fa عوامل خطر ساز ابتلا به زخم فشاری در بیماران دارای ضایعه مغزی - نخاعی بستری در منزل پرستاری Nursing پژوهشي اصیل Original Research <p dir="rtl" class="MsoNormal" style="text-align: justify line-height: normal margin: 0cm 21.25pt 0pt 0cm unicode-bidi: embed direction: rtl"><b><span lang="AR-SA" style="font-family: 'B Traffic' font-size: 10pt mso-hansi-font-family: Arial mso-ascii-font-family: Arial">مقدمه:</span></b><span lang="AR-SA" style="font-family: 'B Traffic' font-size: 10pt mso-hansi-font-family: Arial mso-ascii-font-family: Arial"><span style="mso-spacerun: yes">  </span>بیماران </span><span lang="FA" style="font-family: 'B Traffic' font-size: 10pt mso-hansi-font-family: Arial mso-bidi-language: FA mso-ascii-font-family: Arial">دچار</span><span lang="AR-SA" style="font-family: 'B Traffic' font-size: 10pt mso-hansi-font-family: Arial mso-ascii-font-family: Arial"> ضایعات مغزی- نخاعی به میزان زیادی </span><span lang="FA" style="font-family: 'B Traffic' font-size: 10pt mso-hansi-font-family: Arial mso-bidi-language: FA mso-ascii-font-family: Arial">در معرض خطر ابتلا به زخم فشاری قرار دارند.</span><span lang="AR-SA" style="font-family: 'B Traffic' font-size: 10pt mso-hansi-font-family: Arial mso-ascii-font-family: Arial"> این مطالعه با هدف بررسی عوامل خطرزای زخم فشاری در بیماران با ضایعات مغزی- نخاعی بستری در منزل انجام گرفت.<!--stripped--><!--stripped--></span></p> <p dir="rtl" class="MsoNormal" style="text-align: justify line-height: normal margin: 0cm 21.25pt 0pt 0cm unicode-bidi: embed direction: rtl"><b><span lang="AR-SA" style="font-family: 'B Traffic' font-size: 10pt mso-hansi-font-family: Arial mso-ascii-font-family: Arial">روش کار:</span></b><span lang="AR-SA" style="font-family: 'B Traffic' font-size: 10pt mso-hansi-font-family: Arial mso-ascii-font-family: Arial"><span style="mso-spacerun: yes">  </span>این مطالعه مقطعی با نمونه­گیری </span><span lang="FA" style="font-family: 'B Traffic' font-size: 10pt mso-hansi-font-family: Arial mso-bidi-language: FA mso-ascii-font-family: Arial">در دسترس بر روی 60 بیمار </span><span lang="AR-SA" style="font-family: 'B Traffic' font-size: 10pt mso-hansi-font-family: Arial mso-ascii-font-family: Arial">بستری در منزل</span><span dir="ltr" lang="AR-SA" style="font-family: 'Arial','sans-serif' font-size: 10pt mso-bidi-font-family: 'B Traffic'"> </span><span lang="FA" style="font-family: 'B Traffic' font-size: 10pt mso-hansi-font-family: Arial mso-bidi-language: FA mso-ascii-font-family: Arial">در سال 91 در همدان</span><span lang="AR-SA" style="font-family: 'B Traffic' font-size: 10pt mso-hansi-font-family: Arial mso-ascii-font-family: Arial"> انجام شد. بیماران از نظر عوامل خطرزای زخم فشاری با مقیاس استاندارد </span><span lang="FA" style="font-family: 'B Traffic' font-size: 10pt mso-bidi-language: FA">برادن </span><span lang="AR-SA" style="font-family: 'B Traffic' font-size: 10pt">و چک لیست عوامل زمینه­ای</span><span lang="FA" style="font-family: 'B Traffic' font-size: 10pt mso-bidi-language: FA"><span style="mso-spacerun: yes">  </span></span><span lang="AR-SA" style="font-family: 'B Traffic' font-size: 10pt">به</span><span lang="FA" style="font-family: 'B Traffic' font-size: 10pt mso-bidi-language: FA"> فاصله هر 48 الی72 ساعت به مدت سه هفته مورد پایش قرار گرفتند. جهت تعیین رابطه ابتلا به زخم فشاری و نمره مقیاس برادن و وجود عوامل زمینه­ای از </span><span lang="AR-SA" style="font-family: 'B Traffic' font-size: 10pt">رگرسیون لوجستیک، ضریب همبستگی گاما استفاده گردید.<!--stripped--><!--stripped--></span></p> <p dir="rtl" class="MsoNormal" style="text-align: justify line-height: normal margin: 0cm 21.25pt 0pt 0cm unicode-bidi: embed direction: rtl"><b><span lang="AR-SA" style="font-family: 'B Traffic' font-size: 10pt">یافته‎ها:</span></b><span lang="FA" style="font-family: 'B Traffic' font-size: 10pt mso-bidi-language: FA"> از60 بیمار مورد مطالعه </span><span lang="AR-SA" style="font-family: 'B Traffic' font-size: 10pt">7/51% مرد بودند، 3/83% دچار سکته مغزی، 7/6% ضربه به سر، 5</span><span lang="FA" style="font-family: 'B Traffic' font-size: 10pt mso-bidi-language: FA">%</span><span lang="AR-SA" style="font-family: 'B Traffic' font-size: 10pt"> قطع نخاع، 5% ترومای ستون فقرات بودند. میزان ابتلا به زخم فشاری </span><span lang="FA" style="font-family: 'B Traffic' font-size: 10pt mso-bidi-language: FA">25</span><span lang="AR-SA" style="font-family: 'B Traffic' font-size: 10pt">% بود.</span><span lang="AR-SA" style="font-family: 'B Traffic' font-size: 10pt mso-bidi-language: FA"> </span><span lang="AR-SA" style="font-family: 'B Traffic' font-size: 10pt">بین میزان هموگلوبین و ابتلا به زخم فشاری </span><span lang="FA" style="font-family: 'B Traffic' font-size: 10pt mso-bidi-language: FA">(05/0</span><font face="PMingLiU"><span dir="ltr" style="font-size: 10pt mso-bidi-font-family: 'B Traffic' mso-bidi-language: FA">p<</span></font><span lang="FA" style="font-family: 'B Traffic' font-size: 10pt mso-bidi-language: FA">) و معیارهای مقیاس برادن<span style="mso-spacerun: yes">  </span>با<span style="mso-spacerun: yes">  </span>ابتلا به زخم فشاری ارتباط معنی­دار وجود داشت(001/0</span><font face="PMingLiU"><span dir="ltr" style="font-size: 10pt mso-bidi-font-family: 'B Traffic' mso-bidi-language: FA">p<</span></font><span lang="FA" style="font-family: 'B Traffic' font-size: 10pt mso-bidi-language: FA">).</span><span lang="AR-SA" style="font-family: 'B Traffic' font-size: 10pt"><!--stripped--><!--stripped--></span></p> <p dir="rtl" class="MsoNormal" style="text-align: justify line-height: normal margin: 0cm 21.25pt 0pt 0cm unicode-bidi: embed direction: rtl"><b><span lang="FA" style="font-family: 'B Traffic' font-size: 10pt mso-bidi-language: FA">نتیجه نهایی:</span></b><span lang="FA" style="font-family: 'B Traffic' font-size: 10pt mso-bidi-language: FA"> کاهش درک حسی، افزایش رطوبت بستر، تغذیه نامناسب، کاهش فعالیت و تحرک، افزایش اصطکاک و سائیدگی، کاهش هموگلوبین</span><span dir="ltr" lang="FA" style="font-size: 10pt mso-bidi-font-family: 'B Traffic' mso-bidi-language: FA"><font face="PMingLiU"> </font></span><span lang="FA" style="font-family: 'B Traffic' font-size: 10pt mso-bidi-language: FA">و کاهش نمره مقیاس برادن از عوامل خطر ابتلا به زخم فشاری در بیماران با ضایعات مغزی - نخاعی بستری در منزل می باشد که<span style="mso-spacerun: yes">  </span>برخی از این عوامل قابل پیشگیری هستند.</span><span lang="AR-SA" style="font-family: 'B Traffic' font-size: 10pt"><!--stripped--><!--stripped--></span></p> <p class="MsoNormal" style="text-align: justify margin: 0cm 12.6pt 0pt 18pt"><span class="hps"><b><span style="line-height: 115% font-family: 'Times New Roman','serif' font-size: 10pt mso-ascii-theme-font: major-bidi mso-hansi-theme-font: major-bidi mso-bidi-theme-font: major-bidi">Background: </span></b></span><span style="line-height: 115% font-family: 'Times New Roman','serif' font-size: 12pt mso-ascii-theme-font: major-bidi mso-hansi-theme-font: major-bidi mso-bidi-theme-font: major-bidi">Critically ill brain-spinal cord injured patients are at high risk for pressure ulcers. The aim of this study was to investigate risk factors of developing pressure ulcers in critically ill patients with brain-spinal cord injuries. <!--stripped--><!--stripped--></span></p> <p class="MsoNormal" style="text-align: justify margin: 0cm 12.6pt 0pt 18pt"><span class="longtext"><b><span style="line-height: 115% font-family: 'Times New Roman','serif' font-size: 10pt mso-ascii-theme-font: major-bidi mso-hansi-theme-font: major-bidi mso-bidi-theme-font: major-bidi">Methods:</span></b></span><span class="longtext"><span style="line-height: 115% font-family: 'Times New Roman','serif' font-size: 12pt mso-ascii-theme-font: major-bidi mso-hansi-theme-font: major-bidi mso-bidi-theme-font: major-bidi"> This cross-sectional study </span></span><span style="line-height: 115% font-family: 'Times New Roman','serif' font-size: 12pt mso-ascii-theme-font: major-bidi mso-hansi-theme-font: major-bidi mso-bidi-theme-font: major-bidi">was conducted on 62 home care patients with brain-spinal cord injuries in Hamadan city in 2012. For three weeks, every 48 to 72 hours, patients <span class="hps">were monitored for pressure ulcer risk factors by the use of Braden Scale </span><span class="longtext">and a checklist of background factors. Data was analyzed by the use of </span><span class="hps">logistic regression</span> and <span class="hps">gamma correlation coefficient</span>.<span class="longtext"><span style="background: white"><!--stripped--><!--stripped--></span></span></span></p> <p class="MsoNormal" style="text-align: justify margin: 0cm 12.6pt 0pt 18pt"><span class="longtext"><b><span style="line-height: 115% font-family: 'Times New Roman','serif' font-size: 10pt mso-ascii-theme-font: major-bidi mso-hansi-theme-font: major-bidi mso-bidi-theme-font: major-bidi">Results:</span></b></span><span class="longtext"><span style="line-height: 115% font-family: 'Times New Roman','serif' font-size: 12pt mso-ascii-theme-font: major-bidi mso-hansi-theme-font: major-bidi mso-bidi-theme-font: major-bidi"> From among<span style="mso-spacerun: yes">  </span>60 patients studied, 51.7% were male, 83.3% suffered from<span style="mso-spacerun: yes">  </span>stroke, 6.7% had head trauma and10% had spinal cord </span></span><span class="hps"><span style="line-height: 115% font-family: 'Times New Roman','serif' font-size: 12pt mso-ascii-theme-font: major-bidi mso-hansi-theme-font: major-bidi mso-bidi-theme-font: major-bidi">injuries</span></span><span class="longtext"><span style="line-height: 115% font-family: 'Times New Roman','serif' font-size: 12pt mso-ascii-theme-font: major-bidi mso-hansi-theme-font: major-bidi mso-bidi-theme-font: major-bidi">. The incidence of pressure ulcers among them was 25%. There were seen significant relationships both between </span></span><span style="line-height: 115% font-family: 'Times New Roman','serif' font-size: 12pt mso-ascii-theme-font: major-bidi mso-hansi-theme-font: major-bidi mso-bidi-theme-font: major-bidi">The incidence of pressure ulcers and the level of hemoglobin <span class="longtext">(p=0.05) and between </span>the incidence of pressure ulcers and the Braden scale <span class="longtext">(p<0.001)</span>. <span class="longtext"><span style="background: white"><!--stripped--><!--stripped--></span></span></span></p> <p class="MsoNormal" style="text-align: justify margin: 0cm 12.6pt 0pt 18pt"><span class="hps"><b><span style="line-height: 115% font-family: 'Times New Roman','serif' font-size: 10pt mso-ascii-theme-font: major-bidi mso-hansi-theme-font: major-bidi mso-bidi-theme-font: major-bidi">Conclusion: Based on this study </span></b></span><span class="hps"><span style="line-height: 115% font-family: 'Times New Roman','serif' font-size: 12pt mso-ascii-theme-font: major-bidi mso-hansi-theme-font: major-bidi mso-bidi-theme-font: major-bidi">decreased sensory perception</span></span><span style="line-height: 115% font-family: 'Times New Roman','serif' font-size: 12pt mso-ascii-theme-font: major-bidi mso-hansi-theme-font: major-bidi mso-bidi-theme-font: major-bidi">, increased bed’s <span class="hps">moisture</span>, <span class="hps">poor nutrition</span>, <span class="hps">decreased mobility</span>, increased <span class="hps">friction and wear</span>, low level of <span class="hps">hemoglobin </span>and low score of <span class="hps">Braden Scale are risk factors for developing pressure ulcers in home care patients</span> with brain-spinal cord injuries. Some of these risk factors can be prevented and treated. <!--stripped--><!--stripped--></span></p> زخم فشاری، ضایعات مغزی نخاعی، عوامل خطرساز ، مقیاس برادن Braden Scale / brain-spinal cord injury / pressure ulcers /risk factor 47 57 http://nmj.umsha.ac.ir/browse.php?a_code=A-10-1-1138&slc_lang=fa&sid=1 Gh.h .Falahinia, M. Vali Kian, F. Shamsaei , M. Salavati غلامحسین فلاحی نیا 10031947532846001482 10031947532846001482 No A.R. Soltanian محمد ولی کیان 10031947532846001483 10031947532846001483 No دکتر فرشید شمسائی 10031947532846001484 10031947532846001484 No محسن صلوانی 10031947532846001485 10031947532846001485 No دکتر علیرضا سلطانیان 10031947532846001486 10031947532846001486 No