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下肢静脉溃疡患者的溃疡相关问题及医疗保健需求:一项描述性横断面研究。

Ulcer-related problems and health care needs in patients with venous leg ulceration: a descriptive, cross-sectional study.

作者信息

Heinen Maud M, Persoon Anke, van de Kerkhof Peter, Otero Marisol, van Achterberg Theo

机构信息

Centre for Quality of Care Research (WOK), Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.

出版信息

Int J Nurs Stud. 2007 Nov;44(8):1296-303. doi: 10.1016/j.ijnurstu.2006.05.001. Epub 2006 Jul 5.

Abstract

BACKGROUND

Patients with leg ulceration often have long lasting and recurrent wounds. The treatment exists mainly of wound-care and compression therapy. International literature shows several indications of problems in relation to leg ulceration, but no studies were performed to give a comprehensive overview of all problems identified and care received related to these problems.

OBJECTIVES

The aim of the study was to describe leg ulcer-related problems in patients with leg ulcers based on venous insufficiency or a mixed aetiology. Furthermore, an inventory of current care and care deficits in the care for leg ulcer patients was made.

METHODS

The study had a descriptive, cross-sectional design. A sample of 141 patients was taken from the population of outpatient clinics of seven hospitals in the Netherlands. Data were collected through patient interviews, questionnaires and wound-observations. Medical information was provided by the dermatologist or derived from the patients' medical file.

RESULTS

The study identified a number of serious problems. Main problems were pain (85%), outdoor mobility (47%) and problems in finding appropriate footwear (60%). Statistical analysis showed no differences between patients with ulcers based on a venous aetiology and ulcers based on mixed aetiology. Fifty to seventy percent of the patients did not receive any care in relation to these problems. Only a rather small proportion of the patients, however, regarded the help as insufficient.

CONCLUSION

Care at outpatient clinics is mainly focused on wound care and compression therapy. Pain treatment and care related to problems encountered by patients appears to be insufficient. This is not only affecting the patient's quality of life, but is likely to affect also the healing process and prevention of leg ulcers. Nurses and dermatologist should take their responsibilities in this matter.

摘要

背景

腿部溃疡患者常常有持久且反复出现的伤口。治疗主要包括伤口护理和压力治疗。国际文献显示了一些与腿部溃疡相关的问题迹象,但尚未进行研究以全面概述所发现的所有问题以及针对这些问题所接受的护理。

目的

本研究的目的是描述基于静脉功能不全或混合病因的腿部溃疡患者中与腿部溃疡相关的问题。此外,还对腿部溃疡患者当前的护理情况及护理缺陷进行了清查。

方法

本研究采用描述性横断面设计。从荷兰七家医院的门诊患者群体中抽取了141名患者作为样本。通过患者访谈、问卷调查和伤口观察收集数据。医疗信息由皮肤科医生提供或源自患者的病历。

结果

该研究发现了一些严重问题。主要问题包括疼痛(85%)、户外行动能力(47%)以及难以找到合适的鞋类(60%)。统计分析表明,基于静脉病因的溃疡患者和基于混合病因的溃疡患者之间没有差异。50%至70%的患者在这些问题上未得到任何护理。然而,只有相当小比例的患者认为所得到的帮助不足。

结论

门诊护理主要集中在伤口护理和压力治疗上。疼痛治疗以及针对患者所遇到问题的护理似乎不足。这不仅影响患者的生活质量,还可能影响腿部溃疡的愈合过程及预防。护士和皮肤科医生应在此事上承担起责任。

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