A qualitative analysis of pressure injury development among medically underserved adults with spinal cord injury.
A qualitative analysis of pressure injury development among medically underserved adults with spinal cord injury.
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DOI：
10.1080/09638288.2018.1552328
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发表时间：
2020-07
影响因子：
2.2
通讯作者：
Clark, Florence A.
中科院分区：
文献类型：
--
作者：
Florindez, Lucia, I;Carlson, Mike E.;Pyatak, Elizabeth;Blanchard, Jeanine;Cogan, Alison M.;Sleight, Alix G.;Hill, Valerie;Diaz, Jesus;Blanche, Erna;Garber, Susan L.;Clark, Florence A.
即使在接受了预防技术的教育后，患有脊髓损伤(SCI)的医疗服务不足的成年人仍然处于遭受医疗严重压力性损伤的高风险中。本研究的目的是确定在基于生活方式的压力损伤预防计划期间，导致医疗服务不足的成年脊髓损伤患者发生严重压力损伤的情况，并为未来的康复方法和干预设计提供建议。这项研究对随机对照试验的治疗记录进行了定性的二次病例分析。参与者是25名居住在社区、医疗服务不足的SCI成年人，他们在RCT干预过程中出现了严重的医疗压力性损伤。在25名参与者中，发现了40例独特的严重压力伤。与医疗严重压力性损伤发展有关的六个主题是：(1)缺乏与伤口护理有关的基本知识；(2)设备和供应问题；(3)合并症；(4)不遵守规定的卧床休息；(5)不活动；(6)干预措施无法触及的情况。这些因素加在一起，可能削弱了干预计划的有效性。改进措施，例如在提供护理之前评估患者的健康素养水平，提供量身定制的伤口护理教育，以及关注设备需求，都有可能改变未来的康复计划和改善健康结果。
Medically underserved adults with spinal cord injury (SCI) remain at high risk of incurring medically serious pressure injuries even after receiving education in prevention techniques. The purpose of this research is to identify circumstances leading to medically serious pressure injury development in medically underserved adults with SCI during a lifestyle-based pressure injury prevention program, and provide recommendations for future rehabilitation approaches and intervention design. This study entailed a qualitative secondary case analysis of treatment notes from a randomized controlled trial. Participants were 25 community-dwelling, medically underserved adults with SCI who developed medically serious pressure injuries during the course of the intervention of the RCT. Among the 25 participants, 40 unique medically serious pressure injuries were detected. The six themes related to medically serious pressure injury development were: (1) lack of rudimentary knowledge pertaining to wound care; (2) equipment and supply issues; (3) comorbidities; (4) non-adherence to prescribed bed rest; (5) inactivity; and (6) circumstances beyond the intervention’s reach. Together, these factors may have undermined the effectiveness of the intervention program. Modifications, such as assessing health literacy levels of patients prior to providing care, providing tailored wound care education, and focusing on equipment needs, have potential for altering future rehabilitation programs and improving health outcomes.
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作者：
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