改良式男用尿布對成人失禁性皮膚炎之成效探討

Effects of Modified Male Diaper on Adults with Incontinence Associated Dermatitis

郭俊弘(CHUN-HUNG KUO)

指導教授 ： 游金靖

中臺科技大學/護理學院/護理研究所/碩士(2020年)

摘要

背景：成人失禁性皮膚炎（簡稱IAD），是長期臥床失禁患者中常見的皮膚疾病。對於大小便無法自理的病人，尿布已是護理照護過程所不可或缺的必需品，但市售尿布並無男女之別，由於男女生理構造不同，男性外生殖器官皮膚皺摺處常難以清潔與疏忽，造成皮膚紅斑及破皮。
目的：本研究旨在探討改良式男用尿布介入，對依賴尿布的長期臥床男性病人，其外生殖器官處患有成人失禁性皮膚炎的改善成效。
方法：採兩組前後測設計，每組各32位，介入時間為2週。實驗組介入的護理處置為使用改良式男用尿布，搭配黏貼式尿布採取半粘貼的方式；控制組為一般尿布傳統包覆。以皮膚損傷程度及紅斑面積為皮膚炎症程度指標；及皮膚酸鹼值、濕潤度、溫度為皮膚生理指標，兩者作為評值成人失禁性皮膚炎改善程度的成效指標，並以SPSS 18.0統計軟體建檔分析。
結果：兩組病患人口基本屬性皆未達統計學上顯著差異，屬同質性。介入後兩組前後測成效比較，改良式男用尿布能顯著性改善皮膚炎症程度指標的皮膚損傷程度（p< .05）與減少紅斑面積（p< .001）；及降低皮膚生理指標（p< .001）。
結論：改良式男用尿布的皮膚保護隔離，比一般尿布傳統包覆好，不易沾到排泄物及減少皮膚浸潤，能間接改善成人失禁性皮膚炎。後續也可供長期照護參酌與運用，及促進男性之性別友善。

關鍵字

男性尿布 ； 成人失禁性皮膚炎 ； 失禁

並列摘要

Background：Incontinence-associated dermatitis（IAD）is a skin condition commonly seen among incontinent and bedridden patients. Diapers are indispensable in the nursing care process for patients who are unable to urinate and defecate independently. However, the diapers that are available on the market are not distinguished between male and female, and due to the differences in the physiological structure of males and females, the creased area near the male genitalia is often difficult to clean and negligence, which can cause erythema or abrasion.
Objective：This research aims to probe into the improvement effectiveness on male bedridden patients, who depend on diapers, and with IAD on their productive organs, from the intervention of modified male diapers.
Method：Two groups of 32 subjects each were tested successively, with the duration of the intervention lasting two weeks. Care intervention for the experimental group was implemented using modified diapers with semi-adhesion, whereas the control group was administered general diapers with traditional wrapping. The dermatitis degree indicator was determined according to the degree of skin abrasion and erythema, while the skin physiological indicator was decided from the degree of skin acidity, the degree of skin moisture, and the skin temperature, with the two indicators used as an overall effectiveness indicator for the extent of improvement in cases of IAD. Analytical documents were constructed using SPSS 18.0 statistical software.
Results：The basic attributes for the two groups of patient population did not show any statistical significance, and displayed homogeneity. Regarding the comparison in the effectiveness between the two groups before and after the intervention, modified diapers are able to significantly improve the degree of skin abrasion（p< .05）and reduce the area of erythema（p< .001）from the dermatitis degree indicator, as well as lower the skin physiological indicator（p< .001）.
Conclusion：Modified diapers have better skin protection and isolation qualities compared to traditional-wrapping diapers, with patients less likely to be stained by or soaked in excrement, which indirectly improves IAD. This research can be used for reference and application in long-term care, and to facilitate gender-friendly care for males.

並列關鍵字

male diaper ； Incontinence-associated dermatitis ； incontinence

參考文獻

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