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題 名 | 長期照護機構褥瘡住民使用新型褥瘡墊效果之研究=Effect of Newly Designed Antidecubitus Mattress on Long-Term Care Residents with Pressure Sore |
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作 者 | 歐玲君; 吳幸娟; 柯俊宏; 張尹凡; 梁富文; 張秦松; 莊華盈; 吳至行; | 書刊名 | 臺灣老年醫學暨老年學雜誌 |
卷 期 | 14:1 2019.02[民108.02] |
頁 次 | 頁16-30 |
分類號 | 419.71 |
關鍵詞 | 褥瘡; 減壓墊; 壓力重新分布; 機構; 長期照護; Pressure sore; Mattress; Pressure redistribution; Institution; Long-term care; |
語 文 | 中文(Chinese) |
中文摘要 | 目的:長照機構患者於當營養狀況不佳或是失能臥床都是褥瘡高危險族群,骨頭凸出處或較長時間壓迫的部位是好發處。適當的減壓墊製造壓力源的重新分佈策略可以有預防效果,除了減少住院天數,也減少醫療花費。然而,褥瘡墊仍有清洗不便、價位較高以及成效不滿意等實用方面的問題,因此本研究將評估一種新型褥瘡墊於改善長照機構褥瘡患者的療效。方法:本研究採交叉研究設計。經立意取樣後,共收案21位具32處依據歐洲褥瘡諮議委員會(EPUAP)分類為第一級到第三級褥瘡但營養狀況穩定並在收案前三個月內無住院病史的長照機構住民(平均年齡為82.6±8.7歲;女:男=10:11)。依據機構駐所分組為實驗組A組(褥瘡個數為19處,該組先使用得禎®新型褥瘡墊)與對照組B組(褥瘡個數為13處,該組先未使用減壓墊者)。A組與B組持續15日後,在第15日評估傷口變化後隨即將實驗組與對照組互換並再持續15日至第30天。褥瘡癒合情形由受訓良好之評估員以褥瘡癒合分數(PUSH)每次間隔三日定期評估。統計分析以第17版SPSS無母數雙樣本中位數差異檢定分析傷口癒合分數變化,以p<0.05定義為具統計意義。結果:A組(n=19)在第0天、第15天及第30天的PUSH分數分別是9.2±2.3,7.7±3.6及6.2±4.0。B組的PUSH分數則分別是8.4±2.2,7.9±3.5及7.8±3.0。經過差異檢定後發現A組在第0天到第15天、第16天到第30天及第0天到第30天均可看到有統計意義的改善(依序分別為p<0.05;p<0.01;p<0.01),而B組則未達統計意義的改善。將兩組於第15天交叉前後的資料合併之後分析,發現PUSH分數於有使用新型褥瘡墊組(32處;介入前=8.7±2.9;介入後=7.7±3.3,p<0.05)及無使用新型褥瘡墊組(32處;介入前=8.0±3.1,介入後=6.9±3.9,p<0.05),都有統計意義的改善效果。結論:照顧長期照護機構住民時,如能在褥瘡發現時早期且適當使用此新型褥瘡墊,將有助改善褥瘡癒合情形。 |
英文摘要 | Objectives: Long-term care residents with malnutrition or bedriddenness are highly susceptible to pressure sores, especially those in protruding bony or compressed areas. A quality antidecubitus mattress may help redistribute the pressure for preventing or improving pressure sore. However, inconvenience in cleaning, relatively high cost, and unsatisfactory effectiveness of available mattresses indicate an unmet need for antidecubitus mattress for different severities of pressure sore. The study analyzed the effectiveness of a newly designed antidecubitus mattress for long-term care residents with pressure sore Methods: A Adopting a crossover design, the study enrolled 21 subjects (mean age=82.6±8.7 y/o, M/F=10/11) with 32 pressure sores (Grades 1 to 3 by 2016 European Pressure Sore Advisory Panel, EPUAP) and stable nutritional status but without hospital admission in the past 3 months through purposive sampling. Subjects were dichotomized conveniently into Group A members (19 pressure sores) provided with Der Zeng® mattress for the first 15 days (D0 to D15) and Group B members (13 pressure sores) provided with no mattress for the same period. A crossover intervention was applied from D16 to D30 for both groups. The healing effectiveness of the mattress on pressure sore was evaluated per 3 days by well-trained staff using the Pressure Sore Scale for Healing (PUSH) score. The Wilcoxon signed rank test by SPSS 17^(th) edition was used for statistical analysis and the statistical difference was defined at a p value lower than 0.05. Results: The PUSH scores at D0, D15, and D30 for Group A members with mattress provided first were 9.2±2.3, 7.7±3.6 and 6.2±4.0, respectively. Those for Group B members provided with no mattress first were 8.4±2.2, 7.9±3.5 and 7.8±3.0, respectively. Statistical significances were found in Group A (D0 to D15, p<0.05; D16 to D30, p<0.01; D0 to D30, p<0.01), but not in Group B. With the D15 crossover data of pressure sores of both groups combined, the PUSH scores suggested significant improvement in the group with mattress (n=32, before=8.7±2.9, after=7.7±3.3, p<0.05), as well as in the group with no mattress (n=32, before=8.0±3.1, after=6.9±3.9, p<0.05) after intervention. Conclusion: Appropriate and early use of the newly designed antidecubitus mattress appears to help improve the healing of pressure sores for long-term care residents. |
本系統中英文摘要資訊取自各篇刊載內容。