Evde Bakım Hastalarında Periferik Arter Hastalığını Öngörücü Faktörler

Abstract

Amaç: Çalışmanın amacı evde bakım hastalarında periferik arter hastalığı için (PAH) öngörücü faktörlerin araştırılmasıdır. Gereç ve Yöntem: Tanımlayıcı tipte olan bu araştırma, İstanbul'da 01.07.2014-01.12.2014 tarihleri arasında üçüncü basamak bir hastanenin Evde Sağlık Birimine hizmet almak için ilk kez başvuran 285 hasta ile gerçekleştirilmiştir. Bilinen PAH tanısı olan hastalar çalışma dışı bırakılmıştır. Sosyodemografik özellikler, yatağa bağımlı kalma süresi, kronik hastalıklar, kullanılanı ilaçlar ve sigara içme durumu kaydedilmiştir. Daha sonra hastaların ayak tırnaklarında şekil bozukluğu, periferik kıl kaybı, ayak yaraları kaydedilmiş, hastaların fonksiyonel durumları ile deri kıvrım kalınlıkları değerlendirilmiştir. PAH ayak bileği-kol indeksi (ABI) ile değerlendirilmiş ve 0.9'un altı PAH olarak kabul edilmiştir. İstatistiksel analizde ki-kare testi, Mann-Whitney U testi ve lojistik regresyon analizi kullanılmıştır. Bulgular: Katılımcıların yaş ortalaması 75,84±1,17 yıldır (%34 E; %65 K). Hastaların %16,8'inde (n=48) periferik arter hastalığı saptanmıştır. Halen veya geçmişte sigara kullanımı (β:4.09), periferik kıl kaybı (β:3.42), ayak tırnaklarında şekil bozukluğu (β:3.02) ve deri kıvrım kalınlığında artış (β:1.124), PAH varlığını öngören faktörler olarak belirlenmiştir. Sonuç: Bu araştırmanın bulguları, evde bakım hizmeti sunanların PAH'ı öngörebilmek için hastaların sigara içme geçmişini sorgulaması, deri kıvrım kalınlığını değerlendirmesi ve kıllarda dökülme ve tırnak deformiteleri açısından ayak parmaklarını incelemesi gerektiğini göstermektedir.

Keywords

• ayak bileği-kol indeksi
• periferik arter hastalığı
• immobilite
• kalp ve damar hastalıkları
• evde sağlık hizmetleri

Predictive Factors of Peripheral Arterial Disease in Home Care Patients

Abstract

Objective: The aim of the present study was to investigate the predictive factors of peripheral arterial disease (PAD) in home care patients. Materials and Methods: This descriptive study was conducted in Istanbul with 285 homebound patients who applied for the first time to receive services from the Home Health Care Unit of a tertiary hospital between 01.07.2014 and 01.12.2014. The patients having known PAD diagnosis were excluded. Sociodemographic characteristics, home dependency duration, chronic diseases, medications used and smoking status were recorded. Then, deformities in the patients' toenails, peripheral hair loss, foot wounds were recorded, and the patients' functional status and skinfold thickness were evaluated peripheral arterial disease was evaluated by ankle–brachial index (ABI). An ABI below 0.9 was considered indicative of PAD. A chi-square test, Mann–Whitney U test and a logistic regression analysis were used in the statistical analysis. Results: The mean age of the participants was 75.84±1.17 years (34% M; 65% F). Peripheral artery disease was detected in 16.8% (n=48) of the patients. Current or former smoking (β: 4.09), peripheral hair loss (β: 3.42), deformity of toenails (β: 3.02), and increased skinfold thickness (β: 1.124) were identified as predictors of PAD. Conclusion: The findings of the present study suggest that home healthcare providers should inquire about the patient's smoking history, assess skinfold thickness, and examine the toes for hair loss and deformities, to predict PAD.

Keywords

• ankle-brachial index
• peripheral artery disease
• immobility
• cardiovascular disease
• screening
• home health care

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