ผลของโปรแกรมการดูแลผิวหนังร่วมกับการใช้เบาะยางรถจักรยานใส่น้ำหุ้มด้วยเสื่อกระจูดเพื่อป้องกันการเกิดแผลกดทับในผู้สูงอายุที่นอนติดเตียง

Abstract

This cross-over design aimed to exam the effect of skin-care program combined with water-filled rubber cushion covered with krajud mat on pressure ulcer prevention in bedridden elderly patients living in the community. Fifteen patients participated in this study for 10 days. The participants were randomly assigned to receive usual care for 5 days or to receive the skin care program incorporated with usual care for 5 days, followed by 5 days with the other care. The skin care program consisted of 1) skin assessment, skin care, 2) maintaining skin moisture, 3) reducing interface pressure at the sacral area using water-filled rubber cushion covered with krajud mat. Interface pressure, skin temperature, skin moisture, skin pH and pressure sore incidence were measured. The content validity of skin-care program was examined by three experts. Before data collection, interface pressure, skin temperature, skin moisture and skin pH sensors were calibrated and yielded acceptable values according to the manufacturers' instructions. The reliabilities of these sensors were tested using test-retest method. The reading error of interface pressure was = 2 mmHg., skin moisture sensor was + 1.5 %, skin pH sensor was + 0.17, and skin temperature was # 0.2°C that met the acceptable values endorsed by the manufacturers. Demographic data were analyzed using descriptive statistics. Comparison of interface pressure and skin moisture were analyzed using Friedman test. Comparison of skin temperature and skin pH were analyzed using One-Way Repeated Measures ANOVA. The result revealed that: 1. The interface pressure with usual care and with skin care program combined with water-filled cushion covered with krajud mat showed no statistically significant difference X - 31, p = 85). 2. Skin temperature with usual care and with skin care program combined with water-filled cushion covered with krajud mat showed no statistically significant difference (F(1,13) 13) = p p= .74). 3. Skin moisture with usual care and with skin care program combined with water-filled cushion covered with krajud mat showed no statistically significant difference (X= 4.13,p = .13). 4. Skin pH with usual care and with skin care program combined with water- filled cushion covered with krajud mat showed no statistically significant difference (F(1, 13) = 1.97, p = 17). 5. No pressure ulcer occurred is any of the participants during the study period. Although there were no statistically significant differences of interface pressure, skin temperature, skin pH, or skin hydration after using skin care program, there was a tendency to show a decrease in the above parameters on day 3; thus, the skin-care program might reduce the development of pressure ulcers in bed-ridden elderly patients. Future study using randomized controlled trial is needed.