長期照護機構褥瘡住民使用新型褥瘡墊效果之研究

Objectives: Long-term care residents with malnutrition or bedriddenness are highly susceptible to pressure sores, especially those in protruding bony or compressed areas. A quality antidecubitus mattress may help redistribute the pressure for preventing or improving pressure sore. However, inconvenience in cleaning, relatively high cost, and unsatisfactory effectiveness of available mattresses indicate an unmet need for antidecubitus mattress for different severities of pressure sore. The study analyzed the effectiveness of a newly designed antidecubitus mattress for long-term care residents with pressure sore Methods: A Adopting a crossover design, the study enrolled 21 subjects (mean age=82.6±8.7 y/o, M/F=10/11) with 32 pressure sores (Grades 1 to 3 by 2016 European Pressure Sore Advisory Panel, EPUAP) and stable nutritional status but without hospital admission in the past 3 months through purposive sampling. Subjects were dichotomized conveniently into Group A members (19 pressure sores) provided with Der Zeng® mattress for the first 15 days (D0 to D15) and Group B members (13 pressure sores) provided with no mattress for the same period. A crossover intervention was applied from D16 to D30 for both groups. The healing effectiveness of the mattress on pressure sore was evaluated per 3 days by well-trained staff using the Pressure Sore Scale for Healing (PUSH) score. The Wilcoxon signed rank test by SPSS 17^(th) edition was used for statistical analysis and the statistical difference was defined at a p value lower than 0.05. Results: The PUSH scores at D0, D15, and D30 for Group A members with mattress provided first were 9.2±2.3, 7.7±3.6 and 6.2±4.0, respectively. Those for Group B members provided with no mattress first were 8.4±2.2, 7.9±3.5 and 7.8±3.0, respectively. Statistical significances were found in Group A (D0 to D15, p＜0.05; D16 to D30, p＜0.01; D0 to D30, p＜0.01), but not in Group B. With the D15 crossover data of pressure sores of both groups combined, the PUSH scores suggested significant improvement in the group with mattress (n=32, before=8.7±2.9, after=7.7±3.3, p＜0.05), as well as in the group with no mattress (n=32, before=8.0±3.1, after=6.9±3.9, p＜0.05) after intervention. Conclusion: Appropriate and early use of the newly designed antidecubitus mattress appears to help improve the healing of pressure sores for long-term care residents.