Made available in DSpace on 2014-12-17T14:47:08Z (GMT). No. of bitstreams: 1
NiedjaCSF.pdf: 973157 bytes, checksum: 786ab340ce2334d43b17d88aff5a2481 (MD5)
Previous issue date: 2005-07-22 / To characterize patients according to gender, age category, internment time, diagnostical hypothesis and location of the pressure ulcer; to identify the susceptibility conditions, intrinsical and extrinsical factors present on ICU patients and to verify on the existence of association between the susceptibility conditions and the intrinsecal and extrinsecal factors on the occurrence of PU. Methods: It is a descriptive study, of longitudinal design of the panel type, with quantitative approach, performed on two ICU s of a private hospital located in Natal/RN, with 40 patients interned at these units. The data collection was performed on all three shifts through a structured observation and physical exam of the patients' skin form seeking to identify the presence of PU. Results: The greatest occurence of PU was on individuals of the male gender (70%) when compared to the female gender (30%), that difference being statistically significant (p=0,0267), with the male gender presenting 4,3 times greater chance of developing PU than the female; the predominant age category was from 60 years of age on (85%), 60,0% presented 1 to 2 PU s after 7 (seven) days of permanence in the ICU s, the predominant diagnostical hypothesis on the patients with PU were the respiratory diseases (42,3%) and the most frequent locations of PU were the sacral region (40,0%) and heels (36,0%). 25 PU s of stage I were diagnosed on 50,0% of the followed patients, with general incidence of 50,0% on both ICUs. from the 88 variables researched, 75 were identified on the patients from the study, being the predominant conditions (anemia, hypotension, leukocytosis, other diseases hypertension blood pressure, cardiac insuffience, pneumonia - and ansiolythic), the intrinsecal factors (diminished muscular strenght and/or mass, discrete edema, totally compromised mobile coordination and total inability for movement on the bed) and the extrinsecal factors (inadequate mattress type, permanence on a single position for >2 hours, shearing/friction force, bed clothes with folds that leave marks on the body, pressure force) predominated on patients with PU. The male gender variables (p=0,0267,OR=4,3), sedation (p=0,0006,OR=4,1), psychomotive agitation (p=0,0375,OR=5,8) and leukocytosis (p=0,0285,OR=5,0) presented a significant statistical diference when analyzed independently. We verified an association of 17,3%, statistically significant (p=0,0384), between the susceptibility conditions (anemia, leukocytosis and hypotension), the intrinsecal factors (age equal or above 60 years, diminished/absent pain sensibility and smooth, fine or delicate skin) and the extrinsecal factors (inadequate mattress, pressure forces, shearing/friction force, permanence on a single position for more than 2 hours, elevation between 30 to 45 degrees and inadequate bed clothes' conditions), with a chance ratio of 4,6 times the risk of occurrence of PU on the patients that presented the referred association. Conclusion: The incidence of PU detected on the ICU-interned patients was high and we made evident the existence of association between the susceptibility conditions, the intrinsecal and extrinsecal factors on the occurrence of PU s on the ICUinterned patients, and thus we accept the alternative hypothesis proposed on the study / Identificar a incid?ncia de UP em pacientes internados nas UTIs, segundo sexo, faixa et?ria, tempo de interna??o, hip?tese diagn?stica e localiza??o de ?lcera de press?o; identificar a incid?ncia de ?lcera de press?o (UP) nas Unidades de Terapias Intensivas (UTIs); identificar as condi??es predisponentes, fatores intr?nsecos e extr?nsecos presentes nos pacientes internados nas UTIs e verificar a exist?ncia de associa??o entre as condi??es predisponentes e os fatores intr?nsecos e extr?nsecos na ocorr?ncia de UP. M?todos: Trata-se de um estudo descritivo, com delineamento longitudinal do tipo painel, com abordagem quantitativa, realizado em duas UTIs de um hospital privado localizado em Natal/RN, com 40 pacientes internados nessas unidades. A coleta dos dados foi realizada nos tr?s turnos por meio de um formul?rio estruturado de observa??o e exame f?sico da pele dos pacientes buscando identificar a presen?a de UP. Resultados: A maior ocorr?ncia de UP foi em indiv?duos do sexo masculino (70%) em rela??o ao feminino (30%), sendo esta diferen?a, estatisticamente significante (p= 0,0267), com sexo masculino apresentando 4,3 vezes mais chance de desenvolver UP do que o feminino; a faixa et?ria predominante foi a partir de 60 anos (85%), 60,0% apresentaram de 1 a 2 UPs ap?s 7 (sete) dias de perman?ncia nas UTIs, a hip?tese diagn?stica predominante nos pacientes com UP, foram as doen?as respirat?rias (42,3%) e as localiza??es mais freq?entes de UP foram ? regi?o sacral (40,0%) e calc?neos (36,0%). Foram diagnosticadas 25 UPs em est?gio I em 50,0% dos pacientes acompanhados, com incid?ncia geral de 50% nas duas UTIs. Das 88 vari?veis pesquisadas, 75 foram identificadas nos pacientes do estudo, sendo que as condi??es predominantes (anemia, hipotens?o, leucocitose, outra doen?as (HAS, ICO, PNM) e ansiol?tico), os fatores intr?nsecos (a for?a e/ou massa muscular diminu?da, edema discreto, coordena??o motora totalmente prejudicada e inabilidade total para movimenta??o no leito) e os fatores extr?nsecos (tipo de colch?o inadequado, posicionamento em um mesmo dec?bito por >2 horas, for?a de cisalhamento/fric??o, roupas de cama com dobras deixando marcas no corpo, for?a de press?o) predominaram nos pacientes com UP. As vari?veis como sexo masculino (p=0,0267, RC=4,3), seda??o (p=0,0015, RC=9,3), for?a de cisalhamento/fric??o (p=0,0393, RC=3,3), for?a de press?o (p=0,0006, RC=4,1), agita??o psicomotora (p=0,0375, RC=5,8) e leucocitose (p=0,0285, RC=5,0) apresentaram diferen?a estat?stica significante quando analisadas isoladamente. Verificamos uma associa??o de 17,3%, estatisticamente significante (p=0,0384), entre as condi??es predisponentes (anemia, leucocitose e hipotens?o), os fatores intr?nsecos (idade maior ou igual a 60 anos, sensibilidade dolorosa diminu?da/ausente e pele lisa, fina ou delicada) e os fatores extr?nsecos (colch?o inadequado, for?as de press?o, for?a de cisalhamento/fric??o, posicionamento em um mesmo dec?bito por mais de 2 horas, eleva??o de 30 a 45 graus e condi??es de roupas de cama inadequadas), com uma raz?o de chance de 4,6 vezes o risco de ocorr?ncia de UP nos pacientes que apresentaram a referida associa??o. Conclus?o: A incid?ncia de UP detectada nos pacientes internados nas UTIs foi elevada e evidenciamos a exist?ncia de associa??o entre as condi??es predisponentes, os fatores intr?nsecos e extr?nsecos na ocorr?ncia de UPs nos pacientes internados nas UTIs, portanto aceitamos a hip?tese alternativa proposta no estudo
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/14831 |
| Date | 22 July 2005 |
| Creators | Fernandes, Niedja Cibegne da Silva |
| Contributors | CPF:51326728415, http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4708368Z6&dataRevisao=null, Garcia, Telma Ribeiro, CPF:09663967153, http://lattes.cnpq.br/5849780347831135, Farias, Glaucea Maciel de, CPF:02567415491, http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4792903Z9&dataRevisao=null, Germano, Raimunda Medeiros, CPF:00446114472, http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4721938D8, Torres, Gilson de Vasconcelos |
| Publisher | Universidade Federal do Rio Grande do Norte, Programa de P?s-Gradua??o em Enfermagem, UFRN, BR, Assist?ncia ? Sa?de |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
Page generated in 0.0026 seconds