Integridade da pele de área perilesional prejudicada e integridade tissular prejudicada relacionada à circulação alterada em pessoas com úlceras vasculogênicas
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2010-03-05
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Universidade Federal de Goiás
Resumo
Vasculogenic ulcers represent a public health problem that requires an interdisciplinary approach emphasizing nursing. The focus of nursing on caring when this disease is present should be on diagnoses impaired tissue integrity and impaired perilesional skin integrity , among others. Despite the high number of bandages made to the outpatient units of the Goiania Department of Health, the nursing staff has not conducted systematic approach and evaluation. The aim of this study was to analyze the occurrence of impaired
tissue integrity related to altered circulation and impaired perilesional skin integrity in patients with vasculogenic ulcers treated in primary health units in Goiania, Goias, Brazil. The association between the related factors and defining
characteristics of these diagnoses with social, demographic and individual clinical variables were also investigated. A cross sectional observational clinical study in municipal health units that operate 24 hours a day was conducted from February to August 2009. From the population of 67 individuals with vasculogenic ulcers who were being treated in the network, 42 participants were included in the study. Interviews, physical examinations, planigraphy, digital photography of the wound, and analyses of patient records were used in data
collection. Descriptive statistical procedures were performed for data analysis. To analyze the relationship between each related factor (RF) and the defining characteristics (DC) with social, demographic and clinical variables, the X2 test
was used, and for the association of the number of RFs and the DC of the diagnoses and the variables of interest, the Mann-Whitney and Kruskal-Wallis tests were used, for which p �� 0.05 was adopted. The study was approved by
the UFG Research Ethics Committee (protocol 032/2008). Participants were predominately males (73.8%), age �� 50 years old. All (100%) showed impaired tissue integrity, highlighting the RFs: impaired circulation (100%), of venous
origin (90.5%), knowledge deficit (100%), and chemical irritants (95.2%). In relation to the DC, granulation tissue and/or epithelialization (a new proposal for inclusion), destroyed tissue (95.2%), and damaged tissue (76.2%) were
identified. All (100%) had impaired perilesional skin integrity, and the RF impaired circulation and changes in pigmentation were also found in 100% of the cases studied. The inclusion of the RF knowledge deficit was found in 100% of the participants. Impaired tissue integrity presented association
between the gender of the participants and the temperature extremes (p=0.001). For the impaired perilesional skin integrity, there was association between gender and the exudation (p=0.049), mechanical factors (p=0.049),
impaired physical mobility (p=0.032), bony prominences (p=0.034), extreme age (p=0.035), developmental factors (p=0.035), and hyperthermia (p=0.003). There was a statistically significant association for the number of RFs of the impaired perilesional skin integrity in relation to the current work situation (p=0.020). The significant occurrence of impaired perilesional skin integrity signalizes the importance of expanded evaluation by the professionals. The results indicate the presence of RFs that are highly sensitive to nursing interventions, such as knowledge deficit. The association of RFs and CDs with social, demographic
and clinical variables indicates the need for differentiated nursing interventions in relation to the gender of patients.
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MALAQUIAS, Suelen Gomes. Impaired perilesional skin integrity and impaired tissue integrity related to altered circulation in patients with vasculogenic ulcers. 2010. 221 f. Dissertação (Mestrado em Cuidado em Enfermagem) - Universidade Federal de Goiás, Goiânia, 2010.