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Abstract(s)
A dimensão das Dermatites Associadas à Incontinência (DAI) é desconhecida em vários contextos da prestação de cuidados de saúde em Portugal. É uma condição com etiologia específica, comummente confundida com úlceras de pressão, que necessita de um diagnóstico eficaz e diferencial. Para esse efeito, existem atualmente instrumentos de avaliação da DAI com carácter diagnóstico e que orientam a atitude do profissional numa abordagem prática que incorpora a prevenção no próprio tratamento da lesão.
Este estudo emerge da preocupação com a inexistência de um registo sistemático destas lesões. Definiu-se, assim os seguintes objetivos para este estudo: estimar a prevalência de DAI de uma população geriátrica; e identificar e caracterizar as lesões e os seus portadores.
Criou-se, para o efeito, um instrumento de avaliação, à luz da mais recente evidência científica sobre a DAI, apoiado sobretudo em instrumentos já existentes: IADS, SCAT, entre outros.
A recolha de dados foi realizada pelos investigadores durante o mês de Maio de 2015. Foram estudados todos os utentes da valência de uma ERPI da Santa Casa da Misericórdia. Observaram-se as localizações anatómicas mais frequentemente atingidas por DAI, a mobilidade, a incontinência e sistema de proteção, por forma a estudar possíveis relações destas com a DAI.
Foram estudados 118 utentes; com uma idade média 82,32 anos; sendo o género feminino o mais representado, com cerca de ¾ do total. A prevalência de lesão por DAI foi de 11,02%, com um tempo de evolução médio de 12,23 dias; as localizações anatómicas mais atingidas foram as regiões perianal, genital e sulco nadegueiro. Todas as lesões apresentavam rubor, não se tendo presenciado rash ou sangramento; a maioria das lesões apresentava dimensão superior a 20 cm2. O estudo dos indivíduos com e sem DAI mostrou a existência de diferenças com significância estatística relativamente às variáveis idade, mobilidade e dupla incontinência. Os resultados desta investigação corroboram os de outros estudos internacionais, servindo de primeiro referencial para o conhecimento epidemiológico deste tipo de lesões em Portugal.
The extent of the health problem known as incontinence-associated dermatitis (IAD) has not been evaluated in the several contexts of health care services in Portugal. The issue starts in the concept itself: despite its specific etiology, it is commonly mistaken for pressure ulcers. This strengthens the need for an accurate and differential diagnosis. For that purpose some IAD assessment tools with a diagnostic character are presently available, leading its professional user towards a practical approach in which prevention is incorporated in the injury treatment itself. Emerging from the need to study the epidemiology of IAD in risk patients, the following aims were set: to become aware of the prevalence of IAD in a geriatric nursing home resident population and to get to know the injury characteristics as well as the features of the individuals enrolled. Methods: the data were collected by the main researcher in one week of May 2015. All the nursing home residents of Santa Casa da Misericórdia of Arganil were studied. Every anatomic location most commonly affected by IAD was examined and the variables type of mobility, continence and skin protection system were considered in order to evaluate their possible relationship with IAD. Results and conclusions: a total of 118 ERPI residents of Santa Casa da Misericórdia de Arganil were studied; the average age of the population is 83,32; females comprise ¾ of the total; the prevalence of IAD was 11,02%, with an average treatment evolution time of 12,23 days; the most affected anatomic locations were the anal area, the perineal area and the intergluteal cleft. All the injuries showed redness but no rash or bleeding; all the injuries except one were larger than 20cm2. The study of patients with and without IAD supported the existence of differences with statistic significance in relation to the variables age, type of mobility and double incontinence. The results of this research match those of several international studies and may be used as a primary referential approach for the epidemiologic knowledge of this kind of injuries in Portugal.
The extent of the health problem known as incontinence-associated dermatitis (IAD) has not been evaluated in the several contexts of health care services in Portugal. The issue starts in the concept itself: despite its specific etiology, it is commonly mistaken for pressure ulcers. This strengthens the need for an accurate and differential diagnosis. For that purpose some IAD assessment tools with a diagnostic character are presently available, leading its professional user towards a practical approach in which prevention is incorporated in the injury treatment itself. Emerging from the need to study the epidemiology of IAD in risk patients, the following aims were set: to become aware of the prevalence of IAD in a geriatric nursing home resident population and to get to know the injury characteristics as well as the features of the individuals enrolled. Methods: the data were collected by the main researcher in one week of May 2015. All the nursing home residents of Santa Casa da Misericórdia of Arganil were studied. Every anatomic location most commonly affected by IAD was examined and the variables type of mobility, continence and skin protection system were considered in order to evaluate their possible relationship with IAD. Results and conclusions: a total of 118 ERPI residents of Santa Casa da Misericórdia de Arganil were studied; the average age of the population is 83,32; females comprise ¾ of the total; the prevalence of IAD was 11,02%, with an average treatment evolution time of 12,23 days; the most affected anatomic locations were the anal area, the perineal area and the intergluteal cleft. All the injuries showed redness but no rash or bleeding; all the injuries except one were larger than 20cm2. The study of patients with and without IAD supported the existence of differences with statistic significance in relation to the variables age, type of mobility and double incontinence. The results of this research match those of several international studies and may be used as a primary referential approach for the epidemiologic knowledge of this kind of injuries in Portugal.