Abstract：
OBJECTIVE: To: (1) report on the prevalence of community-acquired pressure injuries (CAPIs) in patients admitted into the acute care setting; (2) examine the socio-economic and home environment associated with CAPIs; and (3) understand the challenges of caring for patients with CAPIs at home.
METHODS: This mixed-method study recruited patients admitted with CAPIs in the acute care hospital between March 2021 to June 2022. The hospital\'s pressure injury (PI) database was used to screen patients admitted with CAPIs. A purposive sample of CAPI patients and their caregivers participated in this study. A cross-sectional survey study was first performed to examine the prevalence of CAPIs and the socio-economic and home environment factors. Semi-structured interviews were conducted to understand the caregivers\' challenges in caring for patients with CAPIs at home.
RESULTS: The CAPI prevalence was reported at 1.1 % during the study period (1039 had CAPIs out of 97 912 patients admitted to the hospital). A total of 70 caregivers and patients consented to participate in the study. The mean age of patients was 84.2 (SD = 10.4) years old; 68.6 % (n = 48) were females. Majority presented with a deep tissue injury (DTI) (37.1 %; n = 26) or unstageable PI (31.4 %; n = 22). More than half of the patients had alternating air mattresses at home (54.3 %; n = 38), and only 10 % (n = 7) had positioning wedges and used a sliding sheet for turning. The mean age of the caregivers was 43.4 years old (SD = 13.1), and 84.3 % (n = 59) were female. Continuous data were summarised using means and standard deviations, and categorical data were summarised using frequencies and percentages. Logistic regression found no significant socio-demographic and clinical predictors of patients having PI stages 2, 3, and 4 compared to patients with DTI and unstageable PI. Challenges to caring for PI at home included high financial burden, physical limitations, and personal challenges in CAPIs management.
CONCLUSIONS: CAPIs are prevalent among older patients admitted to the acute care setting. Understanding the influence of socio-economic factors is crucial for developing comprehensive strategies to mitigate the occurrence and impact of PIs. Ongoing support and education to the caregivers in the community is essential to address the reported challenges in PI care.
METHODS: This mixed-method study recruited patients admitted with CAPIs in the acute care hospital between March 2021 to June 2022. The hospital\'s pressure injury (PI) database was used to screen patients admitted with CAPIs. A purposive sample of CAPI patients and their caregivers participated in this study. A cross-sectional survey study was first performed to examine the prevalence of CAPIs and the socio-economic and home environment factors. Semi-structured interviews were conducted to understand the caregivers\' challenges in caring for patients with CAPIs at home.
RESULTS: The CAPI prevalence was reported at 1.1 % during the study period (1039 had CAPIs out of 97 912 patients admitted to the hospital). A total of 70 caregivers and patients consented to participate in the study. The mean age of patients was 84.2 (SD = 10.4) years old; 68.6 % (n = 48) were females. Majority presented with a deep tissue injury (DTI) (37.1 %; n = 26) or unstageable PI (31.4 %; n = 22). More than half of the patients had alternating air mattresses at home (54.3 %; n = 38), and only 10 % (n = 7) had positioning wedges and used a sliding sheet for turning. The mean age of the caregivers was 43.4 years old (SD = 13.1), and 84.3 % (n = 59) were female. Continuous data were summarised using means and standard deviations, and categorical data were summarised using frequencies and percentages. Logistic regression found no significant socio-demographic and clinical predictors of patients having PI stages 2, 3, and 4 compared to patients with DTI and unstageable PI. Challenges to caring for PI at home included high financial burden, physical limitations, and personal challenges in CAPIs management.
CONCLUSIONS: CAPIs are prevalent among older patients admitted to the acute care setting. Understanding the influence of socio-economic factors is crucial for developing comprehensive strategies to mitigate the occurrence and impact of PIs. Ongoing support and education to the caregivers in the community is essential to address the reported challenges in PI care.
摘要：
目的：目的：（1）报告急性护理环境中社区获得性压力性损伤（CAPI）的患病率；（2）检查与CAPI相关的社会经济和家庭环境；（3）了解在家中照顾CAPI患者的挑战。
方法：这项混合方法研究招募了2021年3月至2022年6月在急性护理医院接受CAPI治疗的患者。使用医院的压力损伤（PI）数据库筛选接受CAPI的患者。CAPI患者及其护理人员的目的样本参与了这项研究。首先进行了横断面调查研究，以检查CAPI的患病率以及社会经济和家庭环境因素。进行了半结构化访谈，以了解护理人员在家中照顾CAPI患者的挑战。
结果：在研究期间，据报道CAPI患病率为1.1%（在97.912名患者中，有1039名患者接受了CAPI）。共有70名护理人员和患者同意参与该研究。患者的平均年龄为84.2（SD=10.4）岁；68.6％（n=48）为女性。大多数患者表现为深部组织损伤（DTI）（37.1%；n=26）或无法分级的PI（31.4%；n=22）。超过一半的患者在家中使用交替的气垫（54.3％；n=38），只有10％（n=7）有定位楔，并使用滑动片进行车削。护理人员的平均年龄为43.4岁（SD=13.1），84.3%(59例)为女性。连续数据使用平均值和标准偏差进行汇总，分类数据使用频率和百分比进行汇总。Logistic回归发现，与DTI和不可停滞PI患者相比，PI2、3和4期患者的社会人口统计学和临床预测因子均无统计学意义。在家照顾PI的挑战包括沉重的经济负担，物理限制，以及CAPI管理中的个人挑战。
结论：CAPI在接受急性治疗的老年患者中很普遍。了解社会经济因素的影响对于制定全面战略以减轻PI的发生和影响至关重要。对社区护理人员的持续支持和教育对于解决所报告的PI护理挑战至关重要。
方法：这项混合方法研究招募了2021年3月至2022年6月在急性护理医院接受CAPI治疗的患者。使用医院的压力损伤（PI）数据库筛选接受CAPI的患者。CAPI患者及其护理人员的目的样本参与了这项研究。首先进行了横断面调查研究，以检查CAPI的患病率以及社会经济和家庭环境因素。进行了半结构化访谈，以了解护理人员在家中照顾CAPI患者的挑战。
结果：在研究期间，据报道CAPI患病率为1.1%（在97.912名患者中，有1039名患者接受了CAPI）。共有70名护理人员和患者同意参与该研究。患者的平均年龄为84.2（SD=10.4）岁；68.6％（n=48）为女性。大多数患者表现为深部组织损伤（DTI）（37.1%；n=26）或无法分级的PI（31.4%；n=22）。超过一半的患者在家中使用交替的气垫（54.3％；n=38），只有10％（n=7）有定位楔，并使用滑动片进行车削。护理人员的平均年龄为43.4岁（SD=13.1），84.3%(59例)为女性。连续数据使用平均值和标准偏差进行汇总，分类数据使用频率和百分比进行汇总。Logistic回归发现，与DTI和不可停滞PI患者相比，PI2、3和4期患者的社会人口统计学和临床预测因子均无统计学意义。在家照顾PI的挑战包括沉重的经济负担，物理限制，以及CAPI管理中的个人挑战。
结论：CAPI在接受急性治疗的老年患者中很普遍。了解社会经济因素的影响对于制定全面战略以减轻PI的发生和影响至关重要。对社区护理人员的持续支持和教育对于解决所报告的PI护理挑战至关重要。
