School of Nursing, UCLA, Los Angeles, California.
Division of Geriatrics, David Geffen School of Medicine, UCLA, Los Angeles, California.
Wound Repair Regen. 2019 Jul;27(4):386-395. doi: 10.1111/wrr.12714. Epub 2019 Mar 18.
The Bates-Jensen Wound Assessment Tool (BWAT) is used to assess wound healing in clinical practice. The purpose of this study was to evaluate BWAT use among nursing home residents with pressure injury. Findings and reliability estimates from the BWAT related to pressure injury characteristics (stage, anatomic location) and natural history (resolved, persisted) among 142 ethnically and racially diverse residents are reported. In this prospective 16-week study, 305 pressure injuries among 142 participants (34% prevalence) are described by stage, anatomic location, and BWAT scores. Visual and subepidermal moisture assessments were obtained from sacrum, buttock, ischial, and heel ulcers weekly. Participants were 14% Asian, 28% Black, 18% Hispanic, 40% White with a mean age of 78 ± 14 years, and were 62% female; 80% functionally dependent (bed mobility extensive/total assistance) and at risk (Braden Scale score 14 ± 2.7). The reliability coefficient for BWAT score (all participants, all anatomic locations) was high (r = 0.90; p < 0.0001; n = 1,161 observations). Weighted Kappas for characteristics ranging from 0.46 (skin color surrounding wound) to 0.79 (undermining) were consistent for all participants. BWAT scores showed strongest agreement coefficients for stage 4 pressure injury (r = 0.69), pressure injuries among Asian and White ethnicity/racial groups (r = 0.89, and r = 0.91, respectively), and sacrum anatomic location (r = 0.92) indicating scores are better correlated to fair skin tones. Lower agreement coefficients were demonstrated for stage 2 pressure injury (r = 0.38) and pressure injuries among African American and Hispanic ethnicity/racial groups (r = 0.88 and 0.87, respectively). BWAT scores were significantly different by pressure injury stage (F = 496.7, df = 6, p < 0.001) and anatomic location (F = 33.76, df = 8, p < 0.001). BWAT score correlated with pressure injury natural history (ulcer resolved 18.4 ± 7.4, ulcer persisted 24.9 ± 10.0; F = 70.11, df = 2, p < 0.001), but not with comorbidities. The BWAT provides reliable, objective data for assessing pressure injury healing progress.
贝茨-詹森伤口评估工具 (BWAT) 用于评估临床实践中的伤口愈合情况。本研究的目的是评估 BWAT 在有压疮的养老院居民中的使用情况。报告了来自 142 名具有不同种族和种族的居民的 BWAT 与压疮特征（阶段、解剖位置）和自然史（解决、持续）相关的发现和可靠性估计。在这项前瞻性的 16 周研究中，描述了 142 名参与者中的 305 个压疮（34%的患病率），按阶段、解剖位置和 BWAT 评分进行描述。每周从骶骨、臀部、坐骨和足跟溃疡处获得视觉和皮下水分评估。参与者中 14%为亚洲人，28%为黑人，18%为西班牙裔，40%为白人，平均年龄为 78±14 岁，62%为女性；80%功能依赖（床移动广泛/完全辅助）和有风险（Braden 量表评分为 14±2.7）。BWAT 评分（所有参与者，所有解剖部位）的可靠性系数较高（r=0.90;p<0.0001;n=1161 次观察）。特征加权 Kappa 值从 0.46（伤口周围皮肤颜色）到 0.79（潜行）不等，所有参与者均一致。BWAT 评分对 4 期压疮（r=0.69）、亚洲和白种人/种族群体中的压疮（r=0.89 和 r=0.91）以及骶骨解剖位置（r=0.92）显示出最强的一致性系数，表明评分与肤色较浅的皮肤相关度更好。对于 2 期压疮（r=0.38）和非裔美国人和西班牙裔/种族群体中的压疮（r=0.88 和 r=0.87），则显示出较低的一致性系数。BWAT 评分在压疮阶段（F=496.7，df=6，p<0.001）和解剖位置（F=33.76，df=8，p<0.001）方面存在显著差异。BWAT 评分与压疮自然史相关（溃疡愈合 18.4±7.4，溃疡持续 24.9±10.0；F=70.11，df=2，p<0.001），但与合并症无关。BWAT 为评估压疮愈合进展提供了可靠、客观的数据。
