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给予中风患者的卫生护理措施对患者生命体征的影响:一项自身对照的实验前研究。

The effect of hygienic care practices given to stroke patients on vital signs of patients: A self-comparison pre-experimental study.

作者信息

Tunç İsmail, Tosun Betül, Dirgar Ezgi

机构信息

Department of Nursing, Faculty of Health Sciences, Hasan Kalyoncu University, Gaziantep, Turkey.

Faculty of Nursing, Hacettepe University, Ankara, Turkey.

出版信息

Nurs Crit Care. 2025 Mar;30(2):e13283. doi: 10.1111/nicc.13283.

Abstract

BACKGROUND

Hygiene and skin care are crucial for stroke patients in intensive care, yet the effects of bathing practices on vital signs in mechanically ventilated stroke patients remain underexplored.

AIM

This study aimed to assess the effects of full bed baths and wiping baths on vital signs in stroke patients.

STUDY DESIGN

A self-comparison pre-experimental study was conducted with 90 stroke patients treated in three intensive care units at a Turkish hospital between 10 January 2021 and 01 January 2022. Patients received either a full bed bath (first measurement day) or a wiping bath (second and third measurement days). Vital signs and arterial blood gas values were measured before and after each bath.

RESULTS

Of the participants, 55.5% were male, with a mean age of 64.2 ± 14.8 years. Significant changes in heart rate, systolic blood pressure, diastolic blood pressure and body temperature were observed after the full bed bath (heart rate: λ = 0.156, F = 43.940; systolic BP: λ = 0.484, F = 17.981; diastolic blood pressure: λ = 0.835, F = 7.216; body temperature: λ = 0.97, F = 142.92; p < .001). Similarly, wiping baths resulted in significant changes (heart rate: λ = 0.354, F = 34.776; systolic blood pressure: λ = 0.384, F = 16.372; diastolic blood pressure: λ = 0.492, F = 17.603; body temperature: λ = 0.236, F = 176.765; p < .001). Arterial blood gas changes were significant after wiping baths on Day three (pH: t = 3.351, p = .001; PaO: t = 2.400, p = .018).

CONCLUSIONS

Both full and wiping bed baths significantly affect vital signs and arterial blood gases in stroke patients. Nurses should tailor bathing practices to patient needs, continuously monitoring vital signs.

RELEVANCE TO CLINICAL PRACTICE

This study highlights how bathing practices impact vital signs and arterial blood gases in intensive care patients. It emphasizes tailoring interventions to patient needs and preferences, as full baths may suit some, while wiping baths offer advantages, particularly for blood pH and PaO levels.

摘要

背景

卫生护理和皮肤护理对重症监护中的中风患者至关重要,但机械通气中风患者的洗浴方式对生命体征的影响仍未得到充分研究。

目的

本研究旨在评估全床浴和擦浴对中风患者生命体征的影响。

研究设计

采用自身对照的实验前研究,对2021年1月10日至2022年1月1日期间在土耳其一家医院的三个重症监护病房接受治疗的90例中风患者进行研究。患者在第一天接受全床浴,在第二天和第三天接受擦浴。每次洗浴前后测量生命体征和动脉血气值。

结果

参与者中,55.5%为男性,平均年龄为64.2±14.8岁。全床浴后心率、收缩压、舒张压和体温出现显著变化(心率:λ=0.156,F=43.940;收缩压:λ=0.484,F=17.981;舒张压:λ=0.835,F=7.216;体温:λ=0.97,F=142.92;p<0.001)。同样,擦浴也导致了显著变化(心率:λ=0.354,F=34.776;收缩压:λ=0.384,F=16.372;舒张压:λ=0.492,F=17.603;体温:λ=0.236,F=176.765;p<0.001)。第三天擦浴后动脉血气变化显著(pH:t=3.351,p=0.001;PaO:t=2.400,p=0.018)。

结论

全床浴和擦浴均对中风患者的生命体征和动脉血气有显著影响。护士应根据患者需求调整洗浴方式,并持续监测生命体征。

与临床实践的相关性

本研究强调了洗浴方式对重症监护患者生命体征和动脉血气的影响。它强调根据患者需求和偏好调整干预措施,因为全床浴可能适合一些患者,而擦浴则有其优势,特别是对血液pH值和PaO水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2712/11848507/5feeb6f48969/NICC-30-0-g002.jpg

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