預測胃腸肝膽科病人發生壓瘡之危險因子

Predicting Risk Facors for Pressure Ulcer among Patients in a Gastroenterology and Hepatology Ward

10.6142/VGHN.34.2.130

陳貞如(Jen-Ru Chen)；李歡芳(Huan-Fang Lee)；王維芳(Wei-Fang Wang)；方玉瓊(Yu-Chiung Fang)

Braden scale 量表 ； 胃腸肝膽科 ； 壓瘡 ； Braden scale ； gastroenterology and hepatology ward ； pressure ulcer

榮總護理

34卷2期（2017 / 06 / 01）

130 - 141

繁體中文

壓瘡是重要的護理照護品質指標，不僅攸關病人的生活品質也會造成醫療成本的負擔。胃腸肝膽科病人常有營養與體液輸出入不平衡的問題，且因皮膚脆弱及尾骶骨附近常受摩擦或壓力過大，導致壓瘡的產生。目前針對胃腸肝膽科病人之壓瘡危險因子的探討研究仍不足，故本研究目的為探討胃腸肝膽科病人發生壓瘡之危險因子。本研究採橫斷性研究設計，立意選樣南部某醫學中心胃腸肝膽科病房住院3 天或以上且無壓瘡之病人121 位。收案期間6 個月。研究資料除人口學資料外，研究工具以Braden scale 量表及MUST 營養評估進行危險因子評估。資料分析法為描述性分析、卡方檢定、t 檢定與迴歸分析。研究結果顯示胃腸肝膽科病人之人口學相關變項與營養狀態在有無發生壓瘡上並無顯著差異，但Braden scale 量表中的摩擦力與剪力項目，是唯一預測胃腸肝膽科病人發生壓瘡的危險因子，且摩擦力/ 剪力項目每增加1 分，則病人會發生壓瘡的機率就會減少0.265 倍。本研究建議，在執行病人移動之護理活動時應特別注意翻身與移動技巧，避免以拖拉方式移動病人增加摩擦力及剪力之風險，同時介入相關皮膚保護措施，可降低病人發生壓瘡的風險。

Pressure ulcers are an important indicator of quality of care. The condition may jeopardize patients' quality of life and increase medical expense. Patients with gastroenterological or hepatobiliary diseases often exhibit the malnutrition and imbalanced body fluids. Regions with delicate skin, such as the sacral area, may sustain friction/shear force resulting in pressure ulcers. However, few studies have been conducted regarding the risk factors for pressure ulcers among patients with gastroenterological or hepatobiliary disease. The purpose of this study was to explore these risk factors. This study involved applying a cross-sectional research design. A total of 121 participants from a gastroenterology and hepatology ward of a medical center in Southern Taiwan were included. The inclusion criteria were that patients were without pressure ulcer before inclusion and stayed at the hospital for more than 3 days thereafter. The data collection period was 6 months. Demographic data, the Braden scale, and the malnutrition universal screening tool were used to assess the risk factors. The analysis methods were descriptive analysis, the chi-square test, t-test, and regression. Our results demonstrated that demographic data and nutrition status had no impact on the development of pressure ulcers. Only the degree of friction/shear indicated on the Braden scale was significantly related to the development of pressure ulcers, with the risk of developing pressure ulcers decreasing 0.265 times per score increase. Our findings suggest that caregivers should avoid pulling when moving patients and changing their position, and that they should provide skin protection to reduce the risk of pressure ulcer development.

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