MEASURING TEWL AND SKIN SURFACE PH IN THE ELDERLY

描述：(改编自调查人员摘要)目的 护理研究是检查经皮穿皮水与 会皮炎发生过程中皮肤表面pH值与皮肤损失率的关系 并进行一项预防会阴的先导性干预研究 皮炎。本研究将回答以下研究问题：(1) 经皮吸收水分的差异有统计学意义吗 大小便失禁和大小便失禁老年人之间的皮肤表面pH值水平？(2)是 经皮吸收水分的差异有统计学意义 尿失禁老年人与孤立性尿失禁老年人比较 大小便失禁？(3)在统计学上有显著差异吗 大便失禁老年人会皮炎的发生率 与患有孤立性尿失禁(尿失禁或大便失禁)的老年人相比？(4)有没有 会阴发育率差异有统计学意义 皮炎取决于年龄、性别、成人一次性内裤的时间长度 每24小时穿一次，大小便失禁发作次数，次数 成人内裤被检查和更改，大便的一致性，以及 报告大小便失禁的患者？(5)用一种 酸性溶液将皮肤的PH值保持在酸性水平(低于PH值 5.9)，从而预防老年人会阴皮炎？两个阶段 将进行前瞻性的纵向临床研究。在第一阶段，两者 主题间(大小便失禁)和主题内设计 将使用(尿液、大便和大便失禁)。二百多元 20名受试者将使用连续的系列设计在 城市医疗中心。在220名受试者中，将有100名是大陆长老 将提供经皮水分损失和皮肤表面pH值的基线数据 级别。其余的受试者(120)将大小便失禁，并满足 一般纳入标准。会阴评估和各种皮肤 每周测量三次。描述性统计， 三因素方差分析和COX回归分析 分析此阶段的数据。在第二阶段，重复措施加倍 盲目设计将在城市医疗中心进行。六十 大小便失禁的受试者将采用连续系列设计。 在符合入选标准后，将随机分配每个科目 无论是对照组还是试验组。实验性的 小组将收到酸性皮肤洗涤之前，而不是水 涂上保湿剂和防潮剂。每门课都会是 每周评估五次会阴皮炎的发展情况。仅限 首席调查员将知道哪些受试者正在接受酸性 酸洗。描述性统计和单向方差分析将 在这一阶段的研究中使用。这项研究的结果预计将 为会阴的发病机制和治疗提供有价值的资料 老年人的皮炎。这项研究还将为 指导对一个经常被忽视的健康问题的进一步干预研究 关心。

DESCRIPTION: (Adapted from investigator's abstract) The purpose of this nursing study is to examine the association between transepidermal water loss (TEWL) and skin surface pH in the development of perineal dermatitis in the elderly and to conduct a pilot intervention study to prevent perineal dermatitis. This study will answer the following research questions: (1) Is there a statistically significant difference in transepidermal water loss and skin surface pH levels between continent and incontinent elders? (2) Is there a statistically significant difference in transepidermal water loss and pH levels in urofecal incontinent elders versus elders with isolated incontinence? (3) Is there a statistically significant difference in the rate of developing perineal dermatitis for urofecal incontinent elders versus elders with isolated incontinence (urinary or fecal)? (4) Is there a statistically significant difference in the rate of developing perineal dermatitis depending on age, gender, length of time adult disposable briefs are worn per 24 hour period, number of incontinent episodes, number of times adult briefs are checked and changes, stool consistency, and role of the patient in reporting incontinence? (5) Does treating the skin with an acidic acid solution maintain the skin's pH at an acidic level (less than pH of 5.9), thus preventing perineal dermatitis in the elderly? A two phase prospective longitudinal clinical study will be conducted. In Phase I, both a between subjects (continent vs incontinent) and within subjects design (urinary, fecal, and urofecal incontinent) will be used. Two hundred and twenty subjects will be obtained using a consecutive series design at an urban medical center. Of the 220 subjects, 100 will be continent elders who will provide baseline data on transepidermal water loss and skin surface pH levels. The remaining subjects (120) will be incontinent and meet the general inclusion criteria. Perineal assessment and various skin measurements will be obtained three times per week. Descriptive statistics, three-way analysis of variance, and Cox regression analysis are planned to analyze the data in this phase. In Phase II a repeated measures double blind design will be conducted at an urban medical center. Sixty incontinent subjects will be obtained using a consecutive series design. After meeting the inclusion criteria, each subject will be randomly assigned to either the control group or the experimental group. The experimental group will receive an acidic acid skin wash rather than water prior to applying a moisturizer and moisture repellant. Each subject will be assessed five times a week for the development of perineal dermatitis. Only the principal investigator will know which subjects are receiving the acidic acid wash. Descriptive statistics and one-way analysis of variance will be used on this phase of the study. Results of this study are expected to provide valuable data on the pathogenesis and treatment of perineal dermatitis in the elderly. This study will also provide information to guide further intervention studies in an often-ignored problem in health care.