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Yaşlılarda Basınç Yaralanması Risk Faktörleri

Year 2019, Volume: 2 Issue: 2, 50 - 57, 31.08.2019

Abstract

Uygun
bakım planlamaları ile önlenebilen basınç yaralanmaları, özellikle fiziksel
olarak sınırlı veya yatağa bağımlı yaşlılarda yaygın bir sağlık problemidir.
Yaşın ilerlemesi sonucu diğ
er tüm organ
sistemlerinde olduğu gibi, derinin tüm düzeylerinde yaşlanma ile ilişkili
değişiklikler oluşur.  Hareketsizlik,
beslenme eksikliği ve
çoklu
sistemlerdeki bozulmaların kronik hastalıklarla birleşmesi neticesinde
yaşlılarda yaşlanan cildin kırılganlığı artmaktadır. Demans, serebrovasküler
hastalık veya Alzheimer hastalığı gibi n
örolojik
hastalıklarda gözlemlenebilen değişik düzeylerdeki duyusal algılama
bozuklukları, ajitasyon veya mobilizasyon bozuklukları yaşlı bireyin basınç
yaralanması riskini arttırır. Bunun yanında mikroorganizmalara karşı
koruyuculuğun, kollajen yapımının ve immün yanıtın azalması yaşlı bireyde
basınç yaralanmalarının oluşumunu tetikleyen ve yara tedavisini olumsuz
etkileyen ek faktörlerdir. Yaşlılarda basınç yaralanması riskini arttıran bir
diğer faktör ise malnütrisyondur. Gerek ev ortamında gerekse sağlık hizmeti
sunan kurumlarda yaşlı bireyde malnütrisyon gelişme ihtimali yüksektir. Enerji
ve sıvı alımındaki yetersizlikler, vitamin ve mineral eksiklikleri ile
birleşerek doku bütünlüğünün devamlılığının sağlanmasını olumsuz yönde etkiler.
Basınç yaralanmaları meydana geldiğinde tedavisi zor ve maliyetlidir. Oluşan
yaralanma hastanın ve hasta yakınlarının günlük yaşamını etkileyen ve hastayı
sosyal izolasyona sürükleyebilen bir problem haline gelebilmektedir. İleri evre
basınç yaralanmaları kronik yaralar halini alarak yaşamının kalan kısmında
yaşlı bireyin rehabilitasyon ihtiyacını arttırabilir. Yaşlı bireyin basınç
yaralanması bakımı; hastanın, hasta yakınlarının ve sağlık hizmet sunucularının
iş yükünü arttırırken, maddi kayıplara neden olmaktadır.

Yaşlılarda
basınç yaralanması yaklaşımının birinci basamağı basınç yaralanmalarının
oluşmadan önlenmesidir.
Önlemenin
anahtarı ise yaşlı bireylerin basınç yaralanması riski oluşturan faktörleri
doğru şekilde tanımlamak, kanıta dayalı önleyici bakım tedbirlerini planlamak
ve uygulamaya sokmaktır. Bu makalede cilt yaşlanması, yaşlılığa eşlik eden
hastalıklar, bilişsel bozukluklar, beslenme yetersizlikleri gibi yaşlılarda
basınç yaralanması geliş
imine neden olan
risk fakt
örleri incelecektir.

References

  • KAYNAKLAR
  • 1. Haesler E(Ed.). Prevention and Treatment of Pressure Ulcers: Quick Reference Guide. 2nd Ed. Osborne Park, Western Australia: European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance; 2014. 2. Tubaishat A, Papanikolaou P, Anthony D, et al. Pressure ulcers prevalence in the acute care setting: A Systematic Review, 2000-2015. Clin Nurs Res. 2018;27(6):643-659.3. Inan DG, Oztunç G. Pressure ulcer prevalence in Turkey: a sample from a university hospital. J Wound Ostomy Continence Nurs. 2012;39(4):409-413.4. Jaul E. Assessment and management of pressure ulcer in the elderly. Drugs Aging 2010;27(4): 311-325. 5. Kim CG, Park S, Ko JW, et al. The relationship of subepidermal moisture and early stage pressure injury by visual skin assessment. J Tissue Viability. 2018;27(3):130-134. 6. Down F, Guy H, Gilroy P, et al. Are 95% of hospital-acquired pressure ulcers avoidable. Wounds UK 2013;9(3):16-22.7. Lavallée JF, Gray TA, Dumville J, et al. Barriers and facilitators to preventing pressure ulcers in nursing home residents: A qualitative analysis informed by the Theoretical Domains Framework. Int J Nurs Stud. 2018;82:79-89.8. Teo CSM, Claire CA, Lopez V, et al. Pressure injury prevention and management practices among nurses: A realist case study. International Wound Journal 2019;16(1):153-163.9. Lee E. Longitudinal outcomes of home care in Korea to manage pressure ulcers. Res Nurs Health. 2017;40(3):255-262.10. Acar K, Aygin D. Risk factors for wound developing and interventions for prevention and care in elderly. Journal of The Turkish Society of Critical Care Nurse 2015;19(2):54-59. 11. Lyder H. Pressure ulcer prevention and management. JAMA 2003;289(2):223-226. 12. Porter-Armstrong AP, Moore ZE, Bradbury I, et al. Education of healthcare professionals for preventing pressure ulcers. Cochrane Database Syst Rev. 2018;5:CD011620. 13. İnözü E, Özakpınar HR, Durgun M, et al. Approach to the pressure sores in geriatric. Dicle Medical Journal 2012; 39 (3):408-412.14. Goldberg E. The lived experience of diverse elders with chronic wound. Ostomy Wound Management 2010;56(11):36-46. 15. Courvoisier DS, Righi L, Béné N, et al. Variation in pressure ulcer prevalence and prevention in nursing homes: A multicenter study. Appl Nurs Res. 2018;42:45-50. 16. Dealey C, Posnett J, Walker A. The cost of pressure ulcers in the United Kingdom. J Wound Care. 2012;21(6):261-262.17. Baumgarten M, Margolis DJ, Localio AR, et al. Pressure ulcers among elderly patients early in the hospital stay. J Gerontol A Biol Sci Med Sci. 2006;61(7):749-54.18. Orhan B. Practice for preventing pressure ulcers: evidence based practices. Archives Medical Review Journal 2017;26(4):427-440.19. Garcia AD, Thomas DR. Assessment and management of chronic pressure ulcers in the elderly. Med Clin North Am. 2006;90(5):925-944.20. Kobayashi T, Nagao K. "Deepening" Insight on Skin Aging and Anti-microbial Immunity. Cell Metab. 2019;29(3):515-517.21. Yetkin H, Ceyhan AM, Yıldırım M. Skin aging and treatment. Medical Journal of Süleyman Demirel University 2009;16(2):32-38. 22. Sgonc R, Gruber J. Age-related aspects of cutaneous wound healing: A mini-review. Gerontology 2013;59(2):159–164. 23. Yıldırım B, Özkahraman Ş, Ersoy S. Physiological changes in elderly and nursing care. Journal of Duzce University Health Sciences Institute 2012;2(2): 19-23.24. Lechner A, Lahmann N, Neumann K, et al. Dry skin and pressure ulcer risk: A multi-center cross-sectional prevalence study in German hospitals and nursing homes. Int J Nurs Stud. 2017;73:63-69. 25. Barrois B, Colin D, Allaert FA. Prevalence, characteristics and risk factors of pressure ulcers in public and private hospitals care units and nursing homes in France. Hospital Practise 2018;46(1):1-7.26. Jaul E. Non-healing wounds: the geriatric approach. Arch Gerontol Geriatr. 2009;49(2):224-226. 27. Gould L, Abadir P, Brem H, at al. Chronic wound repair and healing in older adults: current status and future research. J Am Geriatr Soc. 2015;63(3):427-438. 28. Hardman MJ, Ashcrof GS. Estrogen, not intrinsic aging, is the major regulator of delayed human wound healing in the elderly. Genome Biology 2008; 9(5): R80.29. Ünal B(Ed.), Ergöl G(Ed.). Study of frequency of chronic diseases and risk factors in Turkey. Türkiye Kronik Hastalıklar ve Risk Faktörleri Sıklığı Çalışması. Republic of Turkey Ministry of Healty. Ankara: 2013. p.69-219.30. Başak T, Uzun Ş, Arslan F. Perineal skin care of person with urinary incontinence: Review. Türkiye Klinikleri Journal of Medical Sciences 2009;29(1): 202-205. 31. Gray M, Giuliano K.K. Incontinence-Associated Dermatitis, characteristics and relationship to pressure injury. Journal of Wound Ostomy Continence Nurse 2018;45(1):63-67. 32. Çevik A, Basat O, Uçak S. Evaluation of nutritional status and its effect on biochemical parameters in elderly people admitted to home health care services. Konuralp Medical Journal 2014;6(3):31-37. 33. Pezzana A1, Cereda E, Avagnina P, et al. Nutritional care needs in elderly residents of long-term care institutions: potential implications for policies. J Nutr Health Aging. 2015;19(9):947-954.34. Gruen D. Wound healing and nutrition: going beyond dressings with a balanced care plan. Journal of The American College of Certified Wound Specialists 2010;2(3):46–49. 35. Neloska L, Damevska K, Nikolchev A, et al. The association between malnutrition and pressure ulcers in elderly in long-term care facility. Open Access Maced J Med Sci. 2016;4(3):423-427.36. Ellis M. Pressure ulcer prevention in care home settings. Nursing Older People 2017;29(3) 29-35. 37. Ersoy EO, Öcal S, Öz A, et al. Evaluation of risk factors for decubitus ulcers in intensive care unit patients. Turkish Journal of Intensive Care 2013;4(1): 9-12.38. Eglseer D, Hödl M, Lohrmann C. Nutritional management of older hospitalised patients with pressure injuries. International Wound Journal 2018;16(1):1–7. 39. Ersoy N, Taşçi İ, Özgürtaş T, et al. Effect of seasonal changes on nutritional status and biochemical parameters in Turkish older adults. Nutr Res Pract. 2018;12(4):315-323.40. Adıbelli Ş, Korkmaz F, Pressure injury risk assessment scales for adult patients. Journal of Health Science Süleyman Demirel University 2018;9(2): 136-140.41. Moore ZE, Patton D. Risk assessment tools for the prevention of pressure ulcers. Cochrane Database Syst Rev. 2019;1:CD006471. 42. National Institute for Health and Care Excellence. Pressure ulcers: prevention and management. https://www.nice.org.uk/guidance/cg179. Accessed April 23, 2014.

Pressure Injury Risk Factors in Elderly

Year 2019, Volume: 2 Issue: 2, 50 - 57, 31.08.2019

Abstract

Pressure injuries that can
be prevented by appropriate care planning are a common health problem
especially in physically limited or bed-bound elderly. As a result of the
progression of age, as with all other organ systems, aging-related changes
occur at all layers of the skin.  As a
result of the combination of immobility, nutritional deficiency and disruption
of multiple systems with chronic diseases, the fragility of the aging skin of
the elderly increases. Sensory perception disturbances, agitation or limited
mobility at different levels that can be observed in dementia, cerebrovascular
disease or neurological diseases such as Alzheimer's disease increase the risk
of pressure injury to the elderly.  In
addition, protection against microorganisms, collagen synthesis, and reduced
immune response are additional factors that trigger the formation of pressure
injuries in the elderly and adversely affect wound treatment. Malnutrition is
another factor that increases the risk of pressure injury in the elderly. Malnutrition
is a high probability of development in elderly people in both home and health
care institutions. The inadequacies in energy and fluid intake, negatively
affect the continuity of tissue integrity combined with vitamin and mineral
deficiencies. When pressure injuries occur, treatment is difficult and costly.
The resulting injury can become a problem that affects the daily life of the
patient and his / her relatives and may lead the patient to social isolation.
Advanced stage pressure injuries can become chronic wounds and may increase the
rehabilitation needs of the elderly person in the rest of life. Pressure injury
care of the elderly increases the workload of the patient, patient relatives, and
health service providers and causes financial losses.

The first step of the
pressure injury approach in the elderly is to prevent pressure injuries before
they occur. The key to prevention is to correctly identify the factors that
create the risk of pressure injury for elderly individuals, to plan and implement
evidence-based preventive care measures. In this article, it will be examined
the risk factors that cause pressure injury in the elderly such as skin aging,
diseases concomitant with old age, cognitive disorders and nutritional
deficiency.













 

References

  • KAYNAKLAR
  • 1. Haesler E(Ed.). Prevention and Treatment of Pressure Ulcers: Quick Reference Guide. 2nd Ed. Osborne Park, Western Australia: European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance; 2014. 2. Tubaishat A, Papanikolaou P, Anthony D, et al. Pressure ulcers prevalence in the acute care setting: A Systematic Review, 2000-2015. Clin Nurs Res. 2018;27(6):643-659.3. Inan DG, Oztunç G. Pressure ulcer prevalence in Turkey: a sample from a university hospital. J Wound Ostomy Continence Nurs. 2012;39(4):409-413.4. Jaul E. Assessment and management of pressure ulcer in the elderly. Drugs Aging 2010;27(4): 311-325. 5. Kim CG, Park S, Ko JW, et al. The relationship of subepidermal moisture and early stage pressure injury by visual skin assessment. J Tissue Viability. 2018;27(3):130-134. 6. Down F, Guy H, Gilroy P, et al. Are 95% of hospital-acquired pressure ulcers avoidable. Wounds UK 2013;9(3):16-22.7. Lavallée JF, Gray TA, Dumville J, et al. Barriers and facilitators to preventing pressure ulcers in nursing home residents: A qualitative analysis informed by the Theoretical Domains Framework. Int J Nurs Stud. 2018;82:79-89.8. Teo CSM, Claire CA, Lopez V, et al. Pressure injury prevention and management practices among nurses: A realist case study. International Wound Journal 2019;16(1):153-163.9. Lee E. Longitudinal outcomes of home care in Korea to manage pressure ulcers. Res Nurs Health. 2017;40(3):255-262.10. Acar K, Aygin D. Risk factors for wound developing and interventions for prevention and care in elderly. Journal of The Turkish Society of Critical Care Nurse 2015;19(2):54-59. 11. Lyder H. Pressure ulcer prevention and management. JAMA 2003;289(2):223-226. 12. Porter-Armstrong AP, Moore ZE, Bradbury I, et al. Education of healthcare professionals for preventing pressure ulcers. Cochrane Database Syst Rev. 2018;5:CD011620. 13. İnözü E, Özakpınar HR, Durgun M, et al. Approach to the pressure sores in geriatric. Dicle Medical Journal 2012; 39 (3):408-412.14. Goldberg E. The lived experience of diverse elders with chronic wound. Ostomy Wound Management 2010;56(11):36-46. 15. Courvoisier DS, Righi L, Béné N, et al. Variation in pressure ulcer prevalence and prevention in nursing homes: A multicenter study. Appl Nurs Res. 2018;42:45-50. 16. Dealey C, Posnett J, Walker A. The cost of pressure ulcers in the United Kingdom. J Wound Care. 2012;21(6):261-262.17. Baumgarten M, Margolis DJ, Localio AR, et al. Pressure ulcers among elderly patients early in the hospital stay. J Gerontol A Biol Sci Med Sci. 2006;61(7):749-54.18. Orhan B. Practice for preventing pressure ulcers: evidence based practices. Archives Medical Review Journal 2017;26(4):427-440.19. Garcia AD, Thomas DR. Assessment and management of chronic pressure ulcers in the elderly. Med Clin North Am. 2006;90(5):925-944.20. Kobayashi T, Nagao K. "Deepening" Insight on Skin Aging and Anti-microbial Immunity. Cell Metab. 2019;29(3):515-517.21. Yetkin H, Ceyhan AM, Yıldırım M. Skin aging and treatment. Medical Journal of Süleyman Demirel University 2009;16(2):32-38. 22. Sgonc R, Gruber J. Age-related aspects of cutaneous wound healing: A mini-review. Gerontology 2013;59(2):159–164. 23. Yıldırım B, Özkahraman Ş, Ersoy S. Physiological changes in elderly and nursing care. Journal of Duzce University Health Sciences Institute 2012;2(2): 19-23.24. Lechner A, Lahmann N, Neumann K, et al. Dry skin and pressure ulcer risk: A multi-center cross-sectional prevalence study in German hospitals and nursing homes. Int J Nurs Stud. 2017;73:63-69. 25. Barrois B, Colin D, Allaert FA. Prevalence, characteristics and risk factors of pressure ulcers in public and private hospitals care units and nursing homes in France. Hospital Practise 2018;46(1):1-7.26. Jaul E. Non-healing wounds: the geriatric approach. Arch Gerontol Geriatr. 2009;49(2):224-226. 27. Gould L, Abadir P, Brem H, at al. Chronic wound repair and healing in older adults: current status and future research. J Am Geriatr Soc. 2015;63(3):427-438. 28. Hardman MJ, Ashcrof GS. Estrogen, not intrinsic aging, is the major regulator of delayed human wound healing in the elderly. Genome Biology 2008; 9(5): R80.29. Ünal B(Ed.), Ergöl G(Ed.). Study of frequency of chronic diseases and risk factors in Turkey. Türkiye Kronik Hastalıklar ve Risk Faktörleri Sıklığı Çalışması. Republic of Turkey Ministry of Healty. Ankara: 2013. p.69-219.30. Başak T, Uzun Ş, Arslan F. Perineal skin care of person with urinary incontinence: Review. Türkiye Klinikleri Journal of Medical Sciences 2009;29(1): 202-205. 31. Gray M, Giuliano K.K. Incontinence-Associated Dermatitis, characteristics and relationship to pressure injury. Journal of Wound Ostomy Continence Nurse 2018;45(1):63-67. 32. Çevik A, Basat O, Uçak S. Evaluation of nutritional status and its effect on biochemical parameters in elderly people admitted to home health care services. Konuralp Medical Journal 2014;6(3):31-37. 33. Pezzana A1, Cereda E, Avagnina P, et al. Nutritional care needs in elderly residents of long-term care institutions: potential implications for policies. J Nutr Health Aging. 2015;19(9):947-954.34. Gruen D. Wound healing and nutrition: going beyond dressings with a balanced care plan. Journal of The American College of Certified Wound Specialists 2010;2(3):46–49. 35. Neloska L, Damevska K, Nikolchev A, et al. The association between malnutrition and pressure ulcers in elderly in long-term care facility. Open Access Maced J Med Sci. 2016;4(3):423-427.36. Ellis M. Pressure ulcer prevention in care home settings. Nursing Older People 2017;29(3) 29-35. 37. Ersoy EO, Öcal S, Öz A, et al. Evaluation of risk factors for decubitus ulcers in intensive care unit patients. Turkish Journal of Intensive Care 2013;4(1): 9-12.38. Eglseer D, Hödl M, Lohrmann C. Nutritional management of older hospitalised patients with pressure injuries. International Wound Journal 2018;16(1):1–7. 39. Ersoy N, Taşçi İ, Özgürtaş T, et al. Effect of seasonal changes on nutritional status and biochemical parameters in Turkish older adults. Nutr Res Pract. 2018;12(4):315-323.40. Adıbelli Ş, Korkmaz F, Pressure injury risk assessment scales for adult patients. Journal of Health Science Süleyman Demirel University 2018;9(2): 136-140.41. Moore ZE, Patton D. Risk assessment tools for the prevention of pressure ulcers. Cochrane Database Syst Rev. 2019;1:CD006471. 42. National Institute for Health and Care Excellence. Pressure ulcers: prevention and management. https://www.nice.org.uk/guidance/cg179. Accessed April 23, 2014.
There are 2 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Review
Authors

Emine Sezgünsay

Tülay Başak

Publication Date August 31, 2019
Submission Date July 21, 2019
Acceptance Date September 1, 2019
Published in Issue Year 2019 Volume: 2 Issue: 2

Cite

APA Sezgünsay, E., & Başak, T. (2019). Yaşlılarda Basınç Yaralanması Risk Faktörleri. Geriatrik Bilimler Dergisi, 2(2), 50-57.
AMA Sezgünsay E, Başak T. Yaşlılarda Basınç Yaralanması Risk Faktörleri. JoGS. August 2019;2(2):50-57.
Chicago Sezgünsay, Emine, and Tülay Başak. “Yaşlılarda Basınç Yaralanması Risk Faktörleri”. Geriatrik Bilimler Dergisi 2, no. 2 (August 2019): 50-57.
EndNote Sezgünsay E, Başak T (August 1, 2019) Yaşlılarda Basınç Yaralanması Risk Faktörleri. Geriatrik Bilimler Dergisi 2 2 50–57.
IEEE E. Sezgünsay and T. Başak, “Yaşlılarda Basınç Yaralanması Risk Faktörleri”, JoGS, vol. 2, no. 2, pp. 50–57, 2019.
ISNAD Sezgünsay, Emine - Başak, Tülay. “Yaşlılarda Basınç Yaralanması Risk Faktörleri”. Geriatrik Bilimler Dergisi 2/2 (August 2019), 50-57.
JAMA Sezgünsay E, Başak T. Yaşlılarda Basınç Yaralanması Risk Faktörleri. JoGS. 2019;2:50–57.
MLA Sezgünsay, Emine and Tülay Başak. “Yaşlılarda Basınç Yaralanması Risk Faktörleri”. Geriatrik Bilimler Dergisi, vol. 2, no. 2, 2019, pp. 50-57.
Vancouver Sezgünsay E, Başak T. Yaşlılarda Basınç Yaralanması Risk Faktörleri. JoGS. 2019;2(2):50-7.

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