Modifiable patient-related factors associated with pressure ulcers on the sacrum and heels: Secondary data analyses

J Adv Nurs. 2019 Nov;75(11):2773-2785. doi: 10.1111/jan.14149. Epub 2019 Aug 27.


Aim: To explore factors associated with the presence of category I-IV pressure ulcers on the sacrum and heels.

Design: Cross-sectional, secondary data analysis using data collected from the Landelijke Prevalentiemeting Zorgproblemen (LPZ) project, a multicentre prevalence study including nursing home residents and community care clients (N = 4,842) in the Netherlands in 2017.

Methods: A single binary logistic regression model was designed to identify factors associated with the presence of pressure ulcers. Additionally, a multiple binary logistic regression model including modifiable explanatory factors associated with the presence of pressure ulcers was designed.

Results: Impaired mobility, friction and shear (evaluated using the Braden Scale) are significantly associated with the presence of both sacral and heel category I-IV pressure ulcers. Incontinence-associated dermatitis is significantly associated with category I-IV sacral pressure ulcers.

Conclusion: In pressure ulcer prevention, nursing interventions should focus on frequent repositioning and mobilization while avoiding exposure of the skin to friction and shear. The need to consider incontinence-associated dermatitis, incontinence and moisture as important factors in pressure ulcer risk assessment is confirmed.

Impact: Pressure ulcers occur when skin and tissues are deformed between bony prominences and the support surface in a sitting or lying position. They are the result of a complex interaction between direct causal factors and a wide range of indirect factors. Recognition of these factors influences risk assessment guidance and practice. Knowledge of skin-specific factors at the patient level, modifiable by nursing interventions, enables a better targeted and tailored preventive approach.

目的: 探讨与骶骨和脚后跟出现一到五期压疮相关的因素。 设计: 使用自Landelijke Prevalentiemeting Zorgproblemen (LPZ)项目收集的数据以进行一个横断面的二次数据分析,该项目是2017年在荷兰进行的一项多中心现患率调查,其中包括疗养院居民和社区护理服务对象(N = 4842) 方法: 我们设计了一个单一二元逻辑回归模型来确定与压疮出现相关的因素。此外,我们还设计了一个多个二元逻辑回归模型,其中就设计了与压疮出现相关的可修改解释因素。 结果: 活动障碍、摩擦以及剪切(使用压疮评价量表进行评估)都与骶骨和脚后跟的一到五期压疮有显著相关。与尿失禁相关的皮炎与一到五期压疮有显著相关关系。 结论: 为了预防压疮,护理措施应着重于频繁调换位置和活动,同时避免皮肤受到摩擦和剪切。考虑与尿失禁相关的皮炎 尿失禁以及水分是确认压疮风险评估的重要因素。 影响: 在坐立或躺卧状态下支撑表面与骨性隆起之间的组织和皮肤变形是,就会形成压疮。压疮是直接病因和广泛的间接因素相互作用的结果。识别这些因素会对风险评估的知道和实践产生影响。了解患者的皮肤特异因素可通过护理干预措施加以调整,有助于制定更有针对性的预防措施。.

Keywords: associated factor; heel; modifiable; nurses/nursing; pressure ulcers; risk assessment; sacrum.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Female
  • Heel / pathology*
  • Humans
  • Male
  • Netherlands
  • Pressure Ulcer / pathology*
  • Pressure Ulcer / prevention & control
  • Risk Factors
  • Sacrum / pathology*