Patient-Reported Outcome and Experience Measures (PROMs and PREMs) in Pressure Injury Prevention and Care Across European Hospital and Community Nursing Settings: A Scoping Review

Pressure injuries are a frequent and largely preventable adverse event across the whole care continuum, from intensive and acute hospital wards to community and home settings. Internationally, they are graded with the objective European Pressure Ulcer Advisory Panel and National Pressure Injury Advisory Panel (EPUAP/NPIAP) staging system. Staging describes the tissue rather than the person. How patients experience each stage is captured by patient-reported outcome measures (PROMs), and how they experience prevention is captured by patient-reported experience measures (PREMs). Both may be recorded inconsistently and remain disconnected from the objective stage. Prevention and care are increasingly delivered by community and family nurses, yet the patient-reported axis in these settings, and in the newly established community hospitals and community houses, remains under-mapped. This scoping review maps which PROMs and PREMs have been used for pressure injury prevention and care across European hospital and community nursing settings. It identifies which domains are captured at each EPUAP/NPIAP stage and during prevention, characterises the role of the community and family nurse and examines where dedicated protocols may be absent in community hospitals and community houses. The review was conducted following the updated Joanna Briggs Institute (JBI) methodology and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Three databases, namely, PubMed, Scopus and the Cumulative Index to Nursing and Allied Health Literature (CINAHL), were searched within a Population, Concept, Context (PCC) framework. The searches yielded 891 records; after de-duplication, 666 records were screened, and 29 sources were included, of which 25 were conducted in European settings and 2 in Turkey, and 2 were multinational reviews. The instruments identified were the generic EuroQol five-dimension (EQ-5D) and 36-Item Short Form (SF-36) health surveys and the pressure ulcer-specific Pressure Ulcer Quality of Life (PU-QOL) and Wound Quality of Life (Wound-QoL) measures, together with the Quality from the Patient's Perspective (QPP) experience measure and qualitative interviews. The domains captured were pain, mobility and function, sleep, exudate and odour, dignity, psychological impact and health-related quality of life, alongside the experience domains of involvement, communication, continuity and satisfaction. Evidence was concentrated in the United Kingdom, Nordic countries, Switzerland, Spain and Italy, and community and district nursing were well represented. Across these settings, the patient-reported axis was captured with a small and heterogeneous set of instruments and qualitative methods, and it was rarely linked to a specific EPUAP/NPIAP stage. No included source addressed the Italian community hospitals or community houses, and dedicated pressure injury protocols with standardised patient-reported measurement in these new intermediate care structures were not described. Stage-aware PROM and PREM instruments validated for critically ill and proxy respondents and for community use emerge as a priority for future work.