Management of night-time urinary incontinence in residential settings for older people: an investigation into the effects of different pad changing regimes on skin health.
Management of night-time urinary incontinence in residential settings for older people: an investigation into the effects of different pad changing regimes on skin health.
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老年人居住环境中夜间尿失禁的管理：不同护垫更换方式对皮肤健康影响的调查。
DOI：
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发表时间：
2003
影响因子：
4.2
通讯作者：
J. Malone‐Lee
中科院分区：
文献类型：
--
作者：
M. Fader;S. Clarke;D. Cook;G. Dean;R. Brooks;A. Cottenden;J. Malone‐Lee
在老年人居住环境中，吸收垫是管理尿失禁的主要方法。技术的改进已经产生了可以整夜佩戴的高吸收性产品，但是长时间佩戴衬垫对老化皮肤的影响是未知的。本研究的目的是研究两种不同的垫更换制度对皮肤健康的影响。采用交叉设计。从住宅设置的主题被随机分配到两个垫更换制度之一：一个频繁的垫更换制度或不太频繁的垫更换制度。每个方案持续4周，然后是替代方案。在每个方案期间使用（i）Diastron红斑仪、（ii）视觉分级量表、（iii）Servomed比色计和（iv）pH计进行两次皮肤测量。主要结果变量是Diastron红斑指数。81例受试者完成了研究。两种治疗方案在红斑的严重程度或皮肤pH值方面没有显著差异。在较不频繁的垫更换方案中，经表皮水分流失的测量值显著较高，表明皮肤“更湿润”（P = 0.01; 95%CI：2.89-21.39）。5名受试者在不太频繁的垫更换方案中发生2级压疮（擦伤），但在频繁的垫更换方案中没有发生;该结果不显著（P = 0.1; 95% CI：0-1.09）。没有证据表明，较低频率的垫更换制度对皮肤红斑或pH值有影响。有证据表明，皮肤更潮湿，这可能使其更容易受到摩擦和磨损。由于皮肤完整性丧失的临床意义，2级压疮发生率更高的统计学不显著结果是引起关注的原因，值得进一步研究。
Absorbent pads are the main method of managing urinary incontinence in residential settings for older people. Improvements in technology have resulted in highly absorbent products which may be worn all night, but the effects of prolonged pad wearing on aged skin are unknown. The aim of this study was to examine the effects of two different pad changing regimes on skin health. A cross-over design was used. Subjects from residential settings were randomly allocated to one of two pad changing regimes: a frequent pad changing regime or a less frequent pad changing regime. Each regime lasted 4 weeks and was followed by the alternative regime. Skin measurements were taken twice during each regime using (i) the Diastron Erythema meter, (ii) a visual grading scale, (iii) the Servomed evaporimeter, and (iv) a pH meter. The primary outcome variable was the Diastron Erythema meter index. Eighty-one subjects completed the study. No significant differences were found in the severity of erythema, or skin pH, between regimes. Measurements of trans-epidermal water loss were significantly higher in the less frequent pad changing regime indicating that skin was 'wetter' (P = 0.01; 95% CI: 2.89-21.39). Five subjects developed grade 2 pressure ulcers (abrasions) during the less frequent pad changing regime, but none in the frequent pad changing regime; this result was not significant (P = 0.1; 95% CI: 0-1.09). No evidence was found that a less frequent pad changing regime has an effect on skin erythema or pH. There is evidence that skin is wetter which may make it more vulnerable to friction and abrasion. The statistically non-significant finding of greater incidence of grade 2 pressure ulcers is a cause for concern and merits further investigation because of the clinical significance of loss of skin integrity.
在专业护理机构中对睡眠和觉醒进行系统的 24 小时行为观察。
影响因子：
3.7
作者：
Bliwise,DL;Bevier,WC;Bliwise,NG;Edgar,DM;Dement,WC
通讯作者：
Dement,WC
影响因子：
5.6
作者：
AncoliIsrael, S;Clopton, P;Mason, W
通讯作者：
Mason, W