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[德国居家护理服务客户中慢性伤口的患病率及影响因素]

[Prevalence and influencing factors of chronic wounds among clients of home care services in Germany].

作者信息

Raeder Kathrin, Strube-Lahmann Sandra, Müller-Werdan Ursula, Kottner Jan, Lahmann Nils A, Suhr Ralf

机构信息

Charité - Universitätsmedizin Berlin I Klinik für Geriatrie und Altersmedizin I Forschungsgruppe Geriatrie I AG - Pflegeforschung,Berlin, Deutschland.

Charité - Universitätsmedizin Berlin I Klinik für Geriatrie und Altersmedizin I Forschungsgruppe Geriatrie I AG - Pflegeforschung,Berlin, Deutschland.

出版信息

Z Evid Fortbild Qual Gesundhwes. 2019 Mar;140:14-21. doi: 10.1016/j.zefq.2019.01.001. Epub 2019 Feb 15.

Abstract

INTRODUCTION

Chronic or non-healing wounds are a serious problem for both the parties involved and the healthcare system. Currently, there are hardly any reliable data on the prevalence of chronic wounds in outpatient care, although this setting is becoming increasingly important. Therefore, the aim of this study was to determine the prevalence of and the factors associated with chronic wounds in clients cared for by home care services.

METHOD

As part of a cross-sectional study throughout Germany in 2012, a survey was conducted among care recipients provided by home care services. The sample was drawn in a two-step procedure. First, a random sample of home care services was drawn for each federal state, followed by random selection of clients to be interviewed for each service. The aim of the study was to describe the prevalence of chronic wounds and influencing factors such as BMI, age, housing situation, activity and diabetes mellitus. Data collection through questionnaire was carried out by trained nurses.

RESULTS

A total of 144 home care services with 1,296 clients had agreed to participate. With 880 care recipients from 100 home care services finally taking part in the survey, the response rate was 68 %. Of all care recipients examined, 101 had at least one chronic wound; the highest prevalence rates were observed for pressure ulcers (4.6 %) and leg ulcers (4.0 %). Care recipients with diabetes mellitus were more frequently affected by chronic wounds (16.4 %) than non-diabetic recipients (9.5 %). Community-living care recipients (14.1 % chronic wounds; 6.0 % pressure ulcers) and care recipients under the age of 65 (20 % chronic wounds; 9.5 % pressure ulcers) were affected more frequently than care recipients living alone (9.1 % chronic wounds; 3.0 % pressure ulcers) or care recipients older than 65 years (10.5 % chronic wounds; 4.0 % pressure ulcers). In the multivariate calculation, the BMI proved to be the strongest predictor. The prevalence of chronic wounds in the group of obese (BMI>35.3kg/m) care recipients and those with activity restriction is 44.8 %.

CONCLUSION

In view of the fact that one out of nine care recipients receiving assistance from home care services is affected by at least one non-healing wound, special attention should be paid to the prevention, detection and treatment of chronic wounds. Furthermore, it seems particularly necessary to identify the relevant risk groups in order to be able to initiate adequate and preventive measures at an early stage.

摘要

引言

慢性伤口或难愈合伤口对相关各方及医疗保健系统而言都是一个严重问题。目前,关于门诊护理中慢性伤口患病率的可靠数据几乎没有,尽管这种情况正变得越来越重要。因此,本研究的目的是确定接受家庭护理服务的患者中慢性伤口的患病率及其相关因素。

方法

作为2012年在德国开展的一项横断面研究的一部分,对接受家庭护理服务的患者进行了一项调查。样本抽取采用两步法。首先,为每个联邦州随机抽取家庭护理服务机构,然后为每个机构随机选择接受访谈的患者。该研究旨在描述慢性伤口的患病率以及体重指数、年龄、居住状况、活动能力和糖尿病等影响因素。由经过培训的护士通过问卷调查收集数据。

结果

共有144个家庭护理服务机构的1296名患者同意参与。最终,来自100个家庭护理服务机构的880名受助患者参与了调查,回复率为68%。在所有接受检查的受助患者中,101人至少有一处慢性伤口;压疮(4.6%)和腿部溃疡(4.0%)的患病率最高。患有糖尿病的受助患者比未患糖尿病的患者更易受到慢性伤口影响(分别为16.4%和9.5%)。与独居的受助患者(慢性伤口患病率9.1%;压疮患病率3.0%)或65岁以上的受助患者(慢性伤口患病率10.5%;压疮患病率4.0%)相比,社区生活的受助患者(慢性伤口患病率14.1%;压疮患病率6.0%)和65岁以下的受助患者(慢性伤口患病率20%;压疮患病率9.5%)受影响更频繁。在多变量计算中,体重指数被证明是最强的预测因素。肥胖(体重指数>35.3kg/m)且活动受限的受助患者中慢性伤口的患病率为44.8%。

结论

鉴于每九名接受家庭护理服务援助的受助患者中就有一人至少受一处难愈合伤口影响,应特别关注慢性伤口的预防、检测和治疗。此外,识别相关风险群体以便能够在早期启动适当的预防措施似乎尤为必要。

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