Giantin Valter, Toffanello Elena D, Enzi Giuliano, Perissinotto Egle, Vangelista Stefania, Simonato Matteo, Ceccato Corrado, Manzato Enzo, Sergi Giuseppe
Department of Medical and Surgical Sciences, Division of Geriatrics, University of Padua, Italy.
J Clin Nurs. 2008 Jun;17(11):1518-25. doi: 10.1111/j.1365-2702.2007.02140.x.
To compare different body temperature assessment methods in older people and to assess the role of cognitive and functional characteristics in temperature recordings.
Axillary gallium-in-glass thermometers are commonly used. Their accuracy depends on the proper placement of the device and their permanence in place for eight minutes. With adequate instruction, well-functioning patients can measure their axillary temperature by themselves, while in cognitively and functionally impaired older people, inadequate understanding of instructions and misplacement of the thermometer might determine significant recording errors. Electronic ear and axillary temperature measurements are faster, but their accuracy has not been demonstrated convincingly with older people.
Patients (n = 107; aged 65-104 years) were recruited. Barthel Index and Short Portable Mental Status Questionnaire (SPMSQ) scores were obtained for each patient. Temperature readings were obtained using: the axillary gallium-in-glass thermometer, with (T(nurse)) and without (T(self)) the nurse's assistance; the electronic axillary thermometer (T(el)) and the infrared tympanic thermometer (T(tymp)). The T(nurse) was considered as the reference method.
Mean difference and standard deviation (mean +/- SD) in temperature recordings between the different techniques and T(nurse) differed significantly from zero for T(self) (-0.40 SD 0.42) and T(tymp) (+0.19 SD 0.48). No significant differences in temperature recordings emerged between T(nurse) and T(el). In simple linear regression models, the difference between T(self) and T(nurse) significantly correlated with age, gender, SPMSQ score and Barthel Index. Multiple linear regression analysis showed an underestimation of body temperature in older patients with cognitive impairments.
Unassisted gallium-in-glass axillary temperature assessment is inadequate, in older patients. The differences between T(self) and T(nurse) are significantly influenced by age and mental decline. T(el) provides adequate accuracy. Relevance to clinical practice. In geriatric settings, the electronic axillary thermometer is a safe and accurate alternative to the more traditional gallium-in-glass thermometer, with the advantage of saving time (five seconds in recording vs. eight minutes).
比较老年人不同的体温评估方法，并评估认知和功能特征在体温记录中的作用。
腋温玻璃体温计是常用的。其准确性取决于体温计的正确放置以及在原位保持8分钟。在得到充分指导的情况下，功能良好的患者可以自行测量腋温，而对于认知和功能受损的老年人，对指导说明理解不足以及体温计放置不当可能会导致显著的记录误差。电子耳温和腋温测量更快，但在老年人中其准确性尚未得到令人信服的证明。
招募了107名患者（年龄65 - 104岁）。获取每位患者的巴氏指数和简易便携式精神状态问卷（SPMSQ）得分。使用以下方法获取体温读数：腋温玻璃体温计，有护士协助（T（护士））和无护士协助（T（自行））；电子腋温计（T（el））和红外鼓膜体温计（T（鼓膜））。将T（护士）视为参考方法。
不同测量技术与T（护士）之间的体温记录平均差值和标准差（均值±标准差），T（自行）（-0.40±0.42）和T（鼓膜）（+0.19±0.48）显著不为零。T（护士）和T（el）之间的体温记录无显著差异。在简单线性回归模型中，T（自行）与T（护士）之间的差异与年龄、性别、SPMSQ得分和巴氏指数显著相关。多元线性回归分析显示认知受损的老年患者体温被低估。
在老年患者中，无协助的腋温玻璃体温计体温评估不准确。T（自行）与T（护士）之间的差异受年龄和精神衰退的显著影响。T（el）具有足够的准确性。与临床实践的相关性。在老年护理环境中，电子腋温计是比传统腋温玻璃体温计更安全、准确的替代方法，具有节省时间的优势（记录时间为5秒，而玻璃体温计为8分钟）。
