全国52所医院老年住院患者失禁相关性皮炎发生现况及影响因素分析  

Status and influencing factors of incontinence-associated dermatitis among elderly inpatients in 52 hospitals nationwide

作　　者：蒋琪霞 匡丹 王静 郝景平 郝改琳[5] 翁亚娟[6] 李育梅 刘海燕 黄仕明 李博 骆云霞[11] 史素玲[12] 郭海华 白育瑄 Jiang Qixia;Kuang Dan;Wang Jing;Hao Jingping;Hao Gailin;Weng Yajuan;Li Yumei;Liu Haiyan;Huang Shiming;Li Bo;Luo Yunxia;Shi Suling;Guo Haihua;Bai Yuxuan(Burn Plastic Surgery,General Hospital of Eastern Theater Command,Nanjing 210002,China;Nursing Department,Affiliated Hospital of Jiangnan University,Wuxi 214062,China;Nursing Department,Yangpu Hospital,Tongji University,Shanghai 200090,China;Department of Geriatrics,Suqian Traditional Chinese Medicine Hospital,Suqian 223800,China;Nursing Department,Sanmenxia Central Hospital,Sanmenxia 472000,China;Nursing Department,the First People's Hospital of Changzhou,Changzhou 213004,China;Nursing Department,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China;Nursing Department,Siyang Traditional Chinese Medicine Hospital,Suqian 223700,China;Nursing Department,Affiliated Hospital of Zunyi Medical University,Zunyi 563000,China;Nursing Department,Xi'an Gaoling Hospital,Xi'an 710200,China;General Surgery,Jurong People's Hospital,Zhenjiang 212400,China;Nursing Department,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China;Wound Stoma Clinic,Wuan First People's Hospital,Handan 056300,China;Clinical Academic Department,Zhejiang Top Medical Dressing Limited Company,Wenzhou 325027,China)

机构地区：[1]东部战区总医院烧伤整形科,南京210002 [2]江南大学附属医院护理部,无锡214062 [3]同济大学附属杨浦医院护理部,上海200090 [4]宿迁市中医院老年科,宿迁223800 [5]三门峡市中心医院护理部,三门峡472000 [6]常州市第一人民医院护理部,常州213004 [7]温州医科大学附属第二医院护理部,温州325000 [8]泗阳县中医院护理部,宿迁223700 [9]遵义医科大学附属医院护理部,遵义563000 [10]西安市高陵区医院护理部,西安710200 [11]句容市人民医院普外科,镇江212400 [12]河南科技大学第一附属医院护理部,洛阳471000 [13]武安市第一人民医院伤口造口门诊,邯郸056300 [14]浙江医鼎医用敷料有限公司临床学术部,温州325027

出　　处：《中华现代护理杂志》2022年第21期2843-2849,共7页Chinese Journal of Modern Nursing

基　　金：上海王正国创伤医学发展基金会课题(WZGF20200101);全军卫勤保障创新能力专项课题(20WQ027)。

摘　　要：目的探讨全国52所医院老年住院患者失禁相关性皮炎的发生现况及影响因素,并分析老年住院失禁患者的护理现况,为临床干预提供参考依据。方法采用便利抽样法,于2021年3月31日,选取全国52所医院的14675例老年住院患者为研究对象,采用自制的老年住院患者失禁相关性皮炎调查问卷进行调查,收集患者的一般人口学资料、健康状况、失禁情况和皮肤护理措施相关情况。采用二项Logistic回归分析探讨老年住院患者失禁相关性皮炎的影响因素。结果14675例老年住院患者中,皮肤干燥症的现患率为38.78%(5691/14675),失禁现患率为11.06%(1623/14675),失禁相关性皮炎的现患率为1.91%(280/14675);轻度、中度和重度失禁相关性皮炎的现患率分别为1.27%(186/14675)、0.55%(81/14675)、0.09%(13/14675)。1623例老年住院失禁患者护理现况中,落实率较低的项目为:使用中性洗剂清洁皮肤(14.17%,230/1623)、润肤后使用皮肤保护剂(17.68%,287/1623)、每次清洗皮肤后润肤(28.90%,469/1623)。二项Logistic回归分析结果显示,皮肤干燥症、粪失禁、粪尿双失禁、≥2种联合用药、住院时间>30 d是老年住院患者发生失禁相关性皮炎的危险因素。结论老年住院患者失禁相关性皮炎的危险因素主要包括皮肤干燥、失禁类型、≥2种联合用药、住院时间>30 d,临床医护人员制订和实施预防措施时需要关注危险因素。Objective To explore the status and influencing factors of incontinence-associated dermatitis among elderly inpatients in 52 hospitals nationwide,and to analyze the nursing of elderly inpatients with incontinence,so as to provide a reference for clinical intervention.Methods On March 31,2021,convenience sampling was used to select 14675 elderly inpatients from 52 hospitals across the country as the research object.The self-designed Incontinence-associated Dermatitis Questionnaire for Elderly Inpatients was used to collect general demographic data,health status,incontinence,and skin nursing.Binomial Logistic regression was used to investigate the influencing factors of incontinence-associated dermatitis in elderly inpatients.Results Among 14675 elderly inpatients,the prevalence rates of xerosis cutis,incontinence and incontinence-associated dermatitis were 38.78%(5691/14675),11.06%(1623/14675)and 1.91%(280/14675),respectively.The prevalence of mild,moderate and severe incontinence-associated dermatitis were 1.27%(186/14675),0.55%(81/14675),and 0.09%(13/14675),respectively.Among the nursing of 1623 elderly inpatients with incontinence,the items with low implementation rate were the use neutral lotion to clean skin(14.17%,230/1623),use of skin protectant after moisturizing(17.68%,287/1623),moisturizing after cleansing the skin(28.90%,469/1623).The results of binomial Logistic regression analysis showed that xeroderma,fecal incontinence,urinary and fecal incontinence,≥2 kinds of combined medication,and hospital stay>30 days were risk factors for incontinence-associated dermatitis in elderly inpatients.Conclusions The risk factors of incontinence-associated dermatitis in elderly inpatients mainly include xerosis cutis,type of incontinence,≥2 kinds of combined medication,and hospital stay>30 days.

关 键 词：老年人 皮肤干燥症 失禁相关性皮炎 危险因素 护理 

分 类 号：R472[医药卫生—护理学]