Rae Katherine E, Barker Judith, Upton Dominic, Isbel Stephen
Faculty of Health, University of Canberra, 11 Kirinari St, Bruce, Canberra, ACT 2617, Australia.
Canberra Health Services, Canberra Hospital, Yamba Dr, Garran, ACT 2605, Australia.
Nurs Rep. 2025 Mar 19;15(3):111. doi: 10.3390/nursrep15030111.
: Pressure injuries are an ongoing problem commonly managed with the prescription of pressure mattresses. There is conflicting research about the comparable effectiveness of the two types of pressure mattresses, active and reactive. This, coupled with technological advances and an updated understanding of pressure aetiology, means decision-making when prescribing pressure mattresses is complicated. : A pragmatic approach was used to design an equivalence randomised-controlled trial investigating the comparative effectiveness of active and reactive pressure mattresses in a community setting from a wound healing perspective as well as from a user acceptability perspective. : Participants with an existing pressure injury were provided with an active or reactive mattress for wound healing, with wound stages assessed using photography. Usual clinical care was provided based on the protocols of the health care service, including nursing and occupational therapy input. Participants were monitored for the healing of their existing pressure injuries, using the Revised Photographic Wound Assessment Tool. User acceptability feedback was provided through surveys, including impact on comfort, pain levels and bed mobility. An equivalence design was used for data analysis to determine if the surfaces were comparable. : Twelve participants completed the study, which found that people on active mattresses healed 11.71 days (95% CI -55.97-31.78 days) quicker than people on reactive mattresses; however, the small sample size meant that a definitive determination could not be made. Users found bed mobility more challenging, and pain levels decreased, regardless of mattress type. : A pragmatic methodology is imperative for research in this field due to the complexity of pressure injury healing. Researchers exploring multi-faceted conditions should consider a pragmatic design to ensure transferability of results to the clinical setting. The results from this study were inconclusive when determining the equivalence of active and reactive mattresses due to the small sample size. When choosing a mattress, prescribers need to consider user preferences and mattress features to ensure user acceptability.
压疮是一个持续存在的问题，通常通过使用减压床垫来处理。关于主动式和反应式这两种减压床垫的相对有效性，研究结果存在冲突。这一点，再加上技术进步以及对压力病因学的更新认识，意味着在开具减压床垫处方时的决策变得复杂。
采用了一种务实的方法来设计一项等效性随机对照试验，从伤口愈合以及用户可接受性的角度，研究主动式和反应式减压床垫在社区环境中的比较有效性。
为患有现有压疮的参与者提供主动式或反应式床垫以促进伤口愈合，通过摄影评估伤口阶段。根据医疗服务协议提供常规临床护理，包括护理和职业治疗投入。使用修订后的伤口摄影评估工具监测参与者现有压疮的愈合情况。通过调查提供用户可接受性反馈，包括对舒适度、疼痛程度和床上活动能力的影响。采用等效性设计进行数据分析，以确定两种床垫表面是否具有可比性。
12名参与者完成了该研究，结果发现使用主动式床垫的人比使用反应式床垫的人愈合速度快11.71天（95%置信区间为-55.97至31.78天）；然而，样本量较小意味着无法做出明确的判定。无论使用何种床垫类型，用户都发现床上活动更具挑战性，且疼痛程度有所降低。
由于压疮愈合情况复杂，务实的方法对于该领域的研究至关重要。探索多方面情况的研究人员应考虑采用务实的设计，以确保研究结果能够应用于临床环境。由于样本量较小，本研究在确定主动式和反应式床垫的等效性时结果尚无定论。在选择床垫时，开处方者需要考虑用户偏好和床垫特性，以确保用户的可接受性。
