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Advisor(s)
Abstract(s)
As Úlceras de Pressão são, atualmente, reveladas na literatura científica como um
problema complexo de causa multifatorial, que comporta elevados custos quer a nível
individual, familiar e sócio-económico. Considerando ainda que, a sua prevenção é um
indicador de qualidade dos cuidados de enfermagem e que a Pessoa Vítima de Trauma
comporta um alto risco de desenvolvimento de Úlceras de Pressão, torna-se explicita a
pertinência da investigação: “Desenvolvimento de Úlcera de Pressão em Pessoa Vítima
de Trauma”.
O estudo é de natureza retrospectivo, observacional com enfoque descritivo,
correlacional, tendo sido delineados objectivos com o fim de obter respostas científicas e
válidas às questões de investigação: Determinar a prevalência de Úlceras de Pressão em
Pessoa Vítima de Trauma; Identificar fatores predisponentes do desenvolvimento de Úlceras
de Pressão em Pessoa Vítima de Trauma. Para a sua concretização, recorreu-se a uma
amostra não probabilística por conveniência, constituída pelos indivíduos internados no
Serviço de Ortopedia do Hospital Infante D. Pedro, Aveiro, no período de 1 de Janeiro a 31
de Dezembro de 2010, num total de 500 participantes vítimas de trauma. Os dados foram
colhidos do sistema informático, tendo por base uma grelha clínica.
Através da análise de resultados podemos aferir: que a prevalência de Úlceras de
Pressão em Pessoa Vítima de Trauma é de 4%, sendo que os fatores predisponentes ao
desenvolvimento de Úlceras de Pressão são: idade avançada da Pessoa Vítima de Trauma
(U= 2422.00; z=-3.756; p=0.000); maior duração do internamento (U = 2562.50; z = -
3.549; p = 0.000); pressão arterial diastólica mais baixa (U = 2618.50; z = -2.115; p
=0.034); maior intensidade de dor (última avaliação) (U = 2940.00; z = -1.978; p = 0.048);
dependêcia no autocuidado: comer e beber (c
2 = 12.614; p = 0.000); presença de
diabetes mellitus (p = 0.000); presença de diabetes mellitus: insulino-dependente (p =
0.033); o facto de o doente apresentar cateter urinário na admissão (p = 0.025); a
necessidade de colocação de cateter urinário no internamento (c
2 = 38.594; p = 0.000);
uso de fralda (p = 0.004); dependência autocuidado: higiene e proteção dos
tegumentos (c
2 = 4.269; p = 0.039); presença de tegumento cutâneo: pele seca (p =
0.046); necessidade de contenção física (p = 0.036); toma de antibiótico (c
2 = 9.197; p =
0.002); toma de anti-inflamatório (c
2 = 8.704; p = 0.003); maior tempo desde a
admissão até a 1ª aplicação da Escala de Braden (U = 2899.50; z = -1.970; p = 0.049);
mais alto risco de Úlcera de Pressão: primeira avaliação (U = 1539.50; z = -4.456; p =
12
0.000); mais alto risco de Úlcera Pressão: última avaliação (U = 1487.50; z = -4.529; p =
0.000).
Os resultados sugerem que a etiologia do desenvolvimento de Úlceras de Pressão
em Pessoa Vítima de Trauma é multifactorial. Desta forma, enaltece-se a pertinência dos
enfermeiros considerarem: a idade da Pessoa Vítima de Trauma, a duração do seu
internamento; pressão arterial diastólica, a intensidade de dor; a dependência no
autocuidado: comer e beber, eliminação urinária e intestinal e autocuidado: higiene e
proteção dos tegumentos; a necessidade de de contenção física; a toma de antibiótico e de
anti-inflamatório; o tempo desde a admissão até a 1ª aplicação da Escala de Braden; o risco
de Úlcera de Pressão avaliado através da escala de Braden, como elementos integrantes no
planeamento/implementação de medidas preventivas do desenvolvimento de Úlceras de
Pressão. Estas são preponderantes para a diminuição da prevalência de UPPs e
concomitantemente para a melhoria da qualidade dos cuidados de enfermagem.
Palavras-Chave: Úlceras de Pressão; Risco de Úlcera de Pressão; Instrumento de
Avaliação da Pele; Escala de Branden.
ABSTRACT The Pressure Ulcers are currently pointed out in the scientific literature as a complex problem caused by multiple factors, which involves high costs both at individual, family and socio-economic level. Moreover, taking into account that its prevention is an indicator of quality in nursing care and that the Trauma Victim involves a high risk of developing Pressure Ulcers, the relevance of the research "Development of Pressure Ulcer in a Trauma Victim " becomes explicit. This is a retrospective, observational, descriptive and co relational study , whose objectives have been outlined in order to obtain scientific and valid answers to the research questions: to determine the prevalence of Pressure Ulcers in a Trauma Victim; to identify factors predisposing to the development of Pressure Ulcers in a Trauma Victim. To achieve them, a non-probability convenience sample was used; this sample consists of individuals admitted to the Department of Orthopedic Surgery, Hospital Infante D. Pedro, Aveiro, between January 1 to December 31, 2010, a total of 500 trauma victim participants. Data were collected from the computer system, based on a clinical scale. Through the results analysis we can conclude that the prevalence of Pressure Ulcers in a Trauma Victim is 4%, considering that the factors predisposing to the development of Pressure Ulcers are: the Trauma Victims advanced age (U = 2422.00, z = -3,756, p = 0.000), longer period of hospitalization (U = 2562.50, z = -3,549, p = 0.000), lower diastolic blood pressure (U = 2618.50, z = -2,115, p = 0.034), higher pain intensity (last evaluation) (U = 2940.00, z = -1,978, p = 0.048); self-care dependency: eating and drinking (c 2 = 12,614, p = 0.000); presence of diabetes mellitus (p= 0.000); presence of diabetes mellitus: insulin-dependent (p = 0.033), the fact that the patient has urinary catheter at admission (p = 0.025) ; the need for placement of urinary catheter during hospital stay (c 2 = 38,594, p = 0.000), use of diapers (p = 0.004), self- care dependency: hygiene and protection of teguments (c 2 = 4,269, p = 0.039); presence of cutaneous tegument: dry skin (p = 0.046), need for physical restraint (p = 0.036), ); taking of antibiotics (c 2 = 9.197; p = 0.002);taking of anti-inflammatory pills (c 2 = 8.704; p = 0.003) longer time since admission until the 1st application of the Braden Scale (U = 2899.50, z = -1,970, p = 0.049) ; higher risk of Pressure Ulcer: first evaluation (U = 1539.50, z = -4,456, p = 0.000) higher risk of Pressure Ulcer: last evaluation (U = 1487.50, z = -4,529, p = 0.000). The results suggest that the etiology of developing Pressure Ulcers in a Trauma Victim is multifactorial. Thus, we it´s highly relevant that the nurses consider the Trauma Victims age, the length of their hospital stay, diastolic blood pressure, amount of pain, self14 care dependency: eating and drinking, urinary and intestinal elimination and self-care: hygiene and protection of teguments; the need for physical restraint; taking of antibiotics and anti-inflammatory pills; length of time since admission until the 1st application of the Braden Scale; the risk of Pressure Ulcer evaluated using the Braden Scale, as elements taken into account in the planning / implementation of preventive measures for the development of Pressure Ulcers. All these factors are fundamental to decrease the prevalence of Pressure Ulcers and concomitantly to improve the quality of nursing care. Key-words: Pressure Ulcers; Pressure Ulcer Risk; Skin Assessment Procedure; Braden Scale.
ABSTRACT The Pressure Ulcers are currently pointed out in the scientific literature as a complex problem caused by multiple factors, which involves high costs both at individual, family and socio-economic level. Moreover, taking into account that its prevention is an indicator of quality in nursing care and that the Trauma Victim involves a high risk of developing Pressure Ulcers, the relevance of the research "Development of Pressure Ulcer in a Trauma Victim " becomes explicit. This is a retrospective, observational, descriptive and co relational study , whose objectives have been outlined in order to obtain scientific and valid answers to the research questions: to determine the prevalence of Pressure Ulcers in a Trauma Victim; to identify factors predisposing to the development of Pressure Ulcers in a Trauma Victim. To achieve them, a non-probability convenience sample was used; this sample consists of individuals admitted to the Department of Orthopedic Surgery, Hospital Infante D. Pedro, Aveiro, between January 1 to December 31, 2010, a total of 500 trauma victim participants. Data were collected from the computer system, based on a clinical scale. Through the results analysis we can conclude that the prevalence of Pressure Ulcers in a Trauma Victim is 4%, considering that the factors predisposing to the development of Pressure Ulcers are: the Trauma Victims advanced age (U = 2422.00, z = -3,756, p = 0.000), longer period of hospitalization (U = 2562.50, z = -3,549, p = 0.000), lower diastolic blood pressure (U = 2618.50, z = -2,115, p = 0.034), higher pain intensity (last evaluation) (U = 2940.00, z = -1,978, p = 0.048); self-care dependency: eating and drinking (c 2 = 12,614, p = 0.000); presence of diabetes mellitus (p= 0.000); presence of diabetes mellitus: insulin-dependent (p = 0.033), the fact that the patient has urinary catheter at admission (p = 0.025) ; the need for placement of urinary catheter during hospital stay (c 2 = 38,594, p = 0.000), use of diapers (p = 0.004), self- care dependency: hygiene and protection of teguments (c 2 = 4,269, p = 0.039); presence of cutaneous tegument: dry skin (p = 0.046), need for physical restraint (p = 0.036), ); taking of antibiotics (c 2 = 9.197; p = 0.002);taking of anti-inflammatory pills (c 2 = 8.704; p = 0.003) longer time since admission until the 1st application of the Braden Scale (U = 2899.50, z = -1,970, p = 0.049) ; higher risk of Pressure Ulcer: first evaluation (U = 1539.50, z = -4,456, p = 0.000) higher risk of Pressure Ulcer: last evaluation (U = 1487.50, z = -4,529, p = 0.000). The results suggest that the etiology of developing Pressure Ulcers in a Trauma Victim is multifactorial. Thus, we it´s highly relevant that the nurses consider the Trauma Victims age, the length of their hospital stay, diastolic blood pressure, amount of pain, self14 care dependency: eating and drinking, urinary and intestinal elimination and self-care: hygiene and protection of teguments; the need for physical restraint; taking of antibiotics and anti-inflammatory pills; length of time since admission until the 1st application of the Braden Scale; the risk of Pressure Ulcer evaluated using the Braden Scale, as elements taken into account in the planning / implementation of preventive measures for the development of Pressure Ulcers. All these factors are fundamental to decrease the prevalence of Pressure Ulcers and concomitantly to improve the quality of nursing care. Key-words: Pressure Ulcers; Pressure Ulcer Risk; Skin Assessment Procedure; Braden Scale.
Description
Curso de mestrado em enfermagem médico cirúrgica
Keywords
Avaliação de risco Causalidade Ferimentos e lesões Monitorização fisiológica Traumatismo Úlcera de decúbito Úlcera de pressão Causality Monitoring, physiologic Predisposing factors Pressure ulcer Risk assessment Trauma Wounds and injuries
Citation
Publisher
Instituto Politécnico de Viseu, Escola Superior de Saúde de Viseu