Sohbat Safaie, Seyedeh Fatemeh Ghasemi, Fatemeh Valizadeh, Rasool Mohammadi,
Volume 29, Issue 3 (10-2023)
Abstract
Background & Aim: Pressure ulcers pose a serious and anticipated challenge within the health system. The present study aimed to determine the incidence of pressure ulcer and associated factors among children and newborns.
Methods & Materials: In this cohort study a sample size of 1025 children aged 0 to 14 years hospitalized in two medical training centers affiliated with Kermanshah University of Medical Sciences, were included. The sampling method employed was convenience sampling, conducted between March and July 2022. The data collection tools utilized in this study included a demographic information questionnaire, the Glasgow Coma Scale, National Pressure Ulcer Counseling Association classification, and Braden Q Scale. The data was analyzed using both univariate and multivariate logistic regression analyses.
Results: The incidence rate of pressure ulcers was found to be 4.97% (51 people). In terms of severity, the majority of pressure ulcers were categorized as first grade, accounting for 82.14% (46 people), with the hand area being the most frequently affected site of ulceration, representing 35.71% (20 people). The factors exhibited a significantly higher relative risk of pressure ulcers in children and infants included consciousness level of less than 14 (RR=6.07, 2.90-12.73: 95%CI), hospitalization duration of more than five days (RR=1.08, 1.05-1.12: 95%CI), presence of respiratory problems (RR=2.17, 1.19-3.94: 95%CI), immobility (RR=6.46, 3.44-12.13: 95% CI), utilization of NCPAP mask (RR=1.11, 1.05-1.18: 95% CI), and pulse oximeter (RR=6.07, 1.03-1.10: 95% CI). In the multivariate analysis, hospitalization duration of more than five days (RR=4.89, 2.29-10.40: 95% CI, P<0.001) and immobility (RR=2.49, 1.29-6.29: 95% CI, P=0.01) were found to be significantly associated with an increased risk of pressure ulcers.
Conclusion: The incidence rate of pressure ulcers observed in the present study was relatively low, measuring below 5%. Notably, prolonged hospitalization duration and immobility were identified as the most important risk factors contributing to the development of pressure ulcers among children and infants. Moreover, the utilization of specific medical devices, especially angiocaths and NCPAP masks, as well as the presence of respiratory diseases emerged as additional significant factors associated with the occurrence of pressure ulcers.
Seyedeh Fatemeh Ghasemi, Atefeh Jadidi, Fatemeh Valizadeh, Rasool Mohammadi, Fatemeh Janani, Hanieh Goodarzi,
Volume 30, Issue 2 (6-2024)
Abstract
Background & Aim: Intramuscular injections represent a painful procedure for premature infants. This study aimed to compare the effects of pressure massage at Hegu point versus Kunlun–Taixi pressure points on pulse rate, arterial oxygen saturation, and crying duration following intramuscular injection of vitamin K in premature infants.
Methods & Materials: A randomized, single-blind clinical trial was conducted on 100 premature infants admitted to the neonatal intensive care unit between 2020 and 2021. Participants were selected through convenience sampling and then randomly assigned into four groups of 25 individuals each: Hegu point massage, Kunlun–Taixi points simultaneous massage, placebo and control. Prior to the vitamin K injection, the intervention groups received targeted pressure point massage, the placebo group received nasal tip massages, and the control group received standard care. Pulse rate, arterial oxygen saturation, and crying duration were recorded before, during and after the intramuscular injection using a pulse oximeter and chronometer. Data were analyzed using two-way repeated measures analysis of variance in SPSS software version 24.
Results: Significant differences were observed in average pulse rate (P=0.013) and average arterial oxygen saturation (P=0.028). The group receiving simultaneous massage at Kunlun–Taixi points exhibited the lowest mean pulse rates during (149.24±7.78) and after (144.16±8.64) the injection, as well as the highest mean arterial oxygen saturation percentages during (88.36±9.37) and after (88.04±8.33) the injection.
Conclusion: Simultaneous massage of Kunlun–Taixi pressure points reduced changes in pulse rate and arterial oxygen saturation induced by intramuscular injection in premature infants. It is recommended to use this simple and low-priced method to reduce the physiological responses to injection-related pain in premature newborns.
Clinical trial registry: IRCT20210630051743N1
