Journal of tissue viability最新文献

Objective: The aim of the study was to determine the prevalence, risk, and predisposing factors of diabetic foot ulcers in adults with diabetes.

Methods: This study is multi-centered descriptive cross-sectional research. Data were collected between June 2022 and November 2022 in seven cities, including five teaching and research hospitals and two public hospitals. The study included 357 people with diabetes. The sample was selected using stratified and systematic sampling. General demographic characteristics, medical history, laboratory and foot examination results, history of foot ulcer and/or amputation, skin and nail problems, peripheral sensory loss (10 g-Semmes-Weinstein monofilament) and vascular assessment were obtained. Logistic regression analysis was used to screen for factors affecting the diabetic foot.

Results: The prevalence of diabetic foot ulcers was 17.1 % (%13.2-%21.5; %95 CI). Among 296 individuals with diabetes without foot ulcers, 86.5 % (256) had risk level 0, 7.3 % (26) had risk level 1, 3.4 % (10) had risk level 2, and 1.4 % (4) had risk level 3. In regression analysis, the variables of peripheral arterial disease (Exp β: 3.781 - P = .027), history of ulcer (Exp β = 26,180 - P < .001), edema (Exp β: 9.784 - P < .001), fungus between the toes (Exp β = 5.284 - p = .009) were associated with a significantly increased risk of developing diabetic foot.

Conclusion: The prevalence of diabetic foot ulcers was found to be approximately two out of every 10 patients with diabetes, and peripheral arterial disease, history of ulcers, edema, and presence of fungus between the toes were found to be among the risks predicting diabetic foot. All diabetic individuals should be diagnosed in terms of diabetic foot risk factors, and follow-up and treatment should be planned considering the basic building blocks of diabetic foot prevention according to the determined risk group.

Objectives: This study aimed to evaluate the impact of case-based concept map education on nursing students' knowledge of and attitudes toward pressure injury prevention.

Methods: This is a single-group, pre-and post-test,quasi-experimental study. It was conducted in a school of nursing in Türkiye with seventy-seven students. Students received case-supported concept map education to prevent pressure injury. Data were collected using the Pressure Ulcer Prevention Knowledge Assessment Instrument (PUPKAI) and the Pressure Ulcer Prevention Attitude Instrument (APuP) before, immediately after, and four weeks after education. The data were analyzed using one-way analysis of variance for repeated measures.

Results: There were significant differences between the three time points in terms of the PUPKAI total (F = 33.925, p < 0.001) and subscales scores (etiology and development (F = 7.362, p = 0.001), classification and observation (F = 48.386, p < 0.001), nutrition (F = 4.766, p = 0.011), preventive measures to reduce the amount of pressure/shear (F = 42.762, p < 0.001), and preventive measures to reduce the duration of pressure/shear (F = 5.248, p = 0.025), except for risk assessment (p < 0.05). There were also significant differences between the three time points in terms of the APuP total score (F = 33.925, p = 0.018). The Bonferroni test revealed a statistically significant difference between the pre-test and post-test APuP total scores (p = 0.022).

Conclusions: The study demonstrated that case-supported concept map education significantly improved nursing students' knowledge of and attitudes toward pressure injury prevention. These findings suggest that incorporating case-supported concept map education into nursing curricula can effectively enhance students' competence in pressure injury prevention.

Aim: This study examines the mediating role of attitude towards preventing pressure injuries (PIs) in the effect of knowledge about Medical Device-Related Pressure Injuries (MDRPI) on self-efficacy in PI management among Turkish intensive care unit (ICU) nurses.

Materials and methods: A descriptive, cross-sectional study was conducted with 302 ICU nurses in Turkey from October 15, 2023, to April 30, 2024. Data were collected using the Nurse Information Form, Medical Device Related Pressure Injury Knowledge Assessment Test (MDRPI-KAT), Attitude towards Pressure Ulcer Prevention Instrument (APuP), and the Pressure Ulcer Management Self-Efficiency Scale (PUMSES).

Results: ICU nurses had a knowledge score of 9.20 ± 2.32, with a correct response rate of 57.5 %. Their attitude score was 42.41 ± 5.46, with 76.5 % showing a satisfactory attitude (≥75 %). The self-efficacy score for PI management was 60.59 ± 21.03. Knowledge level positively and significantly affected attitude (B = 0.963, 95 % CI [0.720-1.206]), and attitude positively and significantly affected self-efficacy (B = 0.837, 95 % CI [0.370-1.304]). The direct effect of knowledge on PI management self-efficacy was non-significant without a mediator (B = 0.339; p = 0.542; 95 % CI [-0.756-1.435]), but the indirect effect through attitude was significant (B = 0.806; 95 % CI [0.289-1.399]).

Conclusion: The study found that Turkish ICU nurses' knowledge of MDRPIs was below desired levels, though their self-efficacy was slightly above average and their attitudes were satisfactory. Attitude fully mediated the relationship between knowledge and self-efficacy, suggesting that enhancing nurses' knowledge and attitudes can improve their self-efficacy in managing PIs.

Objective: This study aimed to determine nurses' current knowledge, attitudes, and practices in adult intensive care units and palliative care clinics regarding incontinence-associated dermatitis (IAD).

Materials and methods: This descriptive cross-sectional study was conducted with 355 nurses in adult intensive care and palliative services at two hospitals. Data were collected between 5.03.2022 and 15.06.2022 using the" Nurse Demographic Form" and the "Knowledge, Attitude and Practice of Nurses in Managing Incontinence-Associated Dermatitis Questionnaire".

Results: The nurses' mean scores for "Knowledge of IAD Etiology and Diagnosis" were 19.11 (SD 3.29), mean scores for "Knowledge of IAD Risk Factors" were 23.82 (SD 4.27), mean scores for "Attitude Toward IAD Prevention" were 10.1 (SD 2.49), and mean scores for "Practices for IAD Prevention" were 23.71 (SD 3.97). It was found that nurses who used a risk assessment tool to diagnose IAD (p = 0.001), had a procedure or protocol (p = 0.001), and received training on IAD (p < 0.001) had significantly higher "Attitude Towards Prevention of IAD" scores. There was a positive correlation between the number of patients with IAD cared for by the nurses participating in the study and the scores of ''Practices to Prevent IAD'' and ''Knowledge of IAD Risk Factors'', ''Knowledge of IAD Etiology and Diagnosis'' and ''Attitude Towards Preventing IAD'' (p < 0.001).

Conclusion: This study found that intensive care and palliative care nurses' knowledge, attitudes, and practices regarding IAD were insufficient. Considering that IAD is encountered more frequently in these units, it is essential to provide continuous and practical training to nurses about IAD, use risk assessment tools to prevent and treat IAD, determine protocols, establish clinical guidelines, and implement and standardize them.

Aim: The aim of this study was to evaluate the effect of hydrocolloid patch use and facial massage on nasal septum injury and stress in premature infants receiving noninvasive mechanical ventilation (NIMV) support.

Methods: The study was conducted as a single-blind, randomised controlled experimental study with 108 premature infants between 28 and 34 gestation weeks (Hydrocolloid patch group: 36, facial massage group: 36, control group: 36) who were hospitalised in the 3rd level neonatal intensive care unit (NICU) between February 2023 and February 2024, received NIMV support and met the inclusion criteria. The data of the study were collected using the Neonatal Descriptive Information Form, Neonatal Skin Condition Assessment Scale (NSCAS), Nasal Injury Scale (NIS) and Neonatal Stress Scale (NSS).

Results: The preterm infants included in the study did not differ significantly between the groups according to descriptive and clinical characteristics except gender (p > 0.05). NIS scores, NSCAS scores, PICS scores and NSS scores showed significant differences between the groups. In all evaluations, the highest NIS and NSCAS scores were observed in the control group and the lowest NIS and NSCAS scores were observed in the hydrocolloid patch group. When the NSS scores of the groups were analysed, it was found that the lowest was in the group in which facial massage was applied and the highest was in the control group (p < 0.05).

Conclusions: In the study, it was concluded that hydrocolloid tape application was more effective than facial massage application in preventing nasal injuries and decreased the skin condition score, but facial massage application was more effective in decreasing the stress score in premature infants receiving NIMV support.

Aim: The aim of this study was to determine nursing students' levels of knowledge and attitudes regarding medical device-related pressure injuries (MDRPIs), as well as the factors influencing these.

Materials and methods: This descriptive and cross-sectional study was conducted with 581 nursing students between January and May 2024. Data were collected using the Student Information Form, the Medical Device Related Pressure Injury Knowledge Assessment Test (MDRPI-KAT), and the Medical Device Related Pressure Injury Attitude Questionnaire (MDRPI-AQ).

Results: The nursing students had a mean score of 8.76 ± 2.68 on the MDRPI-KAT, indicating an overall correct answer percentage of 54.7 %. The mean total score on the MDRPI-AQ was 44.08 ± 8.12. Furthermore, 75.0 % of the nursing students (n = 436) achieved a positive attitude score (>40 points). According to the results of the structural equation model, the scores on the MDRPI-KAT among nursing students had a statistically significant effect on their scores on the MDRPI-AQ (β = 0.585, p = 0.002).

Conclusion: This study found that the nursing students exhibited insufficient knowledge about MDRPIs.Despite this, the nursing students demonstrated a positive attitude toward MDRPIs.

Aim: From 2015 to 2018, the 'Hospital-Acquired Pressure Injury (HAPI)' project was implemented in one local health district in Australia and utilised an implementation science approach to address rising pressure injury (PI) incidence and prevalence rates. This paper aims to examine whether the project was successful in sustaining low PI incidence and prevalence rates over the five-years following implementation (spanning the 2018/2019 to 2022/2023 financial years and the 2019-2023 calendar years).

Materials and methods: A retrospective cohort study was conducted involving a comprehensive analysis of HAPI incidence, prevalence, and hospital-acquired complication (HAC) data spanning 5 years (incidence and HAC: 2018/2019 to 2022/2023 financial years; prevalence: January 2019 to December 2023 calendar years) post-implementation of the HAPI project.

Results: Since 2018/2019, incidence of HAPIs decreased by 32.6 % (30.7 HAPI per 10,000 episodes of care in 2018/2019 vs 20.7 HAPI per 10,000 episodes of care in 2022/2023 financial year), prevalence remained stable from 1.1 % to 1.27 % (2019 vs 2023 calendar year), and HAC pressure injuries (stage III, IV, suspected deep tissue, unspecified or unstageable) declined by 27.3 % (2.2 HAPI per 10,000 episodes of care in 2018/2019 vs 1.6 HAPI per 10,000 episodes of care in 2022/2023 financial year).

Conclusion: The HAPI project has successfully maintained a low incidence and prevalence rate of HAPI, over 5 years following implementation. This achievement highlights the benefits of utilising an implementation science approach to implementing a multi-faceted intervention in a complex healthcare setting to ensure sustainability beyond the project phase.

Objective: The objective of this scoping review is to map the existing evidence on the epidemiology, care challenges, and impacts of various wound types among individuals living with dementia across different stages of the disease.

Introduction: Dementia is a growing global health concern, projected to rise significantly as the population ages. This condition not only affects cognitive function but also increases the risk of chronic wounds in part due to impairments in mobility, self-care, and communication. Current wound care guidelines inadequately address the specific needs of individuals with dementia. This scoping review seeks to fill this gap by comprehensively exploring the intersection between dementia and wound care.

Inclusion criteria: This review will include studies involving adults aged 18 and older diagnosed with dementia or cognitive impairment who are experiencing alterations in skin integrity, such as pressure injuries, venous and arterial ulcers, and diabetic ulcers. Both qualitative and quantitative studies will be considered, as well as studies focusing on the challenges faced by caregivers in managing wounds in this population. Excluded are studies such as editorials and opinion articles.

Methods: A comprehensive search strategy will be employed across multiple electronic databases, including MEDLINE, CINAHL, PsycINFO, EMBASE, and PubMed, as well as grey literature sources like ProQuest Dissertations & Theses Global and OpenGrey. The search will include studies published in English and French without date restrictions. Data will be extracted using a pilot-tested tool and presented in graphical, diagrammatic, and tabular formats. A narrative summary will accompany these visuals, providing context and insights into the data in relation to the review's objectives.

Background: Patients with venous leg ulcers (VLUs) often carry out inadequate self-care. Person-centered care is recommended as effective support. Understanding the illness trajectory from the patient's perspective could be a way to better understand patients' needs.

Aim: The aim was to describe the illness trajectory experienced by patients with venous leg ulcers.

Methods: Using a qualitative approach, we conducted individual interviews with a purposive sample of 12 patients with venous leg ulcers in the wound outpatient department of a university hospital. Thematic analysis was carried out utilizing the Illness Trajectory Model as the theoretical framework.

Results: 8 women and 4 men with an average age of 74 years had different wound durations, recurrence rates and comorbidities. We identified six illness trajectory-relevant phases: (1) "Accident" or "mosquito bite"; (2) Experiential knowledge reaches its limits; (3) Seeking professional help; (4) Help from the wound clinic; (5) Saying goodbye to normality; (6) Managing VLU in everyday life. VLUs were often caused by accidents and initially treated by patients themselves, with medical help sought later. Over time, patients adapted to treatments like compression therapy, gained self-management (SM) skills to cope with daily life challenges.

Conclusion: All participants performed SM to varying degrees, but not always adequately. Insufficient awareness of the wound as a symptom and complication of a causative disease caused inadequate and ineffective wound management in many cases. Adequate SM developed primarily through learning from experience. The promotion of empirical knowledge and needs-oriented education can improve the SM of affected persons.