Rodrigues Isabel, Mégie Marie-Françoise
Faculty of Medicine, Department of Family Medicine, University of Montreal, Canada.
Ostomy Wound Manage. 2006 May;52(5):46-8, 50, 52-7.
Because the prevalence of chronic wounds in Quebec is unknown, researchers conducted a chronic wound prevalence feasibility study in severely ill, elderly, or bedridden home care patients. Questionnaires seeking information about the number of wounds, patient comorbidities, and characteristics of the most severe wound (etiology, location, duration, progress, and treatments) were mailed to the head nurse and home care nurses of 149 local community health centers. Information regarding nurse and general health center needs related to chronic wound prevention and care also was solicited from nurses in 52 health centers. Data were obtained from 488 patients (average age 68.5 years); an overall prevalence rate of 1.4% was determined. Most patients (81%) had one or two wounds and pressure ulcer was the most common etiology (37% of wounds). Wounds had existed for a mean of 26.8 months (range 0 to 180, median 12 months). Most (94%) patients had a family physician but only one third of family physicians were responsible for the wound care provided/prescribed. Lack of time was the most frequently cited reason for not completing the survey. Wound chronicity, severity (44% of pressure ulcers were Stage III), lack of improvement (60% cited no improvement or worsening of ulcer), the absence of protocols and training in some local community service centers, and inappropriate use of therapeutic modalities are important reasons for concern and provide opportunities for improvement. Sample size and the absence of verifiable data limit the external validity of the findings but results indicate that chronic wounds are a common and important concern among home healthcare patients in Quebec. Improvements in data collection and patient protocols of care are needed to facilitate the acquisition of much-needed wound prevalence and outcomes data to help agencies provide optimal patient care.
由于魁北克慢性伤口的患病率未知，研究人员对重症、老年或卧床的家庭护理患者进行了一项慢性伤口患病率可行性研究。向149个当地社区卫生中心的护士长和家庭护理护士邮寄了问卷，以获取有关伤口数量、患者合并症以及最严重伤口的特征（病因、位置、持续时间、进展和治疗）的信息。还从52个卫生中心的护士那里征求了与慢性伤口预防和护理相关的护士及一般卫生中心需求的信息。数据来自488名患者（平均年龄68.5岁）；确定总体患病率为1.4%。大多数患者（81%）有一两个伤口，压疮是最常见的病因（占伤口的37%）。伤口平均存在26.8个月（范围0至180个月，中位数12个月）。大多数（94%）患者有家庭医生，但只有三分之一的家庭医生负责提供/开出处方的伤口护理。时间不足是未完成调查最常被提及的原因。伤口的慢性、严重程度（44%的压疮为III期）、缺乏改善（60%称溃疡无改善或恶化）、一些当地社区服务中心缺乏方案和培训以及治疗方式使用不当是令人担忧的重要原因，并提供了改进的机会。样本量和缺乏可验证的数据限制了研究结果的外部有效性，但结果表明慢性伤口是魁北克家庭医疗患者中常见且重要的问题。需要改进数据收集和患者护理方案，以促进获取急需的伤口患病率和结果数据，帮助机构提供最佳的患者护理。
