Dr Maella-Rius’ research responds to the growing challenge of dependency-related skin injuries (DRSIs), a set of complex wounds including pressure injuries, shear injuries, moisture-associated skin damage, friction injuries, skin tears, and their combinations. These injuries represent a significant burden for patients, families, and healthcare systems, especially in community settings where continuity of care and prevention strategies are crucial. 

Through a multi-phase design guided by the integrative method—including a scoping review, qualitative studies with patients, caregivers, and nurses, and a theoretical synthesis—this thesis advances the conceptualisation DRSIs and lays the foundations for a situation-specific theory (SST). The SST defines dependency as a life condition, highlights the interplay between vulnerability and skin integrity, and introduces the concept of ‘parallel itineraries’ to reflect the dynamic and shared journey of patients, families, and professionals. 

Key contributions include the recognition of DRSIs as a distinct conceptual field in nursing; the integration of prevention, continuity, and community-based care as central dimensions; and the articulation of a theoretical model that can guide both practice and further research. 

Altogether, Dr Maella-Rius’ work contributes original knowledge to nursing science by connecting evidence, practice, and theory in the field of complex wound care. Her findings strengthen the foundations for patient-centred, preventive, and community-oriented approaches to skin injuries, offering a new perspective to support both clinical decision-making and policy development.