Nagano Midori, Kubo Yoshiko, Egawa Akiko, Kobayashi Masayo, Sato Masami
The Jikei University School of Nursing, Tokyo, Japan.
Faculty of Nursing, Kyouritu Women's University, Tokyo, Japan.
Nurs Open. 2025 Jan;12(1):e70128. doi: 10.1002/nop2.70128.
(1) To classify patients with community-acquired pressure injury (CAPI) according to the risk factors of PI and to assess validity of the classified groups. (2) To clarify characteristics of each group for CAPI prevention and care.
This study is designed to classify CAPI patients into clusters based on a retrospective study of medical records, followed by cluster analysis and description of each cluster's characteristics.
Risk factors and status of CAPI, as well as discharge destination, were investigated based on 1 year's worth of medical records of patients with CAPI on hospital admission during 2018-2019. After calculating descriptive statistics, cluster analysis was conducted by Ward's method of Euclidean distance referring to risk factors of PI. Lastly, each of the defined clusters underwent multiple comparisons.
From 324 patients with CAPI, 272 patients were selected as the study subjects, due to availability of sufficient information regarding risk factors of PI. After classification into three groups, data were interpreted by Euclidean distance and comparison between 'attribute and risk factors of PI' and 'PI and destinations after discharge'.
Patients with CAPI were classified into three clusters and validity of the classification was assessed. Patients who had 'maintained ADL', as well as cognitive status, were expected to be capable of self-care and self-management. Patients with 'low ADL' were characterised by insufficient self-care or home care resulting in having CAPI and would require aged care service. Patients who were at 'very high risk' of having PI were characterised by incurring significant burden on caregivers and need of medical services that prospects terminal care.
（1）根据压力性损伤（PI）的风险因素对社区获得性压力性损伤（CAPI）患者进行分类，并评估分类组的有效性。（2）明确每组CAPI预防和护理的特点。
本研究旨在通过对病历的回顾性研究将CAPI患者分类为不同群组，随后进行聚类分析并描述每个群组的特征。
基于2018 - 2019年住院时患有CAPI患者的1年病历，调查CAPI的风险因素、状况以及出院去向。在计算描述性统计量后，参照PI的风险因素，采用欧氏距离的沃德法进行聚类分析。最后，对每个定义的群组进行多重比较。
由于有关于PI风险因素的足够信息，从324例CAPI患者中选取272例作为研究对象。分为三组后，通过欧氏距离以及“PI的属性和风险因素”与“PI和出院后去向”之间的比较来解释数据。
将CAPI患者分为三个群组并评估分类的有效性。“维持日常生活活动能力（ADL）”以及认知状态良好的患者有望能够自我护理和自我管理。“ADL低”的患者其特点是自我护理或家庭护理不足导致患有CAPI，需要老年护理服务。有PI“极高风险”的患者其特点是给护理人员带来重大负担，需要临终关怀的医疗服务。
