ISSN:1071-5754    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1071-5754    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1071-5754    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1071-5754    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1071-5754    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveThe purpose of this study was to identify risk factors associated with the presence of pressure ulcer development in adult patients at an acute care teaching hospital.DesignThe database was established by combining the results from 3 annual cross-sectional pressure ulcer prevalence studies conducted between 1998 and 2000.Setting and SampleThe sample consisted of all medical and surgical patients who were inpatients on the day of the pressure ulcer surveys. The sample includes a total of 1394 patients.MethodsThis study undertook secondary data analysis with use of logistic regression and descriptive statistics.ResultsOverall pressure ulcer prevalence was calculated at 15.9%, with this figure decreasing slightly to 12.7% when pressure ulcers present on admission were excluded. Initial analysis identified several variables as significant risk factors for pressure ulcer development (age, Braden Scale risk category, and admission type and specialty). However, when entered into a final multivariate model, only 2 factors, age and Braden Scale risk category, were found to be significant. The odds ratio matrix revealed a consistent trend toward increasing odds ratios with increasing Braden Scale risk category within each age group. The magnitude of this trend was more pronounced in the younger age groups, highlighting the importance of undertaking Braden Scale assessments of younger patients, some of whom may be at greater risk of having a pressure ulcer develop than would otherwise be expected.ConclusionPressure ulcer prevalence in this acute care setting is high when compared with other Australian data. However, comparisons of pressure ulcer prevalence across studies are difficult to interpret because of different reporting methods. Although predictor variables for pressure ulcers have been identified in a number of studies, longitudinal studies are needed to identify the cause-and-effect relationships for potential predictor variables. In addition, more sophisticated statistical analyses such as the use of the odds ratio matrix may help guide further research into interaction effects between predictor variables and how these might affect the psychometric properties of risk assessment tools such as the Braden Scale. Pressure ulcer interventions should be targeted at the sacrum and heel, because these appear to be the most frequently observed locations for pressure ulcers.

ISSN:1071-5754    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveThe purpose of this study was to evaluate the interface pressures under the bony prominences of children on several support surfaces to evaluate benefit, in terms of the lowest interface pressures, and cost-effectiveness.DesignA descriptive study design was used.Setting/SubjectsA convenience sample of 54 healthy children from the community ranging in age from infancy through 16 years was enrolled through advertisements in the hospital newsletter. The study was conducted in the General Clinical Research Center located within Texas Children's Hospital, Houston, Texas.InstrumentsThe instrument used to measure the interface pressures was the Mini-Texas Interface Pressure Evaluator.MethodsA comparison was done to evaluate interface pressures under the occiput for infants to children younger than 6 years of age and under the occiput, coccyx, and heel for 6- to 18-year-olds. Five surface combinations were used for measurements: a standard hospital bed or crib mattress; mattress with Delta foam overlay; a mattress with a Gel-E-Donut pillow; a mattress with a Delta foam overlay plus Gel-E-Donut pillow; and an Efica low-air-loss bed.ResultsThe standard hospital mattress yielded the highest interface pressures. The Delta Foam overlay alone or in combination with the Gel-E-Donut pillow produced the lowest occipital pressures in all age groups. The Delta foam overlay produced comparable pressures to the Efica low-air-loss bed when measuring the coccyx and heel interface pressures.ConclusionsThe Delta Foam overlay alone or in combination with the Gel-E-Donut pillow is a cost-effective and therapeutic choice for pressure reduction as demonstrated in this study of healthy children.

ISSN:1071-5754    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

ObjectiveThe objective of this study was to examine the short-term effectiveness of prompted voiding (PV) in cognitively impaired homebound older adults.DesignThis was a prospective, controlled exploratory study with a cross-over design where usual care controls crossed-over to the intervention following an 8-week observation period.SettingAdults aged 60 years and older with urinary incontinence and who met Center for Medicare and Medicaid Services criteria for being homebound were referred to the study by home care nurses from 2 large Medicare-approved home health agencies in a large metropolitan county in southwestern Pennsylvania. Nineteen cognitively impaired older adults were randomly assigned to either the PV intervention or a usual care attention control group.MeasuresMeasures used included structured continence and medical histories, Older American Research and Service Physical and Instrumental Activities of Daily Living scales, Folstein Mini Mental State Examination, Clock Drawing Test, Geriatric Depression Scale, Performance-Based Toileting Assessment, bladder diaries, and physical examination.ResultsNineteen subjects were randomly assigned to a PV (n = 9) or delayed attention-control group (n = 10). Treatment subjects with complete pretreatment and posttreatment data (n = 6) experienced a mean 60% reduction in daytime incontinent episodes compared with a mean 37% reduction among control subjects (n = 10). Following the control phase, subjects crossed over to the treatment protocol. A total of 15 subjects completed the PV protocol. Among all subjects completing the treatment protocol, there was a 22% reduction in daytime incontinent episodes compared with true baseline (immediately following the control phase for those crossing over from the control group).ConclusionsThe PV intervention resulted in clinically significant reductions in urinary incontinence for many of the participants, which may be achievable for many cognitively impaired homebound older adults.

ISSN:1071-5754    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The term “Marjolin's ulcer” is often used to describe the formation of neoplastic changes in the scar tissue of chronic ulcers. This type of carcinoma is most often seen in postburn scars, but it may be seen in many types of chronic wound scars. The most common cell type is squamous cell carcinoma. Squamous cell carcinomas resulting from Marjolin's ulcers have a much greater tendency to metastasize than squamous cell carcinomas arising from other causes, which makes early diagnosis imperative. The 2 case studies in this article describe Marjolin's ulcers occurring in chronic pressure ulcers, which should alert the clinician to the possibility of malignancy in any long-standing wound with an atypical presentation.

ISSN:1071-5754    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1071-5754    

出版商:OVID    

年代:2002

数据来源: OVID