Latimer Sharon, Shaw Joanie, Hunt Tracey, Mackrell Kristyn, Gillespie Brigid M
Sharon Latimer, PhD, is research fellow (Patient Safety in Nursing), School of Nursing and Midwifery, Griffith University; and Nursing Midwifery Education and Research Unit, Gold Coast Hospital and Health Service, Southport, Queensland, Australia. Joanie Shaw, GradCert, is nurse educator, Cancer and Specialty Services, Gold Coast Hospital and Health Service, Southport, Queensland, Australia. Tracey Hunt, MSN, is clinical nurse consultant, Diagnostics and Subspecialty Services, Gold Coast Hospital and Health Service, Southport, Queensland, Australia. Kristyn Mackrell, BSc, is senior occupational therapist, Community & Palliative Care Occupational Therapy Services, Gold Coast Hospital and Health Service, Southport, Queensland, Australia. Brigid M. Gillespie, PhD, is professor (Patient Safety in Nursing), graduate certificate, School of Nursing and Midwifery, Griffith University; and Nursing Midwifery Education and Research Unit, Gold Coast Hospital and Health Service, Southport, Queensland, Australia.
J Hosp Palliat Nurs. 2019 Aug;21(4):257-263. doi: 10.1097/NJH.0000000000000563.
Kennedy terminal ulcers, a subset of pressure injuries, are associated with the dying process. This scoping review aimed to identify and map the published literature on Kennedy terminal ulcers in terms of its definition, prevalence, assessment, treatment, management, health care costs, and quality of life for patients in all health care settings. Using the Arksey and O'Malley scoping review framework, we systematically searched the Cochrane Library, CINAHL, EMBASE, MEDLINE, and ProQuest databases and 5 guideline repositories between 1983 and 2018. The following search terms were used: Kennedy ulcers, Kennedy terminal ulcers, terminal ulcer, skin failure, and Skin Changes at Life's End. Data were extracted using a purposely developed data collection tool. Initial searches yielded 2997 sources, with 32 included in this review. Most Kennedy terminal ulcer literature was published by nurses in the United States. Kennedy terminal ulcer prevalence data are limited, with no validated assessment tools available. Kennedy terminal ulcers may be misclassified as pressure injuries, potentially resulting in financial penalties to the institution. This scoping review revealed significant knowledge and clinical practice gaps in patient assessment, management, and treatment of Kennedy terminal ulcers. Timely patient education may help them to make informed care and quality end-of-life decisions. Further research is needed to inform clinical practice to improve patient care.
肯尼迪终末期溃疡是压疮的一个子集，与濒死过程相关。本综述旨在对已发表的关于肯尼迪终末期溃疡的文献进行识别和梳理，内容涉及所有医疗环境中患者的定义、患病率、评估、治疗、管理、医疗成本和生活质量。我们采用阿克斯和奥马利的综述框架，系统检索了1983年至2018年期间的考克兰图书馆、护理学与健康领域数据库、荷兰医学文摘数据库、医学期刊数据库和ProQuest数据库以及5个指南库。使用了以下检索词：肯尼迪溃疡、肯尼迪终末期溃疡、终末期溃疡、皮肤衰竭和生命末期皮肤变化。数据提取采用专门开发的数据收集工具。初步检索得到2997个来源，本综述纳入了其中32个。大多数关于肯尼迪终末期溃疡的文献是由美国护士发表的。肯尼迪终末期溃疡的患病率数据有限，且没有经过验证的评估工具。肯尼迪终末期溃疡可能被错误分类为压疮，这可能会给机构带来经济处罚。本综述揭示了在肯尼迪终末期溃疡患者评估、管理和治疗方面存在重大的知识和临床实践差距。及时对患者进行教育可能有助于他们做出明智的护理和高质量的临终决策。需要进一步开展研究为临床实践提供信息，以改善患者护理。
