Identification of activities of daily living relating to pressure ulcer development in community-resident individuals with spinal cord injury

2004 Fiscal Year Final Research Report Summary

• Project/Area Number: 15592251
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Fundamental nursing
• Research Institution: Nagoya City University, School of Nursing
• Principal Investigator: HAGISAWA Satsue Nagoya City University, School of Nursing, Professor, 看護学部, 教授 (90040071)
• Co-Investigator(Kenkyū-buntansha): YAMADA Yasuko Nagoya City University, School of Nursing, Associate Professor, 看護学部, 助教授 (30158224)
• Project Period (FY): 2003 – 2004
• Keywords: Pressure ulcer development / Spinal cord injured / Activities of daily living / Pressure distribution / Preventive measure

Research Abstract

Pressure ulcers remain still serious problem for community-resident individuals with spinal cord injury. If it developed, it considerably affects their life, such as spending a time in the hospital with extra costs and sometimes loosing their job. Therefore, they are trained how to prevent the development in their daily life using wheelchair prior to discharge, for example, how to transfer, push-up and inspect the skin of vulnerable areas. However, we have experienced that they developed pressure ulcers without problem of pressure on wheelchair cushion, probably got the ulcers when they were out of wheelchair of their living.
In order to identify the activities of daily living that may result in pressure ulcer development, this study was conducted.
Prior to clinical study, FSA pressure mapping system which is used to measure the interface pressure between the buttock and the supporting surface was evaluated performing linearity, hysteresis, repeatability and temperature sensitivity tests . The results indicated that the repeatability was good, however, hysteresis and linearity at low pressure were not good and the output was not affected by environmental temperature between 20℃ and 30℃ at 50% relative humidity.
Nineteen subjects of community-resident individuals with spinal cord injury participated in this study. The consent was obtained from each subject. The interview and pressure measurement in sitting on wheelchair were performed. The pressures in other activities were also measured to those who gave an approval for measurement.
The results indicated that the interface pressure measured was well distributed (less than 100 mmHg). However, the activities out of wheelchair of their living, for example, washing the body in the bath and sitting on "tatami" resulted in high pressure (more than 200mmHg) at the ischial tuberosities. In the interview it was supposed that they have had such high pressure in unusual activities of their life such as leisure, taking examination and attending the party, which were out of wheelchair, although the pressures under such condition could not be measured. In addition, much attention was not paid to the checking of wheelchair cushion they use, those who check their cushion regularly were only 6 of 19 subjects, others were, if something was wrong, they check it (7) and no-checking (6).
Definitive conclusion was not drawn from this study because of small size of sample, however, it was implied that the activities of off-wheelchair in daily living and cushion checking can not be ignored when identifying the cause of pressure ulcer development in individuals with spinal cord injury.