Aloweni Fazila, Gunasegaran Nanthakumahrie, Lim Siew Hoon, Xin Leow Beverly Wen, Agus Nurliyana, Qi Goh Ivy Hui, Ang Shin Yuh
Nursing Division, Singapore General Hospital, Singapore.
J Tissue Viability. 2024 Feb;33(1):27-42. doi: 10.1016/j.jtv.2023.11.007. Epub 2023 Dec 13.
To: (1) report on the prevalence of community-acquired pressure injuries (CAPIs) in patients admitted into the acute care setting; (2) examine the socio-economic and home environment associated with CAPIs; and (3) understand the challenges of caring for patients with CAPIs at home.
This mixed-method study recruited patients admitted with CAPIs in the acute care hospital between March 2021 to June 2022. The hospital's pressure injury (PI) database was used to screen patients admitted with CAPIs. A purposive sample of CAPI patients and their caregivers participated in this study. A cross-sectional survey study was first performed to examine the prevalence of CAPIs and the socio-economic and home environment factors. Semi-structured interviews were conducted to understand the caregivers' challenges in caring for patients with CAPIs at home.
The CAPI prevalence was reported at 1.1 % during the study period (1039 had CAPIs out of 97 912 patients admitted to the hospital). A total of 70 caregivers and patients consented to participate in the study. The mean age of patients was 84.2 (SD = 10.4) years old; 68.6 % (n = 48) were females. Majority presented with a deep tissue injury (DTI) (37.1 %; n = 26) or unstageable PI (31.4 %; n = 22). More than half of the patients had alternating air mattresses at home (54.3 %; n = 38), and only 10 % (n = 7) had positioning wedges and used a sliding sheet for turning. The mean age of the caregivers was 43.4 years old (SD = 13.1), and 84.3 % (n = 59) were female. Continuous data were summarised using means and standard deviations, and categorical data were summarised using frequencies and percentages. Logistic regression found no significant socio-demographic and clinical predictors of patients having PI stages 2, 3, and 4 compared to patients with DTI and unstageable PI. Challenges to caring for PI at home included high financial burden, physical limitations, and personal challenges in CAPIs management.
CAPIs are prevalent among older patients admitted to the acute care setting. Understanding the influence of socio-economic factors is crucial for developing comprehensive strategies to mitigate the occurrence and impact of PIs. Ongoing support and education to the caregivers in the community is essential to address the reported challenges in PI care.
（1）报告急性护理环境中入院患者社区获得性压疮（CAPI）的患病率；（2）研究与CAPI相关的社会经济和家庭环境；（3）了解在家照顾CAPI患者的挑战。
这项混合方法研究招募了2021年3月至2022年6月期间在急性护理医院因CAPI入院的患者。利用医院的压疮（PI）数据库筛选因CAPI入院的患者。有目的地抽取CAPI患者及其护理人员参与本研究。首先进行横断面调查研究，以检查CAPI的患病率以及社会经济和家庭环境因素。进行半结构化访谈，以了解护理人员在家照顾CAPI患者时面临的挑战。
研究期间报告的CAPI患病率为1.1%（97912名入院患者中有1039例患有CAPI）。共有70名护理人员和患者同意参与研究。患者的平均年龄为84.2岁（标准差=10.4）；68.6%（n=48）为女性。大多数表现为深部组织损伤（DTI）（37.1%；n=26）或不可分期的PI（31.4%；n=22）。超过一半的患者家中有交替充气床垫（54.3%；n=38），只有10%（n=7）有定位楔并使用滑动床单翻身。护理人员的平均年龄为43.4岁（标准差=13.1），84.3%（n=59）为女性。连续数据用均值和标准差汇总，分类数据用频率和百分比汇总。逻辑回归发现，与患有DTI和不可分期PI的患者相比，没有显著的社会人口统计学和临床预测因素可预测患者患有2期、3期和4期PI。在家照顾PI的挑战包括经济负担重、身体限制以及CAPI管理中的个人挑战。
CAPI在入住急性护理环境的老年患者中很普遍。了解社会经济因素的影响对于制定全面策略以减轻PI的发生和影响至关重要。持续为社区中的护理人员提供支持和教育对于解决报告的PI护理挑战至关重要。
