. Epub 2024 Apr 16.

  PMID: 38679544 BACKGROUND

MeSH Terms

Conditions

Pressure Ulcer

Condition Hierarchy (Ancestors)

Skin Ulcer; Skin Diseases; Skin and Connective Tissue Diseases

Study Officials

• Necibe Dağcan Şahin, Asst. Prof.

  Kutahya Health Science University

  STUDY CHAIR

• Ferzan Kalaycı Emek, RA

  Kutahya Health Science University

  STUDY CHAIR

• Burcu Nal, Asst. Prof.

  Kutahya Health Science University

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: March 17, 2025
• First Posted: March 27, 2025
• Study Start: April 11, 2025
• Primary Completion: June 6, 2025
• Study Completion: June 6, 2025
• Last Updated: September 3, 2025

Record last verified: 2025-08

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)