Feridoteca - Tese de Mestrado Úlcera de Pressão




Exploratory-descriptive study whose general objective was to obtain subsidies to be used in a later elaboration of an instrument to evaluate the risk to develop pressure ulcer in hospitalized patients and to orientate the nursing team to the preventive, systematic and individual clients’ care, subjected to this morbid entity. This study was fullfiled in a school hospital in João Pessoa – PB and its population was composed of abed, hospitalized patients in the Medical Clinic of this institution, in the period from November 1997 until February 1998.

The sample, intentional kind, consisted of 52 patients, indicated by nurses in the sector as being of risk to develop the pressure ulcer. In order to collect data an instrument was built where we tried to embrace the predisposing conditions (or associated factors) and the intrinsic and extrinsic risk factors mentioned in the literature as being related to the formation of pressure ulcer, some of them were contemplated in Norton’s, Gosnell’s and Braden’s scales as well as in Waterlow’s Punctuation Card. This instrument was applied to the sample by two researchers, who continuously and independently, researched the promptuaries, examined and observed the select patients so as to fill in data in the formulary.

During data analysis, the average percentage of occurrence of the predisposing conditions and the intrinsic and extrinsic risk factors and Kappa’s index and its confidence interval were calculated to verify the reliability of the obtained results by both researchers. As main results, it was observed that, among the predisposing conditions to the development of pressure ulcer, there was a predominance of hematologic (84,6%) and nutritional (80,8%) alterations. 

Among the intrinsic risk factors, superposed the alteration of the skin humidity (78,8%), alteration in the skin turgidity and elasticity (77,9%), age ³ 60 years old (61,5%) and physical mobility partly damaged (60,6%). Among the extrinsic risk factors, prevailed the force of pressure in the body (80,8%), inadequate conditions of bedclothes (72,1%), inadequate mobilization (67,3%) and inadequate conditions of the mattress (51,9%). These results reinforce the idea that there is a need to construct an instrument to measure the risk to develop pressure ulcer which must be sensible and adequate to our reality, and that incorporates factors not included in the divulged scales in the literature.