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压迫治疗——当前的护理实践:下肢静脉溃疡患者的知识水平

Compression therapy - current practice of care: level of knowledge in patients with venous leg ulcers.

作者信息

Protz Kerstin, Heyer Kristina, Dissemond Joachim, Temme Barbara, Münter Karl-Christian, Verheyen-Cronau Ida, Klose Katharina, Hampel-Kalthoff Carsten, Augustin Matthias

机构信息

University Medical Center Hamburg Eppendorf, Institute for Health Services Research in Dermatology and Nursing (IVDP), CWC - Comprehensive Wound Center, Hamburg, Germany.

Department of Dermatology, Venereology, und Allergology, University Hospital Essen, Essen, Germany.

出版信息

J Dtsch Dermatol Ges. 2016 Dec;14(12):1273-1282. doi: 10.1111/ddg.12938.

Abstract

BACKGROUND AND OBJECTIVES

Compression therapy is a mainstay in the causal treatment of patients with venous leg ulcers. It facilitates healing, reduces pain and recurrences, and increases quality of life. Up until now, there is a scarcity of scientific data with respect to the level of care and the specific knowledge of patients with venous leg ulcers.

PATIENTS AND METHODS

At first presentation, patients with venous leg ulcers anonymously answered a standardized questionnaire. Participating facilities nationwide included 55 outpatient care services, 32 medical practices, four wound centers, and one specialized care center.

RESULTS

Overall, 177 patients (mean age of 69.4; 75.1 % women) participated in the study. The average duration of florid venous leg ulcers was 17 months. With regard to compression therapy, 31.1 % of patients received none; 40.1 % used bandages; 28.8 % used stockings. Of the latter, 13.7 % were treated with compression class III; 67.4 %, with compression class II; and 19.6 %; with compression class I. While 70.6 % put on their stockings after getting out of bed in the morning, 21.1 % wore them day and night. In 39.2 % of individuals, the stockings caused them discomfort. Merely 11.7 % owned a donning device. On average, bandages were worn for 40.7 weeks, and 69 % were used without underpadding. In 2.8 % of patients, ankle and calf circumference was measured to monitor therapeutic success. 45.9 % reported doing leg exercises.

CONCLUSIONS

Although it is considered a basic therapeutic measure in venous leg ulcers, one-third of all patients received no compression treatment. Moreover, given the long duration of ulcers, adequate product selection and correct use have to be questioned, too. Our findings indicate that improvements in the level of knowledge among users and prescribers as well as patient training are required.

摘要

背景与目的

压力治疗是下肢静脉性溃疡患者病因治疗的主要手段。它有助于溃疡愈合,减轻疼痛和降低复发率,并提高生活质量。到目前为止,关于下肢静脉性溃疡患者的护理水平和具体知识,缺乏科学数据。

患者与方法

初次就诊时,下肢静脉性溃疡患者匿名回答一份标准化问卷。全国范围内参与的机构包括55个门诊护理服务机构、32个医疗诊所、4个伤口中心和1个专科护理中心。

结果

总体而言,177名患者(平均年龄69.4岁;75.1%为女性)参与了研究。活动性下肢静脉性溃疡的平均持续时间为17个月。关于压力治疗,31.1%的患者未接受任何治疗;40.1%使用绷带;28.8%使用弹力袜。在使用弹力袜的患者中,13.7%接受三级压力治疗;67.4%接受二级压力治疗;19.6%接受一级压力治疗。虽然70.6%的患者在早晨起床后穿上弹力袜,但21.1%的患者日夜穿着。39.2%的患者表示弹力袜让他们感到不适。只有11.7%的患者拥有穿脱辅助装置。绷带平均使用40.7周,69%的绷带使用时没有衬垫。2.8%的患者测量了脚踝和小腿周长以监测治疗效果。45.9%的患者报告进行腿部锻炼。

结论

尽管压力治疗被认为是下肢静脉性溃疡的基本治疗措施,但三分之一的患者未接受压力治疗。此外,考虑到溃疡持续时间较长,产品选择是否恰当以及使用是否正确也值得质疑。我们的研究结果表明,需要提高使用者和开处方者的知识水平以及对患者进行培训。

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