Yoğun bakım hastalarının ağız sağlığının incelenmesi
Küçük Resim Yok
Tarih
2016
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu araştırma, yoğun bakım hastalarının ağız sağlığı durumları incelenmek amacıyla planlanmıştır. Tanımlayıcı olarak planlanan bu araştırmanın evrenini; Ege Üniversitesi Tıp Fakültesi Hastanesi'nin yoğun bakım birimleri ve İzmir Kuzey Kamu Hastaneler Birliğine bağlı beş merkez hastanenin çalışma izni alınan yoğun bakım birimlerinde Aralık 2015–Haziran 2016 tarihleri arasında yatan hastalar oluşturmuştur. Herhangi bir örnekleme yöntemine gidilmeyip yoğun bakımların yatak sayısına (n=202) tekabül eden, araştırma kriterlerine uyan ve onam veren tüm hastalar çalışmanın örneklemini oluşturmuştur. Çalışmaya 18 yaşından büyük, ağız bakım uygulamasının üzerinden iki saat geçmiş, Sjögren Sendromu tanısı, kafa travması, ağız-çene ameliyatı olmayan ve baş-boyun radyoterapisi veya kemoterapi almayan toplam 202 hasta dahil edilmiştir. Hastaların ağız sağlığı tanılamasında ışık kaynağı, dil basacağı, Yatak Başı Ağız Değerlendirme (YBAD) rehberi ve tanımlayıcı özellikler için Veri Toplama Formu kullanılmıştır. Çalışmanın yürütülebilmesi için Ege Üniversitesi Hemşirelik Fakültesi Etik Kurulu'ndan, çalışmanın yapılacağı Ege Üniversitesi Tıp Fakültesi Hastanesi, İzmir Kuzey Kamu Hastaneler Birliği'nden izin ve araştırmaya katılmayı kabul eden hastalardan yazılı onam alınmıştır. Hastaların yaş ortalaması 67.18±14.85 (min=20, mak=95) olup, %45.5'i (n=92) kadın ve %74.3'ünün (n=150) bilinci açıktır. Hastaların %31.7'si (n=64) solunum destek cihazıyla yapay solunum yapmakta olup bu süre ortalama 15.2±16.31 gündür. Hastaların beslenme şekline bakıldığında ise %51.5'i (n=104) ağız yolu dışında beslenmekte ve bu süre ortalama 11.8±13.23 gündür. Hastaların %18.3'ü (n=37) sigara kullanmakta ve %41.6'sı oksijen tedavisi almaktadır. Yoğun bakım birimlerinin hiç birinde ağız değerlendirme rehberi kullanılmamaktadır. Ağız bakım sıklığı yapay soluyan hastalarda günde ortalama 2.31±1.31 defadır. YBAD rehber puan ortalaması 14.20±3.90 olup aralığı 8 puan (sağlıklı) ile 24 puan (ciddi fonksiyon bozukluğu) arasında değişmektedir. Ağız sağlığı ile hastaların yaş grubu, bilinç durumu, solunum ve beslenme şekli arasında anlamlı bir fark bulunurken (p<0.01), oksijen tedavisi, diş tipi, sigara tüketimi arasında anlamlı bir fark bulunmamıştır (p>0.05). Yapay solunum süresi, ağız yolu dışında beslenme süresi ile ağız sağlığı arasında anlamlı ilişki bulunmazken (p>0.05), kullanılan toplam ilaç sayısı ve bakım sıklığı ile anlamlı bir ilişki bulunmuştur (p<0.05). Ağız bakım uygulama teknikleri ile ağız sağlığı arasında da anlamlı bir fark bulunmuştur (p<0.001). Bu çalışma sonucunda, yoğun bakım hastalarının ağız sağlığı açısından riskli grubu oluşturduğu saptanmıştır. Ağız sağlığı tanılamasında sistematik değerlendirmeyi sağlayacak standardize edilmiş bir değerlendirme rehberi kullanması gerektiği ve bakım uygulamalarının hastanın ihtiyacına uygun olarak belirlenerek etkili bir şekilde yapılması gerektiği önerilmektedir. Bakım tekniklerinin etkinliği deneysel çalışmalarla karşılaştırılmalıdır
This study was planned to examine the intensive care unit patients' oral health. The population of this descriptive study consisted of the hospitalized patients from the intensive care units of Ege University and five central hospitals connected to Izmir North Public Hospital Association between the dates of December 2015- June 2016. There was no sample selection method used in study, the sample of the study comprised all the patients corresponding to the number of all intensive care beds (n=202), meeting the research criteria and received consent. A total of 202 patients over the age of 18, who had not Sjögren Syndrome diagnosis, head trauma, mouth jaw surgery and head-neck radiotherapy or chemotherapy and two hours passed from application of oral care were included in the study. Oral health diagnostics of patients were made using a source of light, a tongue depressor and Bedside Oral Examination (BOE) guide and Data Collection Form used for desciriptive features. To carry out the study, written consents were taken from Ege University Faculty of Nursing Ethical Commitee, Ege University Faculty of Medicine Hospital, Izmir North Public Hospital Association and the patients who approved the study. The average age of the patients was 67.18±14.85 (min=20, mak=95) years, 45.5% were women (n=92) and 74.3% of them were conscious (n=150). 31.7% of patients with artificial respiration and average duration of artificial respiration was 15.2±16.31 days. 51.5 % of them were the patients fed apart from orally and the average duration of the feeding without oral way was 11.8±13.23 days. 18% of patients were smokers and 41.6% of patients were taking oxygen treatment. None of the intensive care units had an oral examination guide. Artificial respiration patients' oral care frequency average was 2.31±1.31 times. BOE guide score average was 14.20±3.90 and score range changed between 8 (healthy) and 20 (severe dsyfunction). There was a statistical difference between patients' oral health and age group, states of consciousness, respiratory and feeding type (p<0.01) but there was no statistical difference between oral health and oxygen treatment, teeth type, smoking (p>0.05). There wasn't a statistical difference between duration of artificial respiration, time of feding without oral way, and oral health (p>0.05) but there was a statistical difference between the total amount of drugs used, oral care frequency and oral health (p<0.05). There was a statistical difference between the oral care technics and oral health (p<0.001). At the end of the study, It was indicated that intensive care unit patients are the risk groups in terms of oral health. It is recommended that an assessment guideline has been standardized for systematic evaluation of patients' oral health should be used and care applications should be determined according the patients' needs and care should be implemented in an effective way. However, the effectiveness of oral care techniques needs further experimental investigation.
This study was planned to examine the intensive care unit patients' oral health. The population of this descriptive study consisted of the hospitalized patients from the intensive care units of Ege University and five central hospitals connected to Izmir North Public Hospital Association between the dates of December 2015- June 2016. There was no sample selection method used in study, the sample of the study comprised all the patients corresponding to the number of all intensive care beds (n=202), meeting the research criteria and received consent. A total of 202 patients over the age of 18, who had not Sjögren Syndrome diagnosis, head trauma, mouth jaw surgery and head-neck radiotherapy or chemotherapy and two hours passed from application of oral care were included in the study. Oral health diagnostics of patients were made using a source of light, a tongue depressor and Bedside Oral Examination (BOE) guide and Data Collection Form used for desciriptive features. To carry out the study, written consents were taken from Ege University Faculty of Nursing Ethical Commitee, Ege University Faculty of Medicine Hospital, Izmir North Public Hospital Association and the patients who approved the study. The average age of the patients was 67.18±14.85 (min=20, mak=95) years, 45.5% were women (n=92) and 74.3% of them were conscious (n=150). 31.7% of patients with artificial respiration and average duration of artificial respiration was 15.2±16.31 days. 51.5 % of them were the patients fed apart from orally and the average duration of the feeding without oral way was 11.8±13.23 days. 18% of patients were smokers and 41.6% of patients were taking oxygen treatment. None of the intensive care units had an oral examination guide. Artificial respiration patients' oral care frequency average was 2.31±1.31 times. BOE guide score average was 14.20±3.90 and score range changed between 8 (healthy) and 20 (severe dsyfunction). There was a statistical difference between patients' oral health and age group, states of consciousness, respiratory and feeding type (p<0.01) but there was no statistical difference between oral health and oxygen treatment, teeth type, smoking (p>0.05). There wasn't a statistical difference between duration of artificial respiration, time of feding without oral way, and oral health (p>0.05) but there was a statistical difference between the total amount of drugs used, oral care frequency and oral health (p<0.05). There was a statistical difference between the oral care technics and oral health (p<0.001). At the end of the study, It was indicated that intensive care unit patients are the risk groups in terms of oral health. It is recommended that an assessment guideline has been standardized for systematic evaluation of patients' oral health should be used and care applications should be determined according the patients' needs and care should be implemented in an effective way. However, the effectiveness of oral care techniques needs further experimental investigation.
Açıklama
Anahtar Kelimeler
Hemşirelik, Nursing, Hemşireler, Nurses, Hemşirelik, Nursing, Hemşirelik bakımı, Nursing care
