Preprečevanje razjede zaradi pritiska pri osebah s paraplegijo : diplomsko delo

Fatur, Monika (author), Plemelj Mohorič, Alenka (mentor), Grabner, Petra (comentor), Lebar, Cecilija (reviewer)

Uvod: okvara hrbtenjače prinaša izgubo motoričnih, senzornih in avtonomnih funkcij hrbtenjače, distalno od mesta okvare. Osebe z okvaro so zelo izpostavljene razvoju sekundarnih zapletov; med najpogostejše spada razjeda zaradi pritiska. Na manjšo pojavnost razjed lahko vpliva aktiven življenjski slog. Namen: namen diplomskega dela je proučiti dejavnike tveganja, izkazane v življenjskem slogu oseb s paraplegijo v Sloveniji in ugotoviti razlike v pojavnosti razjed glede na izvajanje tehnik razbremenjevanja. Ugotavljali smo, ali telesna dejavnost vpliva na število razjed. Predstavili smo vlogo delovne terapije pri aktivni vključenosti oseb v prostočasne okupacije. Metode dela: uporabljen je bil kvantitativni raziskovalni pristop. Namenski vzorec raziskave je predstavljalo 29 preiskovancev, ki so ustrezali naslednjim vključitvenim kriterijem: so starejši od 18 let, izvajajo plačano delo in uporabljajo invalidski voziček na ročni pogon. Podatki so bili pridobljeni s pomočjo anketnega vprašalnika. Rezultati: ugotovili smo, da se izmed vseh dejavnikov tveganja med preiskovanci najizrazitejše pojavlja pitje alkohola (N = 22). Analiza strategij ni pokazala statistično pomembne povezanosti med izvajanjem strategij samonadzora in številom razjed med preiskovanci. Razlika v številu razjed med aktivnimi preiskovanci in tistimi, ki čas preživljajo pasivno se ni izkazala. Statistično pomembna razlika v številu razjed in pogostosti izvajanja tehnik razbremenjevanja med preiskovanci se ni izkazala. Ravno tako se razlika ni pokazala glede števila razjed zaradi pritiska in izvajanja kontrole kože med preiskovanci. Ugotovili smo, da povprečne ocene preiskovancev ne izkazujejo pomembne vloge delovnega terapevta pri preprečevanju razjed med telesno dejavnostjo. Razprava in zaključek: preventiva pred nastankom razjede zaradi pritiska je vseživljenjska obveznost tistih, ki živijo z okvaro. Izkazalo se je, da se dejavniki tveganja za nastanek razjed ne izkazujejo skozi življenjski slog preiskovancev. Izvajanje razbremenjevanja telesa je med osebami s paraplegijo v vsakodnevnem življenju slabše od priporočenega. Naloga delovnih terapevtov je spodbujanje redne telesne dejavnosti. Čeprav je delovni terapevt ključni del zdravstvenega tima, ki je usmerjen v preprečevanje nastanka razjed, je vrednotenje njihovega doprinosa, na področju prostočasnih okupacij, s strani oseb s paraplegijo, nizko.

• Language: Slovenian
• Keywords: diplomska dela, delovna terapija, paraplegija, razjeda zaradi pritiska, preventiva, prosti čas, telesna dejavnost
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [M. Fatur]
• Year: 2020
• Number of pages: 42 str., [17] str. pril.
• PID: 20.500.12556/RUL-116711
• UDC: 615.851
• COBISS.SI-ID: 19997955
• Publication date in RUL: 05.06.2020

Secondary language

• Language: English
• Title: Prevention of pressure ulcer among people with paraplegia : diploma work

Abstract

Introduction: spinal cord injury results in the loss of motoric, sensory and autonomous spinal cord functions, distal to the location of the injury. Patients with the injury are particularly prone to developing secondary complications; pressure ulcers are among the most common complications. An active lifestyle can have a positive impact on the lower occurrence of pressure ulcers. Purpose: the purpose of this thesis is to study risk factors associated with the lifestyle of patients with paraplegia in Slovenia and to establish the differences in the occurrence of pressure ulcers with regard to performing pressure relief techniques. We were trying to establish whether physical activity correlated with the number of pressure ulcers. We presented the role of occupational therapy in the active participation of patients in leisure time activities. Methods: a quantitative research approach was used. The purposive research sample was represented by 29 participants who met the inclusion criteria: they were over 18 years old, they were employed and received a salary and they used a manual wheelchair. The data was acquired via a survey questionnaire. Results: We established that alcohol drinking is the most common risk factor among the participants (N = 22). Strategy analysis did not show a statistically significant correlation between implementing self-control strategies and the number of pressure ulcers in participants. No differences in the number of pressure ulcers among active participants and those who engage in passive leisure activities were found. The correlation between the number of pressure ulcers and the frequency of performing pressure relief techniques among the participants was not statistically significant. The correlation between the number of pressure ulcers and skin care among the participants was not statistically significant either. We established that the average performance appraisal made by the participants did not prove a significant role of the occupational therapist in preventing the development of pressure ulcers during physical activity. Discussion and conclusion: the prevention of pressure ulcer development is a lifelong responsibility of those living with a spinal cord injury. It was established that the participants' lifestyles did not represent risk factors for pressure ulcer development. In their everyday lives, paraplegic spinal cord injured individuals perform a pressure relief less frequently than recommended. The task of occupational therapists is to encourage their patients to do regular physical activity. Although an occupational therapist is a key member of the healthcare team engaged in the prevention of pressure ulcer development, their performance appraisal made by paraplegic spinal cord injured individuals was rated as low.

• Keywords: diploma theses, occupational therapy, paraplegia, pressure ulcer, prevention, leisure time, physical activity