The impact of malnutrition and nutrition-related factors on the development and severity of pressure ulcers in older patients receiving home care
The impact of malnutrition and nutrition-related factors on the development and severity of pressure ulcers in older patients receiving home care
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DOI：
10.1016/j.clnu.2009.05.018
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发表时间：
2010-02-01
影响因子：
6.3
通讯作者：
Sanada, Hiromi
中科院分区：
文献类型：
--
作者：
Iizaka, Shinji;Okuwa, Mayumi;Sanada, Hiromi
背景与目的：探讨营养状况和营养相关因素对家庭护理中获得性压疮的发展和严重程度的影响。方法：随机选取日本270家家庭护理机构，对290例家庭获得性压疮患者和456例非家庭获得性压疮患者进行分析。收集营养状况、护理人员知识和卫生专业人员营养管理数据。压疮分为浅表性和全厚性。结果：在调整其他危险因素后，营养不良与压疮的高发率有显著且最强烈的相关性（OR, 2.29; 95% CI, 1.53-3.44）。由健康专业人员评估患者的营养状况和适当的饮食摄入与压疮发生的几率较低显著相关（OR, 0.43, 0.47; 95% CI, 0.27-0.68, 0.28-0.79）。营养不良也与更严重的压疮密切相关（OR, 1.88; 95% CI, 1.03-3.45）。由健康专业人员评估护理者的营养知识是严重压疮的重要预防因素。结论：压力再分配等危险因素的家庭护理质量有所提高，使营养管理成为预防压疮的重要因素。(C) 2009爱思唯尔有限公司和欧洲临床营养与代谢学会。版权所有。
Background & aims: To investigate the impact of nutritional status and nutrition-related factors on the development and severity of pressure ulcers acquired in the home care setting.Methods: Two hundred and seven home care offices in Japan were selected at random and 290 patients with home-acquired pressure ulcers and 456 patients without pressure ulcers were analyzed. Data on nutritional status, caregiver knowledge, and health professional's nutritional management were collected. Pressure ulcers were categorized as superficial or full-thickness.Results: Malnutrition was significantly and most strongly associated with higher rate of the pressure ulcer after adjusting for other risk factors (OR, 2.29; 95% CI, 1.53-3.44). Assessment of the patient's nutritional status and adequate dietary intake by a health professional were significantly associated with lower odds for developing pressure ulcers (OR, 0.43, 0.47; 95% CI, 0.27-0.68, 0.28-0.79, respectively). Malnutrition was also significantly and most strongly associated with more severe pressure ulcers (OR, 1.88: 95% CI, 1.03-3.45). Assessment of a caregiver's nutritional knowledge by a health professional was a significant preventive factor for severe pressure ulcers.Conclusion: The quality of home care for risk factors such as pressure redistribution has improved, making nutritional management a more crucial factor in pressure ulcer prevention. (C) 2009 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.