Ferrell B A, Josephson K, Norvid P, Alcorn H
Division of Geriatrics, UCLA School of Medicine, Los Angeles, California 90095-1687, USA.
J Am Geriatr Soc. 2000 Sep;48(9):1042-7. doi: 10.1111/j.1532-5415.2000.tb04778.x.
Pressure ulcers are an understudied problem in home care.
To determine the prevalence of pressure ulcers among patients admitted to home care services, describe the demographic and health characteristics associated with pressure ulcers in this setting, and identify the percentage of these patients at risk for developing pressure ulcers.
Cross-sectional survey of patients on admission to home care agencies.
Forty-one home care agencies in 14 states.
A consecutive sample of 3,048 patients admitted March 1 through April 30, 1996 (86% of all admissions). Subjects had a mean age of 75 years; 63% were female and 85% white.
Demographic, social, and clinical characteristics, functional status (Katz activities of daily living scale and Lawton instrumental activities of daily living scale), mental status (Katzman Short Memory-Orientation-Concentration test), pressure ulcer risk (Braden Scale), pressure ulcer status (Bates-Jensen Pressure Ulcer Status Tool), and a checklist of pressure-reducing devices and wound care products being used.
In the total sample of 3,048 patients, 9.12% had pressure injuries: 37.4% had more than one ulcer and 14.0% had three or more ulcers. Considering the worst ulcer for each subject, 40.3% had Stage II and 27% had Stage III or IV injuries. Characteristics associated with pressure ulcers included recent institutional discharge, functional impairment, incontinence, and having had a previous ulcer. About 30% of subjects were at risk for new pressure ulcers. Pressure-relieving devices and other wound care strategies appeared to be underutilized and often indiscriminately applied.
There is substantial need for pressure ulcer prevention and treatment in home care settings.
压疮是家庭护理中一个研究不足的问题。
确定接受家庭护理服务患者中压疮的患病率，描述在此环境下与压疮相关的人口统计学和健康特征，并确定这些患者中发生压疮风险的百分比。
对进入家庭护理机构的患者进行横断面调查。
14个州的41家家庭护理机构。
1996年3月1日至4月30日入院的3048例患者的连续样本（占所有入院患者的86%）。受试者的平均年龄为75岁；63%为女性，85%为白人。
人口统计学、社会和临床特征、功能状态（Katz日常生活活动量表和Lawton工具性日常生活活动量表）、精神状态（Katzman短记忆-定向-注意力测试）、压疮风险（Braden量表）、压疮状况（Bates-Jensen压疮状况工具）以及正在使用的减压装置和伤口护理产品清单。
在3048例患者的总样本中，9.12%有压疮损伤：37.4%有多处溃疡，14.0%有三处或更多溃疡。考虑每个受试者最严重的溃疡，40.3%为II期，27%为III期或IV期损伤。与压疮相关的特征包括近期从医疗机构出院、功能障碍、失禁以及既往有溃疡。约30%的受试者有发生新压疮的风险。减压装置和其他伤口护理策略似乎未得到充分利用，且常常使用不当。
家庭护理环境中对压疮的预防和治疗有很大需求。
