Bliss Donna Zimmaro, Savik Kay, Harms Susan, Fan Qiao, Wyman Jean F
Long-Term Care of Elders, School of Nursing and Center for Gerontological Nursing, University of Minnesota, Minneapolis, USA.
Nurs Res. 2006 Jul-Aug;55(4):243-51. doi: 10.1097/00006199-200607000-00004.
Perineal dermatitis is an adverse outcome of incontinence, which is common in older nursing home residents; yet knowledge about perineal dermatitis in this population is sorely lacking.
To determine the prevalence and significant correlates of perineal dermatitis in older nursing home residents.
Assessment data from 59,558 records in the Minimum Data Set (MDS) were linked with 2,883,049 orders in the medical record which enabled definition of variables related to perineal dermatitis, identification of cases, and determination of the prevalence of perineal dermatitis. Data from two subsamples, each with the records of 10,215 older nursing home residents, were analyzed using logistic regression to identify the significant correlates of perineal dermatitis.
Perineal dermatitis was found in 5.7% (n = 3,405) of residents and 73% of these were incontinent. Having perineal dermatitis was significantly associated with (a) impairments in tissue tolerance (i.e., more health problems, presence of a fever, requiring nutrition support, and having more problems of diminished perfusion or oxygenation); (b)problems of the perineal environment (i.e., having fecal incontinence only, double incontinence, and more items associated with mechanical chafing); and (c) altered toileting ability from daily use of restraints.
Several correlates of perineal dermatitis (mechanical chafing, fecal and double incontinence, and use of restraints) appear modifiable through nursing intervention. Clinical interventions should consider the complex health status of this population.
会阴皮炎是失禁的一种不良后果，在老年疗养院居民中很常见；然而，这一人群中关于会阴皮炎的知识严重匮乏。
确定老年疗养院居民会阴皮炎的患病率及其显著相关因素。
将最低数据集（MDS）中59558份记录的评估数据与病历中的2883049条医嘱相链接，从而能够定义与会阴皮炎相关的变量、识别病例并确定会阴皮炎的患病率。使用逻辑回归分析来自两个子样本（每个子样本包含10215名老年疗养院居民的记录）的数据，以确定会阴皮炎的显著相关因素。
5.7%（n = 3405）的居民患有会阴皮炎，其中73%的人存在失禁情况。患有会阴皮炎与以下因素显著相关：（a）组织耐受性受损（即更多的健康问题、发烧、需要营养支持以及存在更多灌注或氧合减少的问题）；（b）会阴环境问题（即仅存在大便失禁、双重失禁以及更多与机械摩擦相关的情况）；（c）因日常使用约束措施导致如厕能力改变。
会阴皮炎的一些相关因素（机械摩擦、大便失禁和双重失禁以及使用约束措施）似乎可通过护理干预加以改善。临床干预应考虑这一人群复杂的健康状况。
