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- ItemAcesso aberto (Open Access)Adaptação transcultural e análise psicométrica da escala de valoración actual del riesgo de desarrollar úlceras por presión en cuidados intensivos (EVARUCI)(Universidade Federal de São Paulo (UNIFESP), 2016-06-29) Cremasco, Mariana Fernandes [UNIFESP]; Whitaker, Iveth Yamaguchi [UNIFESP]; http://lattes.cnpq.br/4954772252354513; http://lattes.cnpq.br/8476192792890695; Universidade Federal de São Paulo (UNIFESP)Objective: to culturally adapt to Portuguese and validate the Escala de Valoración Actual del Riesgo de desarrollar Úlceras por presión en Cuidados Intensivos (EVARUCI) to the Brazilian reality, as well as to analyse the psychometric properties of the adapted scale in the Intensive Care Unit (ICU) patients and the correlation of the severity of the patient with EVARUCI. Method: methodological research for EVARUCI?s transcultural adaptation and psychometric analysis. Internal consistency was verified by employing Cronbach?s Alpha Coefficient. The Braden Scale was used for concurrent converging validation, and SAPS 3(Simplified Acute Physiology Score) for correlation with the severity of the patient, both analysed through Spearman?s Correlation Test. EVARUCI?s predictive capacity was also analysed. To analyse interobserver reliability, the result of the simultaneous application of EVARUCI?s final version by three nurses was verified through the Intraclass Correlation Coefficient (ICC). Results: The translation of 107 items showed twelve (11.21%) disagreements among translators. In the back translation, five (4.67%) items brought different words from the original, though with similar meanings. In the specialist committee evaluation, two items (1.8%) did not achieve 90% concordance. EVARUCI?s internal consistency proved itself acceptable (?=0.782). One observed a strong significant correlation between Braden and EVARUCI scores (r = - 0.778 e p<0.001). EVARUCI?s ROC curve area reached 0.807 and Braden?s 0.798. In EVARUCI?s score 10, sensibility was 65.2%, specificity was 82%, positive predictive value was 34.3% and OR = 10. In Braden?s score 11, sensibility was 76.1%, specificity was 75.9%, positive predictive value was 34.3% and OR=10. EVARUCI?s values moderately and significantly correlated with those from SAPS 3 score (r = 0.508 e p<0.001). Interobserver reliability was excellent among evaluators (ICC=0.980). Conclusion: EVARUCI?s transcultural adaptation to Brazilian Portuguese was satisfactory regarding reliability and validity, revealing itself as a specific instrument for ICU, with rapid and fast application for PU risk evaluation in critical patients.
- ItemAcesso aberto (Open Access)Aplicação clínica do retalho fáscio-cutâneo da região posterior da coxa em V-Y(Associação Médica Brasileira, 2001-12-01) Calil, J. A. [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Neto, M. S. [UNIFESP]; Castilho, Helton Traber de [UNIFESP]; Garcia, Elvio Bueno [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To analyze the clinical applicability of one-stage treatment of single or multiple sores using the V-Y posterior thigh fasciocutaneous flap. METHODS: Twenty patients were treated, having 25 ulcers in the gluteal and perineal regions, being 23 pressure ulcers, 1 perianal abscess and 1 perineal trauma. In all of the patients the repair was carried out with a fasciocutaneous flap from the posterior region of the thigh. The flap was made with a superior and lateral base, preserving the fasciocutaneous branches of the inferior gluteal arteries, first and second perforating, in the treatment of ischial ulcers. In the associations of the same with sacral ulcer, a fasciocutaneous extension from the gluteal region was added to the flap for a one and only surgical procedure. A superior and medial based flap was made, preserving the fasciocutaneous branch of the inferior gluteal artery in the treatment of the trochanteric ulcers. In the associations with sacral ulcer a fasciocutaneous extension from the gluteal region was added to the posterior thigh flap which permitted the closure of all ulcers in only one surgical procedure. In the associations of trochanteric and ischial ulcers a flap with a superior base was made, preserving the fasciocutaneous branch of the inferior gluteal artery. RESULTS: There was no necrosis of the flap. The immediate complications were 3 infections, 1 dehiscences and 1 hematoma. In a follow-up period of 6 months to 29 months, with one patient being lost to follow up, there were 6 recurrences 6/24 (25.0%) in 5 patients 5/19 (26.32%). CONCLUSION: We conclude that the posterior fasciocutaneous thigh flap, in V-Y, can be used with safety in the treatment of isolated or multiple ulcers in the gluteal and perineal regions.
- ItemAcesso aberto (Open Access)Avaliação de risco de úlcera por pressão: propriedades de medida da versão em português da escala de Waterlow(Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP), 2007-06-01) Rocha, Alessandra Bongiovani Lima; Barros, Sonia Maria Oliveira de [UNIFESP]; CUSC; UNINOVE; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To evaluate the sensitivity and specificity properties of Portuguese version of the Waterlow scale. METHODS: Field test of the scale among forty-four patients admitted to medical units in over sized university hospital for a period of 15 days. RESULTS: Patients who developed pressure ulcer had higher scores on the Waterlow scale than those without PU (18.1±3.4 and 12.8±5.4, p<0.001, respectively). Stepwise logistic regression indicated that skin type and appetite were significant predictors for the development of PU. The ROC curve analysis showed that score of 15 suggest the best combination of sensitivity and specificity, 87% and 76%, respectively. CONCLUSION: The results suggest that the Portuguese version of the Waterlow scale was an accurate and effective tool to predict the development of pressure ulcer in patients admitted to medical surgical units.
- ItemSomente MetadadadosCross-cultural adaptation and validation of the neonatal/infant Braden Q risk assessment scale(Elsevier Sci Ltd, 2016) de Lima, Edson Luiz; Azevedo de Brito, Maria Jose [UNIFESP]; Sebba Tosta de Souza, Diba Maria; Salome, Geraldo Magela; Ferreira, Lydia Masako [UNIFESP]Aim: To translate into Brazilian Portuguese and cross-culturally adapt the Neonatal/Infant Braden Q Risk Assessment Scale (Neonatal/Infant Braden Q Scale), and test the psychometric properties, reproducibility and validity of the in strument. There is a lack of studies on the development of pressure ulcers in chit dren, especially in neonates. Methods: Thirty professionals participated in the cross-cultural adaptation of the Brazilian-Portuguese version of the scale. Fifty neonates of both sexes were assessed between July 2013 and June 2014. Reliability and reproducibility were tested in 20 neonates and construct validity was measured by correlating the Neonatal/Infant Braden Q Scale with the Braden Q Risk Assessment Scale (Braden Q Scale). Discriminant validity was assessed by comparing the scores of neonates with and without ulcers. Results: The scale showed inter-rater reliability (ICC = 0.98; P < 0.001) and intrarater reliability (ICC = 0.79; P < 0.001). A strong correlation was found between the Neonatal/Infant Braden Q Scale and Braden Q Scale (r = 0.96; P < 0.001). Conclusion: The cross-culturally adapted Brazilian version of the Neonatal/Infant Braden Q Scale is a reliable instrument, showing face, content and construct validity. (C) 2015 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.
- ItemEmbargoFerramentas aplicadas para avaliação do conhecimento sobre lesão por pressão em graduandos de enfermagem: Revisão de escopo(Universidade Federal de São Paulo, 2024-10-06) Fontoura, Ana Vitória Bastos [UNIFESP]; Costa, Karina Aparecida Lopes da [UNIFESP]; Aprile, Daniele Cristina Bosco [UNIFESP]; http://lattes.cnpq.br/4098817110853647; http://lattes.cnpq.br/8738547985320225;; http://lattes.cnpq.br/4641939355165043Introdução: A pele, composta por epiderme, derme e hipoderme, desempenha funções vitais, como proteção e regulação térmica. A pressão prolongada sobre essas camadas pode causar lesões por pressão (LPP), resultantes do comprometimento da circulação sanguínea e do cisalhamento do tecido. Fatores intrínsecos, como mobilidade reduzida e diabetes, e fatores extrínsecos, como fricção, aumentam o risco dessas lesões. A prevenção envolve tanto o controle desses fatores quanto a capacitação dos profissionais de enfermagem, e também os estudantes de enfermagem para identificar e tratar as LPP durante sua formação. Objetivo: Este estudo visa mapear as estratégias de avaliação do conhecimento dos graduandos de enfermagem sobre lesões por pressão e identificar o desempenho dos graduandos, além das limitações dos instrumentos aplicados nas respectivas populações. Método: Esta revisão de escopo, conduzida entre fevereiro e setembro de 2024, seguiu as diretrizes do JBI Protocol Template e PRISMA-ScR. A pesquisa foi realizada em bases como PubMed, BVS e SciELO, resultando em 747 artigos analisados com o software Rayyan®. Foram incluídos 18 estudos em inglês, português e espanhol, que utilizaram questionários, escalas e testes para avaliar o conhecimento, com dados apresentados em quadros e figuras. Resultados: Os estudos revisados revelaram um desempenho insatisfatório dos estudantes de enfermagem no conhecimento sobre LPP. Dos 18 estudos incluídos na revisão, destacam-se ferramentas como a Pressure Ulcer Knowledge Assessment Tool (PUKAT) e a Pressure Ulcer Knowledge Test (PUKT). Apesar da compreensão geral baixa entre os participantes, os estudos que implementaram intervenções educativas mostraram que os estudantes obtiveram resultados significativamente melhores em suas avaliações. Conclusão. O mapeamento do conhecimento sobre lesões por pressão entre graduandos ajuda educadores a aprimorar o ensino, capacitando futuros profissionais a prevenir e tratar essas lesões. As escalas PUKAT e PUPKAI-T foram as mais usadas. Isso ressalta a importância de aprimorar a formação acadêmica e as estratégias de ensino sobre o tema nas instituições de ensino.
- ItemAcesso aberto (Open Access)Incidência de úlcera por pressão em pacientes neurocirúrgicos de hospital universitário(Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP), 2009-01-01) Diccini, Solange [UNIFESP]; Camaduro, Camila [UNIFESP]; Iida, Luciana Inaba Senyer [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To identify the incidence of pressure ulcer in the preoperative and postoperative period in neurosurgical patients and to describe preventive measures adopted by nursing staff. METHODS: A prospective study was conducted in the neurosurgical unit of the São Paulo hospital. The sample consisted of inpatients who were admitted for elective surgeries of the central nervous system and who did not have pressure ulcer. RESULTS: Sixty patients participated in the study. They have a mean age of 49 years, ranging from 19 to 78 years. The majority of patients (56.6%) were female. Only 8 patients (13.4%) developed nine pressure ulcers. Among the patients identified as having risk for pressure ulcers, preventive measures were implement to 3 of them (25%) during the preoperative period, to 33 of them (66%) during the immediate postoperative period, and to 23 (86.6%) during the mediate postoperative period. CONCLUSION: The incidence of pressure ulcer in the study sample was 13.3%. There is a need to implement a preventive program to decrease the incidence of pressure ulcers in neurosurgical patients.
- ItemAcesso aberto (Open Access)INDICANUTRI LP: aplicativo de gestão de indicadores nutricionais de pacientes com lesão por pressão(Universidade Federal de São Paulo (UNIFESP), 2018-08-16) Barrios, Weruska Davi [UNIFESP]; Nicodemo, Denise [UNIFESP]; Schmidt, Christiane Steponavicius Sobral [UNIFESP]; Suzuki, Vanessa Yuri; http://lattes.cnpq.br/7996290670653478; http://lattes.cnpq.br/1109015106402921; http://lattes.cnpq.br/5221369826598914; http://lattes.cnpq.br/9786354749641793; Universidade Federal de São Paulo (UNIFESP)Introduction: The diet therapy is important to ensure the nutrients supply, duo to the therapeutic role in chronic and acute diseases. Monitor inpatient nutritional indicators and early intervention has a major impact not only in the improvement of their nutritional status, as well as in the hospitalization cost. Health professionals have already used tools such as the internet, software and applications as a vehicle. Objective: Develop an application for nutritional indicators management in hospitalized patients with pressure ulcer. Method: From September to November 2017; it was conducted a search in Google Play® application store and used Design Thinking methodology to develop the app prototype, through experts consulting such as: nutrition specialist, nursing and hospital managers. Results: It was found 248 applications in the prior art search in different categories that were not relevant to the subject of this study. A questionnaire was given to 31 experts as the first stage of Design Thinking and showed that 94% record their data manually, using 2 to 5 professionals in this activity. Conclusion: It was developed INDICANUTRI LP® - an application for nutritional indicators management for patients with pressure ulcer.
- ItemAcesso aberto (Open Access)Prevalence of pressure ulcers among the elderly living in long-stay institutions in São Paulo(Associação Paulista de Medicina - APM, 2009-07-01) Chacon, Julieta Maria Ferreira [UNIFESP]; Blanes, Leila [UNIFESP]; Hochman, Bernardo [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)CONTEXT AND OBJECTIVE: The prevalence of pressure ulcers varies according to geographic region and population group, such as the institutionalized elderly. The aim of this study was to identify the prevalence of pressure ulcers among elderly people living in long-stay institutions. DESIGN AND SETTING: Cross-sectional study in six long-stay institutions for the elderly in São Paulo, Brazil. METHODS: Demographic and clinical data were collected in six long-stay institutions on two visits to each institution between May and August 2007, during which all elderly patients with pressure ulcers were evaluated. The Braden scale was used to identify the risk of developing pressure ulcers and the National Pressure Ulcer Advisory Panel (NPUAP) stages for classifying the pressure ulcers. Statistical analysis was performed using the chi-square test, Student's t-test and Fisher's exact test. RESULTS: There was no significant difference in the results between visits. The population was 181 elderly people in May and 184 in August: 23 had pressure ulcers in May (prevalence of 12.7%) and 17 in August (prevalence of 9.2%). The mean age at the two times was 84 years, and the average length of stay was 32 months. Pressure ulcers were found mainly in the sacral region (mean, 71.5%), and most commonly in stage II (mean, 41%). CONCLUSION: The prevalence of pressure ulcers was 10.95%. These data provide background information that may aid in developing protocols for applying best practices for prevention and treatment of pressure ulcers, consequently reducing the prevalence.
- ItemAcesso aberto (Open Access)Úlcera por pressão em pacientes submetidos à cirurgia: incidência e fatores associados(Universidade de São Paulo, Escola de Enfermagem, 2011-12-01) Scarlatti, Kelly Cristina [UNIFESP]; Michel, Jeanne Liliane Marlene [UNIFESP]; Gamba, Mônica Antar [UNIFESP]; Gutiérrez, Maria Gaby Rivero de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Pressure ulcers are an important perioperatory care quality indicator This is a longitudinal case series study, performed with the following objectives: to estimate the incidence of pressure ulcers in patients submitted to medium and large surgeries; rate them according to the stage and location; verify the association with the variables: gender, age, body mass index (BMI), co-morbidities, surgical position, duration of surgery, anesthesia type and use of positioning devices, with presence or absence of pressure ulcers. Data collection took place in 2007 in São Paulo, with 199 patients, 20.6% of which presented pressure ulcers, and most (98.6%) in stages I and II, and the main location was the trunk (35.1%). The variables: position, surgery time, general anesthesia, and device use had a statistically significant association. In conclusion, there is a high incidence of pressure ulcers among surgical patients, requiring actions aimed at reducing this type of injury.
- ItemAcesso aberto (Open Access)Úlcera por pressão: risco e gravidade do paciente e carga de trabalho de enfermagem(Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP), 2009-01-01) Cremasco, Mariana Fernandes [UNIFESP]; Wenzel, Fernanda [UNIFESP]; Sardinha, Fernanda Maria [UNIFESP]; Zanei, Suely Sueko Viski [UNIFESP]; Whitaker, Iveth Yamaguchi [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVES: to examine the association between pressure ulcer (PU) in critical care patients and their Braden scale score and the association between patient acuity and nursing workload, and to identify the risk factors for pressure ulcer among patients in critical care units (CCUs). METHODS: This was a cross-sectional study with 74 patients in three CCUs at a major hospital. Data were collected prospectively using the simplified acute physiology score (SAPS II), the nursing activities score (NAS), and the Braden scale. RESULTS: Approximately a third of patients (31%) had a PU. Factors associated with PUs were age, days of hospital stay, the score on the Braden scale, and the score on the SAPS II. The score on the NAS was not associated with PUs. Scores on the SAPS II and NAS were moderately correlated with the score on the Braden scale. CONCLUSION: The development of PUs was associated with advanced age, longer hospital stay, and patient acuity. Patient acuity and nursing workload were predictors of UPs.