Journal of Wound Ostomy and Continence Nursing最新文献

Purpose: To examine effective communication strategies for wound, ostomy, and continence (WOC) nurses working with adolescent patients and provide evidence-based recommendations for improving patient-provider interactions that consider adolescent developmental needs, cultural factors, and privacy concerns.

Method: A narrative review of literature examining adolescent development, healthcare communication, and WOC nursing care was conducted to identify key principles and strategies for effective communication with adolescent patients.

Approach: ST prevalence data were collected concurrently with the quarterly Pressure Injury Prevalence Survey over a period of 12-months (beginning the third quarter of 2017 through the second quarter of 2018) by the Pressure Injury Prevalence Survey Skin Care Champions using the revised Payne-Martin classification system for STs. A data collection form developed by the Wound, Ostomy, and Continence nurse was also completed for the patients with ST(s).

Search strategy: Literature was reviewed from nursing, psychology, and healthcare communication databases focusing on adolescent development, WOC care, nurse-patient communication, and cultural competency in adolescent healthcare settings.

Findings: Key findings include: (1) understanding adolescent development is crucial for effective communication; (2) cultural background significantly influences how adolescents perceive and communicate about WOC care; (3) technology and social media offer both opportunities and challenges for patient engagement; (4) privacy and confidentiality are paramount concerns requiring specific protocols; and (5) developmental-informed communication techniques improve patient outcomes and treatment adherence.

Implications for practice: WOC nurses can enhance care delivery and patient outcomes by employing developmentally appropriate communication strategies, respecting cultural differences, maintaining privacy, and leveraging technology appropriately. These approaches help build trust, promote self-management skills, and establish foundations for long-term health behaviors in adolescent patients.

Purpose: The purpose of this study was to analyze 1 year of data from ongoing assessments of support surface integrity in the acute care (ie, hospital) setting, to formulate recommendations for routine support surface assessment and replacement consideration.

Design: Descriptive study.

Subjects and setting: Data were collected from 85 acute care facilities located in urban, suburban, and rural locations across the United States. Facilities were either current or prospective customers of Medline Industries, LP from who voluntarily agreed to participate in a surface assessment program. Data were collected from January through December 2019.

Methods: Two trained individuals conducted each support surface inspection beginning with a visual inspection of the covering and zipper. Heavy staining or visible prompted an internal inspection of the surface. Finally, a compression test was conducted after which the surface was given a score of its integrity.

Results: Evaluations of 5121 surfaces across 85 acute health facilities showed that 59% (n = 3021) required immediate replacement, and slightly less than one-third of support surfaces were deemed in good condition. The most common failure modes were holes, tears, and thinning. Staining appears to be a leading indicator for mattress failure.

Conclusions: Support surfaces commonly have warrantees of 10 years for manufacturing defects, but this should not be interpreted as the expected years of use. Health care institutions should implement regular inspection practices to identify damaged support surfaces and report them to the appropriate department for replacement. Contaminated surfaces pose an infection control risk, and failure of the physical properties of the support surface may impact pressure redistribution capabilities of the surface.

Purpose: The purpose of the study was to explore the lived experience of Muslims with an ostomy with respect to their cultural and religious practices.

Design: A qualitative, phenomenological design.

Participants and setting: Seven purposively selected participants from a major metropolitan area in South Africa who had lived with an ostomy for 6 months or more were interviewed.

Methods: Interviews were conducted with each participant in the setting of their choice and audio recorded. Transcribed interviews were analyzed using Colaizzi's analytic approach. Data were collected over several months in 2013.

Results: Four themes were generated: They are referred to as the 4 "S's" of living with an ostomy: silence, spirituality, sanitary practices, and survival. Silence was related to the perceived stigma and judgment of others. Participants felt more able to engage in their religious activities as they became aware of the mercy of Allah. Participants encountered difficulties with purification rituals and conforming to the strict requirements for worship. Extra time and attention were given to the sanitary practices in preparation for the rituals of worship. Survival and quality of life were linked to the support received by family, health care providers, and the religious community.

Conclusions: A need exists in the Muslim community for support groups for persons living with an ostomy, and for easily accessible guidance on religious practices and stoma care, particularly in relation to purification preparation for religious obligations. Cultural-religious issues pertaining to ostomy care and support for Muslim patients should be included in the education of health professionals.

Purpose: The aim of this study was to describe patient and wound characteristics associated with 30-day mortality in acutely ill persons.

Design: Retrospective cohort study.

Subjects and setting: The sample comprised 270 critically ill patients who developed pressure injuries during hospitalization at a large Delaware healthcare system. The majority were cared for in the Intensive Care Unit (75.1%, n = 203), managed via a ventilator (54.4%, n = 147), and had renal (62.6%, n = 169) or respiratory (63.3%, n = 171) failure.

Methods: Medical records were collected from an internal database maintained by the Wound, Ostomy, and Continence (WOC) nurse, which was used to track hospital-acquired pressure injuries. Data extracted from the electronic medical record included demographic characteristics, pertinent medical history such as admission diagnoses, comorbidities, and the outcome variable of interest, 30-day mortality.

Results: Ninety-eight (36.3%) patients experienced mortality within 30 days of the identification of their skin injury. Bivariate analysis revealed race, age, renal failure, sepsis, shock, vasopressor use, ICU stay, and stage of injury as significant risk factors associated with the 30-day mortality.

Conclusion: This study underscores the clinical significance of skin injuries during acute hospitalization and the risks associated with 30-day mortality. The data support the need for recognition of skin injuries related to clinical deterioration, early goals of care conversations, and palliative care consults to best provide patient-centered care.

Purpose: The purpose of this study was to describe foot health and foot care needs and demonstrate the feasibility of providing basic foot care for vulnerable populations by nursing students in a community health clinical.

Design: Descriptive study.

Subjects and setting: The sample comprised 41 senior pre-licensure Bachelor of Science in Nursing students, along with 72 participants who received foot care in a homeless shelter, transitional housing, or low-income housing for seniors.

Methods: A descriptive study was conducted of student knowledge in foot care assessment, care, referral, and evaluation of care provided in vulnerable populations within the community over 10 weeks. Students demonstrated assessment and care skills of the feet, prior to data collection. The Simplified 60-Second Diabetic Foot Screening Tool1 was used to assess all first-time participants. In addition, a satisfaction survey was completed by study participants.

Results: The referral rate for those receiving foot care was 46% (n = 33), 74% of the homeless population having the highest referral rate for wound or nail care referrals. Overall, participant satisfaction among those receiving foot care was 4.88 on a Likert scale of 1-5.

Conclusions: Foot care is a health care issue among vulnerable populations, especially in the unhoused and senior community. This study highlights the importance of foot health and the need for ongoing assessment in vulnerable populations.

Purpose: The purpose of this structured review was to synthesize qualitative studies examining sexual life experiences of patients with a fecal ostomy.

Method: This meta-synthesis was based on the interpretive meta-ethnography method defined by Noblit and Hare.

Search strategy: Electronic databases, CINAHL, MEDLINE, PubMed, Web of Science, OVID, Scopus, Springer, and TR Index were searched to identify pertinent sources. Inclusion criteria used a qualitative research design, developed a theme or category, included participants with fecal ostomies aged 18 years or older, and published in English or Turkish. We searched for studies published between January 1990 and December 2020. Grey literature sources and quantitative studies were excluded. Qualitative studies included in this study were evaluated for quality using the Joanna Briggs Institute Qualitative Assessment and Review Instrument (QARI).

Findings: The sample comprised 20 studies. Three main themes were determined: (1) perceived barriers to sexual life, (2) the effect of perceived barriers on sexual life, and (3) sexual counseling related to the effect of an ostomy. Synthesis of the studies provides evidence for the importance of the sexual life experiences of patients with a fecal ostomy and the patient care, patient follow-up, and counseling practices of ostomy nurse specialists.

Implications: Ostomy nurse specialists should be aware that the sexual problems experienced by patients are multifaceted and should provide specific training and counseling about these problems.

Purpose: The aim of this scoping review was to identify validated instruments measuring Patient-Reported Outcome Measures (PROMs) used in research and clinical practice that are deigned to measure the health-related quality of life (HRQoL) of people with chronic wounds.

Method: Scoping literature review.

Search strategy: A search of the electronic databases MEDLINE, PubMed, CINAHL, Web of Science, and Scopus that spanned the years 1990 to April 2024 was conducted. The initial search resulted in 13 094 records. Removal of duplicates, title and abstract searches, and final selection of elements that were read in full yielded 30 records, along with 2 records identified from reference lists of critical articles.

Findings: Twelve validated instruments measuring PROMs assessing HRQoL were identified; 6 were generic and 6 were specific to chronic wounds. The most frequently used generic instruments were the Short Form 36 Health Survey Questionnaire and the EuroQol-five Dimensions-Five levels; they were used in 6 (18.8%) and 3 (9.4%) studies, respectively. The Cardiff Wound Impact Schedule and the Wound-Qol were the most frequently wound-specific instruments; both were applied in 5 (15.6%) studies each. Both condition-specific and generic instruments measure 1 or more conceptual domains that cover the multidimensionality of HRQoL. Generic instruments allow comparison of persons with chronic wounds to populations with other chronic conditions and the general population; however, generic instruments may underestimate changes in QoL in populations with chronic wounds. Condition-specific instruments provide additional information about HRQoL and they are more likely to be responsive to the effects of specific interventions.

Implications: Research related to instruments that measure PROMs for HRQoL for patients with chronic wounds is limited. Additional research such as longitudinal and randomized studies are needed to strengthen the evidence regarding the applicability and dissemination of PROMS to assess HRQoL in this population.