Araştırma Makalesi
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Association Between Pressure Injuries and Nutritional Status in Patients Receiving Home Healthcare Patients

Yıl 2025, Cilt: 15 Sayı: 4, 166 - 170, 31.07.2025
https://doi.org/10.16899/jcm.1705774

Öz

Abstract
Aim: Pressure injuries are commonly observed in home care patients. This study aimed to evaluate the presence of pressure injuries and the nutritional status of patients receiving home healthcare services, and to reveal the relationship between these two conditions.
Material and Method: A total of 81 patients with pressure injuries, followed in September 2023 by the Home Healthcare Unit of XXXX, were evaluated in detail. Patients’ demographic characteristics, presence of chronic diseases, and nutritional status were assessed. The Barthel Index of Activities of Daily Living and the Mini Nutritional Assessment–Short Form (MNA-SF) were applied. A p-value of <0.05 was considered statistically significant.
Results: The median age of patients with pressure injuries was 77 years (range: 15–97), and 45 (55.6%) were female. Pressure injuries were most commonly located in the sacral region (57 patients, 70.4%), with stage 2 being the most frequent (43.9%). Heel injuries were observed in 9 patients (11.1%), also predominantly stage 2 (66.7%). One patient (1.2%) had a pressure injury on the toes, which was stage 2. Sixty-two patients (76.5%) were completely dependent. According to the MNA-SF, 8 patients (9.9%) had normal nutrition, 39 (48.1%) were at risk of malnutrition, and 34 (42%) were malnourished. Malnutrition was significantly more prevalent in patients with sacral pressure injuries (p=0.043). Similarly, the risk of malnutrition was significantly higher in those with trochanteric pressure injuries (p=0.009).
Conclusion: The incidence of pressure injuries was higher in patients who were malnourished or at risk of malnutrition. In order to prevent pressure injuries in patients receiving home healthcare, early identification of malnutrition is essential. During this process, individualized diet planning and appropriate vitamin and mineral supplementation should be provided.

Kaynakça

  • 1. DiPlacido AJ, Cox-Vance L. New Terminology from the National Pressure Ulcer Advisory Panel. Am Fam Physician 2017;95(12):75.
  • 2. National Pressure Injury Advisory Panel., Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline. NPIAP, EPUAP and PPPIA. Accessed from: https://npiap.com.2020
  • 3. Ramadan D, Metin Akten İ. Prevalence and Risk Factors of Pressure Injury in Home Care Patients. Home Heal Care Manag Pract Published online 2024.
  • 4. Berlowitz, D, Incidence and Prevalence of Pressure Ulcers. In Pressure Ulcers in the Aging Population (pp. 19–26). Humana Press 2014
  • 5. Bİçer EKIR. Hemşirelik Öğrencilerinin Basınç Ülseri Önlemeye Yönelik Bilgi ve Uygulamaları Knowledge and Practices of Nursing Students on Pressure Ulcer Prevention 2021;11(1):1-7.
  • 6. Banks M, Bauer J, Graves N, Ash S. Malnutrition and pressure ulcer risk in adults in Australian health care facilities. Nutrition 2010;26(9):896-901.
  • 7. Doley J. Nutrition management of pressure ulcers. Nutr Clin Pract 2010;25(1):50-60.
  • 8. Emily H, ed. National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance. (2014). Prevention and Treatment of Pressure Ulcers: Quick Reference Guide. Osborne Park, Australia: Cambridge Media; 2014.
  • 9. Küçükdeveci AA, Yavuzer G, Tennant A, Süldür N, Sonel B, Arasil T. Adaptation of the modified Barthel Index for use in physical medicine and rehabilitation in Turkey. Scand J Rehabil Med 2000;32(2):87-92.
  • 10. Kankaya H, Karadakovan A. Yaşlı Bireylerde Günlük Yaşam Aktivite Düzeylerinin Yaşam Kalitesi ve Yaşam Doyumuna Etkisi The Effects of Daily Life Activity Levels on the Quality of Life and Life Satisfaction of Elderly. Gümüşhane Üniversitesi Sağlık Bilim Derg Araştırma Makal GUSBD. 2017;6(4):21-29.
  • 11. Kaiser MJ, Bauer JM, Ramsch C, et al. Validation of the Mini Nutritional Assessment short-form (MNA®-SF): A practical tool for identification of nutritional status. J Nutr Heal Aging 2009;13(9):782-788.
  • 12. Kılıç C, Önal AE, Tufan A, Karan MA, Öztürk GB. Geriatri Polikliniğinden Takip Edilen 75 Yaş Üstü Bireylerin Nütrisyonel Değerlendirmesi ve Fonksiyonel Kapasiteleri ile İlişkisinin Araştırılması The Assessment of Nutritional Status and Its Relation with Functionality Among Outpatients Older than 75 Year. Akademik Geriatri Dergisi Published online 2014:79-89.
  • 13. Anders J, Heinemann A, Leffmann C, Leutenegger M, Pröfener F, Von Renteln-Kruse W. Dekubitalgeschwüre - Pathophysiologie und primärprävention. Dtsch Arztebl 2010;107(21):371-382.
  • 14. Song YP, Shen HW, Cai JY, Zha ML, Chen HL. The relationship between pressure injury complication and mortality risk of older patients in follow-up: A systematic review and meta-analysis. Int Wound J 2019;16(6):1533-1544.
  • 15. Güdük Ö, Güdük Ö, Sertbaş Y. Characteristics of Patients Benefiting from Home Health Care Services and Examination of Service Demand. Manisa Celal Bayar Üniversitesi Sağlık Bilim Enstitüsü Derg 2021;8(1):78-83.
  • 16. Bergquist S. Pressure ulcer prediction in older adults receiving home health care: implications for use with the OASIS. Adv Skin Wound Care 2003;16(3):132-139.
  • 17. Özgenel Gy, Kahveci R, Akın S, Özbek S, Özcan M. Bası Yaralarında Tedavi Prensiplerimiz ve Sonuçlarımız. Uludağ Üniversitesi Tıp Fakültesi Derg 2002;28(2):27-32.
  • 18. Haesler E, Rayner RL, Carville KJ. The pan pacific clinical practice guideline for the prevention and management of pressure injury. Wound Pract Res. 2012;20:6.
  • 19. Gündoğdu H. Where do we stand in home nutrition support? J Intern Med 2010; 17, 257-267.
  • 20. Kaiser MJ, Bauer JM, Rämsch C, et al. Frequency of malnutrition in older adults: A multinational perspective using the mini nutritional assessment. J Am Geriatr Soc 2010;58(9):1734-1738.
  • 21. Ülger Z, Halil M, Kalan I, et al. Comprehensive assessment of malnutrition risk and related factors in a large group of community-dwelling older adults. Clin Nutr 2010;29(4):507-511.
  • 22. Türkcüoglu F, Karakoyun-Celik O, Oguz S et al. Malnutrition prevalence and related factors in home care patients: a multicenter study. J Nutr Health Aging. 2023;27(3):123–130.
  • 23. Yilmaz M, Ozdemir B, Kaya O, Demir A. Nutritional status of home care patients and affecting factors throughout a six-month follow-up period. Nutr Clin Pract. 2023;38(2):340–347.
  • 24. Gencer ZE, Özkan Ö. Pressure Ulcers Surveillance Report. Türk Yoğun Bakım Derneği Derg 2015;13(1):26-30.
  • 25. Enginyurt Ö. Dısease Prevalence Of Inpatıents In Pallıatıve-Care. Klin Tıp Aile Hekim 2019;11(1):11-13.
  • 26. Cereda E, Valzolgher L, Pedrolli C. Mini nutritional assessment is a good predictor of functional status in institutionalised elderly at risk of malnutrition. Clin Nutr 2008;27(5):700-705.
  • 27. Wirth R, Smoliner C, Jäger M, et al. Guideline clinical nutrition in patients with stroke. Exp Transl Stroke Med 2013;5(1):1-11.
  • 28. Volkert D, Chourdakis M, Faxen-Irving G, et al. ESPEN guidelines on nutrition in dementia. Clin Nutr 2015;34(6):1052-1073.
  • 29. Aydin G, Mucuk S. The evaluation of daily living activities, pressure sores and risk factors. Rehabil Nurs 2015;40(2):84-91.
  • 30. Alhaug J, Gay CL, Henriksen C, Lerdal A. Pressure ulcer is associated with malnutrition as assessed by Nutritional Risk Screening (NRS 2002) in a mixed hospital population. Food Nutr Res 2017;61(1).
  • 31. Bergquist-Beringer S, Gajewski BJ. Outcome and assessment information set data that predict pressure ulcer development in older adult home health patients. Adv Skin Wound Care 2011;24(9):404-414.
  • 32. Cereda E, Klersy C, Serioli M, et al. A nutritional formula enriched with arginine, zinc, and antioxidants for the healing of pressure ulcers: A randomized trial. Ann Intern Med. 2015;162(3):167-1
  • 33. Stratton, R.J.; Green, C.J.; Elia, M. Disease-Related Malnutrition: An Evidence-Based Approach to Treatment; CABI Publishing: Wallingford, UK, 2003.

Evde Sağlık Hizmeti Alan Hastaların Basınç Yaralanmalarının Değerlendirilmesi ve Beslenme Durumları ile İlişkisi

Yıl 2025, Cilt: 15 Sayı: 4, 166 - 170, 31.07.2025
https://doi.org/10.16899/jcm.1705774

Öz

Öz
Amaç: Basınç yaralanmaları evde bakım hastalarında yaygın olarak görülmektedir. Bu çalışmada evde sağlık hizmeti alan hastaların basınç yaralanması varlığını ve beslenme durumlarını değerlendirmek; bu iki durum arasındaki ilişkiyi ortaya koymak amaçlanmıştır.
Gereç ve Yöntem: XXXX evde sağlık hizmetleri biriminde 2023 yılı Eylül ayında takip edilen hastalardan basınç yaralanması olan 81 hasta ayrıntılı değerlendirildi. Hastaların demografik özellikleri, kronik hastalık varlığı, beslenme şekli sorgulandı ve Barthel Günlük Yaşam aktiviteleri indeksi, Mini Nütrisyonel Değerlendirme-Kısa Form (MNA-SF) ölçekleri uygulandı. p<0.05 istatistiksel olarak anlamlı kabul edildi.
Bulgular: Basınç yaralanması olan hastaların yaş ortancası 77 (15-97) idi. Hastaların 45’i (%55.6) kadındı. Sakrumda 57 (%70.4) hastada basınç yaralanması vardı ve en çok görülen evre 2 (%43.9) idi. Topukta 9 (%11.1) hastada basınç yaralanması vardı ve en çok görülen evre 2 (%66.7) idi. Ayak parmaklarında 1 (%1.2) hastada basınç yaralanması vardı ve evre 2 (%100) idi. Hastaların 62 (%76.5) tam bağımlıydı. MNA-SF tarama durumuna göre normal nütrisyon 8 (%9.9), malnütrisyon riski altında 39 (%48.1), malnütrisyonlu 34 (%42) hasta bulunmaktaydı. Özellikle sakrum bölgesinde basınç yaralanması olanlarda malnütrisyon anlamlı yüksekti (p:0.043). Trokanter bölgesinde basınç yaralanması olan hastalarda da malnütrisyon riski anlamlı yüksekti (p:0.009).
Tartışma: Sonuç olarak malnütrisyon ya da malnütrisyon riski olan hastalarda basınç yaralanması görülme oranı artmıştır. Evde sağlık hizmeti alan hastalarda basınç yaralanmalarının önlenmesi için malnütrisyonun erken dönemde tespit edilmesi gereklidir. Bu süreçte, hastaların bireysel ihtiyaçlarına uygun özel diyet planlamaları yapılmalı ve gerekli vitamin-mineral takviyeleriyle desteklenmelidir.

Kaynakça

  • 1. DiPlacido AJ, Cox-Vance L. New Terminology from the National Pressure Ulcer Advisory Panel. Am Fam Physician 2017;95(12):75.
  • 2. National Pressure Injury Advisory Panel., Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline. NPIAP, EPUAP and PPPIA. Accessed from: https://npiap.com.2020
  • 3. Ramadan D, Metin Akten İ. Prevalence and Risk Factors of Pressure Injury in Home Care Patients. Home Heal Care Manag Pract Published online 2024.
  • 4. Berlowitz, D, Incidence and Prevalence of Pressure Ulcers. In Pressure Ulcers in the Aging Population (pp. 19–26). Humana Press 2014
  • 5. Bİçer EKIR. Hemşirelik Öğrencilerinin Basınç Ülseri Önlemeye Yönelik Bilgi ve Uygulamaları Knowledge and Practices of Nursing Students on Pressure Ulcer Prevention 2021;11(1):1-7.
  • 6. Banks M, Bauer J, Graves N, Ash S. Malnutrition and pressure ulcer risk in adults in Australian health care facilities. Nutrition 2010;26(9):896-901.
  • 7. Doley J. Nutrition management of pressure ulcers. Nutr Clin Pract 2010;25(1):50-60.
  • 8. Emily H, ed. National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance. (2014). Prevention and Treatment of Pressure Ulcers: Quick Reference Guide. Osborne Park, Australia: Cambridge Media; 2014.
  • 9. Küçükdeveci AA, Yavuzer G, Tennant A, Süldür N, Sonel B, Arasil T. Adaptation of the modified Barthel Index for use in physical medicine and rehabilitation in Turkey. Scand J Rehabil Med 2000;32(2):87-92.
  • 10. Kankaya H, Karadakovan A. Yaşlı Bireylerde Günlük Yaşam Aktivite Düzeylerinin Yaşam Kalitesi ve Yaşam Doyumuna Etkisi The Effects of Daily Life Activity Levels on the Quality of Life and Life Satisfaction of Elderly. Gümüşhane Üniversitesi Sağlık Bilim Derg Araştırma Makal GUSBD. 2017;6(4):21-29.
  • 11. Kaiser MJ, Bauer JM, Ramsch C, et al. Validation of the Mini Nutritional Assessment short-form (MNA®-SF): A practical tool for identification of nutritional status. J Nutr Heal Aging 2009;13(9):782-788.
  • 12. Kılıç C, Önal AE, Tufan A, Karan MA, Öztürk GB. Geriatri Polikliniğinden Takip Edilen 75 Yaş Üstü Bireylerin Nütrisyonel Değerlendirmesi ve Fonksiyonel Kapasiteleri ile İlişkisinin Araştırılması The Assessment of Nutritional Status and Its Relation with Functionality Among Outpatients Older than 75 Year. Akademik Geriatri Dergisi Published online 2014:79-89.
  • 13. Anders J, Heinemann A, Leffmann C, Leutenegger M, Pröfener F, Von Renteln-Kruse W. Dekubitalgeschwüre - Pathophysiologie und primärprävention. Dtsch Arztebl 2010;107(21):371-382.
  • 14. Song YP, Shen HW, Cai JY, Zha ML, Chen HL. The relationship between pressure injury complication and mortality risk of older patients in follow-up: A systematic review and meta-analysis. Int Wound J 2019;16(6):1533-1544.
  • 15. Güdük Ö, Güdük Ö, Sertbaş Y. Characteristics of Patients Benefiting from Home Health Care Services and Examination of Service Demand. Manisa Celal Bayar Üniversitesi Sağlık Bilim Enstitüsü Derg 2021;8(1):78-83.
  • 16. Bergquist S. Pressure ulcer prediction in older adults receiving home health care: implications for use with the OASIS. Adv Skin Wound Care 2003;16(3):132-139.
  • 17. Özgenel Gy, Kahveci R, Akın S, Özbek S, Özcan M. Bası Yaralarında Tedavi Prensiplerimiz ve Sonuçlarımız. Uludağ Üniversitesi Tıp Fakültesi Derg 2002;28(2):27-32.
  • 18. Haesler E, Rayner RL, Carville KJ. The pan pacific clinical practice guideline for the prevention and management of pressure injury. Wound Pract Res. 2012;20:6.
  • 19. Gündoğdu H. Where do we stand in home nutrition support? J Intern Med 2010; 17, 257-267.
  • 20. Kaiser MJ, Bauer JM, Rämsch C, et al. Frequency of malnutrition in older adults: A multinational perspective using the mini nutritional assessment. J Am Geriatr Soc 2010;58(9):1734-1738.
  • 21. Ülger Z, Halil M, Kalan I, et al. Comprehensive assessment of malnutrition risk and related factors in a large group of community-dwelling older adults. Clin Nutr 2010;29(4):507-511.
  • 22. Türkcüoglu F, Karakoyun-Celik O, Oguz S et al. Malnutrition prevalence and related factors in home care patients: a multicenter study. J Nutr Health Aging. 2023;27(3):123–130.
  • 23. Yilmaz M, Ozdemir B, Kaya O, Demir A. Nutritional status of home care patients and affecting factors throughout a six-month follow-up period. Nutr Clin Pract. 2023;38(2):340–347.
  • 24. Gencer ZE, Özkan Ö. Pressure Ulcers Surveillance Report. Türk Yoğun Bakım Derneği Derg 2015;13(1):26-30.
  • 25. Enginyurt Ö. Dısease Prevalence Of Inpatıents In Pallıatıve-Care. Klin Tıp Aile Hekim 2019;11(1):11-13.
  • 26. Cereda E, Valzolgher L, Pedrolli C. Mini nutritional assessment is a good predictor of functional status in institutionalised elderly at risk of malnutrition. Clin Nutr 2008;27(5):700-705.
  • 27. Wirth R, Smoliner C, Jäger M, et al. Guideline clinical nutrition in patients with stroke. Exp Transl Stroke Med 2013;5(1):1-11.
  • 28. Volkert D, Chourdakis M, Faxen-Irving G, et al. ESPEN guidelines on nutrition in dementia. Clin Nutr 2015;34(6):1052-1073.
  • 29. Aydin G, Mucuk S. The evaluation of daily living activities, pressure sores and risk factors. Rehabil Nurs 2015;40(2):84-91.
  • 30. Alhaug J, Gay CL, Henriksen C, Lerdal A. Pressure ulcer is associated with malnutrition as assessed by Nutritional Risk Screening (NRS 2002) in a mixed hospital population. Food Nutr Res 2017;61(1).
  • 31. Bergquist-Beringer S, Gajewski BJ. Outcome and assessment information set data that predict pressure ulcer development in older adult home health patients. Adv Skin Wound Care 2011;24(9):404-414.
  • 32. Cereda E, Klersy C, Serioli M, et al. A nutritional formula enriched with arginine, zinc, and antioxidants for the healing of pressure ulcers: A randomized trial. Ann Intern Med. 2015;162(3):167-1
  • 33. Stratton, R.J.; Green, C.J.; Elia, M. Disease-Related Malnutrition: An Evidence-Based Approach to Treatment; CABI Publishing: Wallingford, UK, 2003.
Toplam 33 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Dermatoloji, Klinik Tıp Bilimleri (Diğer)
Bölüm Orjinal Araştırma
Yazarlar

Hümeyra Aslaner 0000-0002-3710-3893

Abdullah Hadi Gürbüz 0000-0002-5590-175X

Ahmet Furkan Ökdem 0009-0006-7307-0722

Zeliha Kaya Erten 0000-0003-1229-7350

Hacı Ahmet Aslaner 0000-0003-3331-8667

Yayımlanma Tarihi 31 Temmuz 2025
Gönderilme Tarihi 26 Mayıs 2025
Kabul Tarihi 17 Temmuz 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 15 Sayı: 4

Kaynak Göster

AMA Aslaner H, Gürbüz AH, Ökdem AF, Kaya Erten Z, Aslaner HA. Association Between Pressure Injuries and Nutritional Status in Patients Receiving Home Healthcare Patients. Journal of Contemporary Medicine. Temmuz 2025;15(4):166-170. doi:10.16899/jcm.1705774