Faculty of Health and Social Care, University of Hull, UK.
J Adv Nurs. 2014 Mar;70(3):543-52. doi: 10.1111/jan.12208. Epub 2013 Jul 11.
This article presents a discussion of the current state of knowledge about bariatric skin-hygiene care and whether this is sufficient to underpin evidence-based nursing practice.
The challenges of providing bariatric skin-hygiene care are highlighted and include managing specific skin changes with associated risk of skin breakdown and practical management needs. The risk of skin breakdown is high and can have a devastating impact on well-being and increased treatment costs.
A four-stage search strategy included: (i) literature search using electronic databases from inception-May 2013; (ii) hand search of selected journals; (iii) review of internet-based guidelines, policies or protocols and (iv) contact with clinical experts.
There is a dearth of robust evidence on bariatric skin-hygiene care. Whilst a range of information and guidelines exist, these are generally based on expert opinion and often used only in a local context.
Nurses are increasingly faced with the challenge of providing skin-hygiene care for patients with bariatric needs. At present, care is largely based on custom and practice or clinical opinion; this limits capacity to provide optimum evidence-based nursing care.
As the prevalence of people needing bariatric skin-hygiene care continues to increase, there is a lack of evidence to inform interventions and hence a growing need for further research in this challenging clinical area to help nurses and patients select the best possible interventions that will meet individual personal-hygiene needs and preserve skin integrity.
本文讨论了当前关于减重患者皮肤卫生护理的知识现状,以及这些知识是否足以支持循证护理实践。
强调了提供减重患者皮肤卫生护理的挑战,包括管理与皮肤破裂风险相关的特定皮肤变化和实际管理需求。皮肤破裂的风险很高,会对幸福感和增加的治疗成本产生严重影响。
采用四阶段搜索策略,包括:(i)从开始到 2013 年 5 月使用电子数据库进行文献检索;(ii)手检选定的期刊;(iii)审查基于互联网的指南、政策或方案;(iv)与临床专家联系。
关于减重患者皮肤卫生护理的循证证据很少。虽然存在各种信息和指南,但这些指南通常基于专家意见,并且通常仅在当地使用。
护士越来越面临为有减重需求的患者提供皮肤卫生护理的挑战。目前,护理主要基于习惯和实践或临床意见;这限制了提供最佳循证护理的能力。
随着需要减重皮肤卫生护理的人群的患病率继续增加,缺乏干预措施的证据,因此,在这个具有挑战性的临床领域,需要进一步研究,以帮助护士和患者选择满足个人个人卫生需求并保护皮肤完整性的最佳干预措施。