Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society最新文献

{"title":"Risk Factors Associated With Hospital-Acquired Pressure Injuries in Patients Undergoing Surgical Hip Fracture Repair.","authors":"Yunchuan Zhao, Jenny Alderden, Nicolette Missbrenner, Anna Quon, Laura J Tivis","doi":"10.1097/WON.0000000000001311","DOIUrl":"https://doi.org/10.1097/WON.0000000000001311","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to identify independent risk factors associated with an increased risk of new hospital-acquired pressure injury (HAPI) formation in surgical patients with a hip fracture.</p><p><strong>Design: </strong>Descriptive, correlational study.</p><p><strong>Subjects and setting: </strong>The sample comprised 14 523 patients with a hip fracture who underwent a surgical procedure in 2019. Data were acquired from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). The ACS-NSQIP contains data from ambulatory surgery departments and acute care hospitals within the United States.</p><p><strong>Methods: </strong>Descriptive and regression analyses were conducted, including bivariate analysis and multiple logistic regression, to identify independent risk factors for HAPI formation. The outcome measure was HAPI formation identified in the data file. Independent variables included sociodemographic characteristics, preoperative health conditions and functional abilities, preoperative laboratory values, and perioperative factors.</p><p><strong>Results: </strong>Among 14 523 patients, 628 (4.3%) developed at least 1 HAPI. Age greater than 70 years (OR = 1.488, P = .010), BMI less than 18.5 kg/m2 (OR = 1.347, P = .047), weight loss more than 10% within 6 months before surgery (OR = 2.775, P < .001), preoperative use of a mobility aid (OR = 1.833, P < .001), insulin dependence in diabetic patients (OR = 1.753, P < .001), preoperative blood urea nitrogen level greater than 24 mg/dL (OR = 1.634, P < .001), and duration from hospital admission to surgery longer than 1 day (OR = 1.400, P = .006) were identified as independent risk factors for HAPI formation.</p><p><strong>Conclusions: </strong>This study highlights the risk factors associated with new HAPI formation in surgical hip fracture patients. Nurses can use these findings to incorporate pressure injury risk factor assessment into routine care planning.</p>","PeriodicalId":520700,"journal":{"name":"Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society","volume":"53 5","pages":"369-375"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Transtheoretical Model-Based Education Supported by Motivational Interviews on Incontinence-Related Quality of Life and Frequency and Severity of Urinary Incontinence in Women: A Randomized Controlled Trial.","authors":"Sevil Cicek Ozdemir, Ayten Senturk Erenel","doi":"10.1097/WON.0000000000001299","DOIUrl":"10.1097/WON.0000000000001299","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effect of an online educational intervention based on the Transtheoretical Model (TTM) and supported by motivational interviewing (MI) on urinary incontinence (UI)-related quality of life and the frequency and severity of UI in women.</p><p><strong>Design: </strong>Pretest-posttest randomized controlled trial.</p><p><strong>Subjects and setting: </strong>The study was completed in Turkey and included 59 women with UI recruited from family health centers, 29 randomized to the intervention group and 30 to the control group. The data were collected between March 2021 and October 2021.</p><p><strong>Methods: </strong>Women in the intervention group were given online training on UI. Five MI and 5 telephone interviews were conducted. Women in the control group received usual care. Data were collected using a Personal Information Form, International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), Incontinence Severity Index (ISI), Incontinence Quality of Life Scale (I-QOL), and Evaluation Form for Stages of Change. Outcomes in the 2 groups were compared using independent groups t-tests for normally distributed data, and the Mann-Whitney U test when data were not normally distributed.</p><p><strong>Results: </strong>After the intervention, quality-of-life (I-QOL) scores were significantly higher in the treatment group than in the control group (P = .02, CI: [1.21-16.93]). There was a significant difference between the groups in stages of change (P < .001). There were no significant group differences in UI frequency (P = .39) or severity (P = .29).</p><p><strong>Conclusions: </strong>Nursing education based on the TTM supported by MI had a positive effect on women's quality of life and progression through the stages of change.</p>","PeriodicalId":520700,"journal":{"name":"Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society","volume":"53 4","pages":"309-317"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Nomogram for Predicting Hospital-Acquired Pressure Injuries Risk in Cardiovascular Intensive Care Unit Patients: A Comparison Cohort Study.","authors":"Hao-Yue Li, Yan Zhang, Xiao-Lan Shui, Zhi-Gang Che, Qi-Fan Liu, Shan-Shan Guo","doi":"10.1097/WON.0000000000001297","DOIUrl":"10.1097/WON.0000000000001297","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to establish a nomogram model for predicting the hospital-acquired pressure injury (HAPI) occurrences in patients receiving care in a cardiovascular intensive care unit (CICU).</p><p><strong>Design: </strong>Comparison Cohort study.</p><p><strong>Subjects and setting: </strong>A review of medical records identified 260 patients that were randomly divided into 2 groups. One group provided a dataset for an AI program to determine the nomogram, (n = 208) and a second group (n = 52) used to test the predictive power of the algorithm. The study setting was Wuhan University, located in central China.</p><p><strong>Methods: </strong>We examined the electronic medical records of patients cared for in our CICU between January 2023 and June 2023. Factors associated with HAPI occurrences were identified using univariate and multivariate logistic regression analyses, and the screened indicators were integrated into a nomogram. The effectiveness of the nomogram was evaluated and verified using receiver operating characteristic curve and decision curve analysis.</p><p><strong>Results: </strong>Univariate and multivariate logistic regression analysis showed that vasopressor use (OR = 2.54, 95% confidence interval [CI] = 1.18-5.46, P = .017), B-type natriuretic peptide (OR = 2.85, 95% Cl = 1.35-6.03, P = .006), elevated lactic acid levels (OR = 12.18, 95% Cl = 4.96-29.95, P < .001), elevated procalcitonin levels (OR = 1.22, 95% Cl = 1.02-1.46, P = .033), and low albumin levels (OR = 0.84, 95% Cl = 0.76-0.93, P < .001) emerged as independent risk factors for HAPI occurrences in the CICU. Based on these factors, we established a nomogram for predicting the risk of HAPI risk in patients cared for in a CICU. The nomogram was well calibrated and showed good discriminative ability (AUC = 0.868).</p><p><strong>Conclusion: </strong>The nomogram model developed in this study demonstrated good predictive capability for predicting CICU patients at risk of developing HAPIs. Findings from this study also have the potential to guide preventive interventions.</p>","PeriodicalId":520700,"journal":{"name":"Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society","volume":"53 4","pages":"290-297"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Context for Practice: Nomogram for Pressure Injury in Critically Ill, Influence of Shame on Wound Healing Outcomes, Urinary Sediment Drainage Through Traditional Versus Micro-Zone Hole Catheter, and Peristomal Pyoderma Gangrenosum.","authors":"Mikel Gray","doi":"10.1097/WON.0000000000001309","DOIUrl":"10.1097/WON.0000000000001309","url":null,"abstract":"","PeriodicalId":520700,"journal":{"name":"Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society","volume":"53 4","pages":"275-276"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peristomal Pyoderma Gangrenosum Related to Systemic Lupus Erythematosus: A Case Study.","authors":"Francesco Carlo Denti, Dorina Bancea, Giulia Vidotto, Andrea Maglio, Davide Brambilla, Debora Rosa, Giulia Villa","doi":"10.1097/WON.0000000000001304","DOIUrl":"10.1097/WON.0000000000001304","url":null,"abstract":"<p><strong>Background: </strong>Peristomal pyoderma gangrenosum (PPG) is a rare complication of peristomal skin. It is difficult to manage, and there are no guidelines for treatment. This case study describes the management of a patient with PPG while taking corticosteroids and cyclosporine as chronic therapy for systemic lupus erythematosus (SLE).</p><p><strong>Case: </strong>Mrs. T had SLE and a colostomy and developed PPG that was unresponsive to previous treatment. She was successfully treated with a barrier film, a topical corticosteroid, and an alginate dressing.</p><p><strong>Conclusion: </strong>The synergistic use of a barrier film, a topical corticosteroid, and an alginate proved to be effective for the management of PPG lesions in SLE.</p>","PeriodicalId":520700,"journal":{"name":"Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society","volume":"53 4","pages":"342-345"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wounds of the Body, Wounds of the Self: Addressing Shame in the Care of Patients Living With Obesity and Chronic Wounds.","authors":"Tim Porter O'Grady","doi":"10.1097/WON.0000000000001298","DOIUrl":"10.1097/WON.0000000000001298","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this integrative review was to examine shame as a hidden determinant of outcomes among patients living with obesity and chronic leg and foot ulcers and to offer evidence-based strategies for wound, ostomy, and continence (WOC) nurses to recognize, mitigate, and transform shame in clinical practice.</p><p><strong>Design: </strong>Integrative review and practice synthesis.</p><p><strong>Search strategy: </strong>Targeted integrative review of literature (2020-2025) using PubMed, CINAHL, PsycINFO, and Cochrane databases with supplemental ancestry or hand searching. Topics included weight stigma, psychosocial determinants of wound care engagement, trauma-informed and dignity-conserving approaches, and service models (telemedicine, peer support, integrated behavioral care).</p><p><strong>Findings: </strong>Shame-amplified by weight stigma and structural inequities-erodes trust, adherence, and engagement, and is associated with poorer healing trajectories. Interventions grounded in the Presence-Partnership-Dignity framework-pairing technical excellence with relational competence-integrate behavioral health and redesign services for emotional safety, thereby improving participation and outcomes.</p><p><strong>Implications: </strong>Addressing shame is not an ancillary concern; it is central to wound care quality. WOC nurses are uniquely positioned to lead practice, education, and system redesign that restores dignity, strengthens self-efficacy, and advances equitable healing.</p>","PeriodicalId":520700,"journal":{"name":"Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society","volume":"53 4","pages":"298-308"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Draining Urinary Sediments Through Conventional Eyelet Catheters and New Intermittent Micro-Hole Zone Catheters.","authors":"Per Bagi, Betina Suldvart, Christian Kamp Nielsen, Nika Ogilvie Bellchambers, Rikke Vaabengaard, Lene Feldskov Nielsen","doi":"10.1097/WON.0000000000001300","DOIUrl":"10.1097/WON.0000000000001300","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to assess sediments in complicated and uncomplicated urine samples and the ability of conventional and micro-hole intermittent catheters to drain these sediments.</p><p><strong>Design: </strong>Randomized, single-blinded, cross-over study.</p><p><strong>Subjects and setting: </strong>Adult healthy volunteers (male and female) and patients regularly using intermittent catheterization were enrolled. Urine samples from these study participants were collected with a conventional eyelet catheter and a micro-hole zone catheter, on separate days. In addition, complicated urine samples defined as urine containing large numbers of visible casts and mucus collected from patients visiting a urology department in Copenhagen Denmark were collected with a conventional catheter with extra-large eyelets.</p><p><strong>Methods: </strong>All urine samples from patients and healthy volunteers were analyzed within 48 hours of collection. The number and size distribution of sediments in uncomplicated urine was evaluated using automated light microscopy. Sediments in complicated urine also were assessed with conventional light microscopy. Laboratory-based drainage tests were performed for complicated urine using both types of catheters.</p><p><strong>Results: </strong>Similar types of sediments were found in all urine samples, with sizes from 2 to 195 μm in clear urine and 2 to 131 μm in cloudy urine. More sediments were found in cloudy and complicated urine compared with clear samples. In complicated urine, the number of sediments in some instances was large enough to obstruct flow in some micro-hole catheters, and a few conventional catheters as well.</p><p><strong>Conclusions: </strong>Most urine samples can be successfully drained through micro-hole zone catheters, but care should be exercised in recommending these catheters to patients with complicated urine, containing large numbers of visible sediments.</p>","PeriodicalId":520700,"journal":{"name":"Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society","volume":"53 4","pages":"318-324"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13344391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Controlling Maceration in Diabetic Foot Ulcers: A Scoping Review.","authors":"Erlin Ifadah, Mao Kunimitsu, Mai Kitagawa, Makoto Oe","doi":"10.1097/WON.0000000000001301","DOIUrl":"10.1097/WON.0000000000001301","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetic foot ulcers (DFUs) are a severe late complication of diabetes, and maceration of the periwound skin is one of the problems that affect the healing process. However, no systematic method to control maceration has been established. The aim of this scoping review was to summarize the available evidence on management methods that can be used to control maceration in DFUs and to identify gaps in the research.</p><p><strong>Method: </strong>Scoping review guided by the PRISMA-Scoping Review (ScR) checklist.</p><p><strong>Search strategy: </strong>Four databases (MEDLINE, CINAHL, PubMed, and Google Scholar) were searched using a combination of terms related to the maceration and the DFUs, with 2 independent researchers screening the articles according to the inclusion criteria and then extracting the data. The inclusion criteria required that all articles needed to report original research/case studies that involved patients with DFUs, and examined management methods that could be used to control maceration.</p><p><strong>Findings/conclusions: </strong>This literature search yielded 1814 articles, of which 16 met the inclusion criteria. Three types of management methods were reported for controlling the maceration. They were absorption of the exudate (extracted from 10 records), application of antimicrobial (extracted from 5 records), and reducing oxidative stress (extracted from 1 record).</p><p><strong>Implications: </strong>Although management methods that can be used to control maceration have been examined by previous studies, we found none that investigated which method was the best for treating for the different conditions found for maceration in the DFUs. Further research is needed to establish guidelines for selecting the management method in accordance with the severity of the maceration in the DFUs.</p>","PeriodicalId":520700,"journal":{"name":"Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society","volume":"53 4","pages":"326-334"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19-Related Wounds in Acutely Ill Inpatients Over the First Two Years of the SARS-CoV-2 Pandemic (CRAFT Study).","authors":"Jennifer Bart, Cristina Phillips, Caitlin Tripp, Meghan Bailey, Elizabeth C Dunn, Xiaoxi Zhang, Magali Rezende De Carvalho, Michael Weaver, Debra Lyon","doi":"10.1097/WON.0000000000001295","DOIUrl":"10.1097/WON.0000000000001295","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to examine the factors associated with the development of wounds in the acutely ill patient population with COVID-19 and to classify the types of wounds seen in these patients.</p><p><strong>Design: </strong>Retrospective single-center descriptive study.</p><p><strong>Subjects and setting: </strong>The target population was acutely ill patients diagnosed with COVID-19 infection who developed wounds during their hospital course. Data collection occurred between March 1, 2020, and March 1, 2022. The sample comprised data from 505 hospitalized patients; most were male (n = 292 patients, 58%) and White (n = 341, 67.5%). Their mean age was mean age was 59.1 years. Common comorbid conditions were renal failure (n = 251, 72.3%), sepsis (n = 245, 70.6%), and malnutrition (n = 116, 33.4%). The study setting was the Shands Teaching Hospital (Gainesville FL), which is located in the Southeastern United States.</p><p><strong>Methods: </strong>Researchers collaborated with the UF Health Integrated Data Repository (IDR) to identify eligible patients, develop a data abstraction manual, and standardize tools to ensure consistency and reliability in data collection. Approximately 4,000 COVID-19-positive patients were hospitalized during this period, and wound diagnoses were identified through cross-referencing the IDR COVID-19 limited data set, i2b2, and detailed chart reviews, including nursing flowsheets and wound consults. Independent team members performed annotation and quality assurance throughout the process.</p><p><strong>Results: </strong>The average oxygen saturation (SpO2) of the sample was 96.2%, with some patients reaching critically low levels of 77.9%, and a mean fibrinogen level of 452 mg/dl. Their average ICU stay was 22.3 days, and the mortality rate was 15.1%. A weak negative correlation was found between SPO2 and fibrinogen levels (Kendall τ = -0.13, P = .00), and between fibrinogen levels and vasopressor use (Kendall τ = -0.18, P = .01).</p><p><strong>Conclusion: </strong>Lower oxygen saturation, elevated fibrinogen levels, and increased vasopressor use may increase the risk of coagulopathy and wound development in patients with COVID-19, particularly in the presence of sepsis and renal failure, which increases the risk of acute skin failure (ASF). Many wounds may have been misdiagnosed as HAPI rather than ASF. Future research should focus on establishing standardized ASF diagnostic criteria to improve diagnosis and treatment.</p>","PeriodicalId":520700,"journal":{"name":"Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society","volume":"53 4","pages":"283-289"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's Not Being Said in Adolescent Ostomy Care: My Perspective.","authors":"Lynn D Mohr","doi":"10.1097/WON.0000000000001296","DOIUrl":"10.1097/WON.0000000000001296","url":null,"abstract":"","PeriodicalId":520700,"journal":{"name":"Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society","volume":" ","pages":"279-282"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}