產後護理之家新生兒尿布性皮膚炎危險因子的調查

背景尿布性皮膚炎是嬰幼兒最常見的接觸性皮膚炎，好發區域為尿布覆蓋部位，再者尿布性皮膚炎的發生率，更是產後護理之家評鑑健康照護品質的重要指標，因此造成產後護理之家新生兒尿布性皮膚炎的危險因子值得深入探討。目的本研究為調查產後護理之家新生兒發生尿布性皮膚炎之基本屬性，並分析影響新生兒尿布性皮膚炎的危險因子。方法本研究採用回溯性研究法（病例對照研究法），於某區域教學醫院附設產後護理之家新生兒為對象，利用方便抽樣的方式，抽選總計207名新生兒參加研究，病例（case）111人，對照（control）96人。藉由病歷閱讀，收集新生兒入住相關紀錄單，以SPSS 20.0整理資料，並應用單變項羅吉斯（Univariate Logistic Regression）回歸針對勝算比（odds ratio）進行分析所有變項與新生兒尿布性皮膚炎的相關性。結果本研究207名新生兒中，男嬰佔97人（46.9％）、女嬰佔110人（53.1％），在研究期間入住產後護理之家發生尿布性皮膚炎共有111人，其發生率為53.6﹪。全母奶餵食佔83人（40.1％）、混合餵食佔124人（59.9％）；入住產後護理之家的新生兒出生平均體重為3103克（SD=428）、小便平均次數為7.5次（SD=1.7）、大便平均次數為5.5次（SD=2.4）、入住平均天數為22.5天（SD=7.3）、每日平均增加體重為25.152（SD=10.9）。其中性別變項的男、女嬰OR值為0.999、出生體重變項的OR值為1.341、體重增加變項的OR值為1.196，因P值均大於0.05，表示性別、出生體重、體重增加與尿布性皮膚炎未具有研究上的顯著差異。但是，飲食種類、入住天數、大便次數之 P值皆小於0.05，故與尿布性皮膚炎具有研究上的顯著差異，且OR值均大於1，更顯示此三變項對於發生尿布性皮膚炎風險有高度正向關係。結論研究結果發現新生兒的餵食種類、大便次數及入住產後護理之家的天數，均為產後護理之家新生兒尿布性皮膚炎的危險因子，建議醫護人員於新生兒出生即開始介入照護，以降低新生兒尿布性皮膚炎發生率。

關鍵字

尿布性皮膚炎；新生兒；產後護理之家；危險因子

並列摘要

Background Diaper dermatitis is a common contact dermatitis problem seen in infants. The affected region is around the buttocks where cover with diaper. Moreover, the incidence of diaper dermatitis should be important to focus on the quality of health from postpartum care; therefore we aimed to survey the risk factor of neonatal diaper dermatitis. Purpose The objective of this research was to investigate the primary indication in the occurrence of infant diaper dermatitis from the postpartum care center, and to analyze further the risk factors for neonatal diaper dermatitis. Method The research was a retrospective study to collet, newborns from a regional teaching hospital with attached postpartum care. A total of 207 newborns in the research, and they were convenience sampling. Related information was collected through newborns’ medical records. SPSS 20.0 was used to analyze the data, by using Logistic regression . Result There was a total of 207 newborns participated in this study. In 2014 in the nursery, there was 48.2% of the newborns suffered from diaper dermatitis. 97 male (46.9%), and 110 female (53.1%). Among them, there are 83 newborns (40.1%) that underwent exclusive breastfeeding; 124 newborns (59.9%) received mixed diet. Average weight of newborns admitted in the postpartum care unit was 3103 grams (SD = 428); average urine frequency was 7.5 times (SD=1.7); number of stool passage was 5.5 times (SD=2.4), average days of admission was 22.5 days (SD= 7.3), and daily weight increase was 25.152 grams (SD=10.9). Among which, incidence between the gender(OR=0.999), birth weight(OR=1.341), increase in body weight(OR=1.196), and diaper dermatitis has no significant difference(P＞0.05). However, the incidence between days of admission, number of stool passage, and diaper dermatitis has a significant difference (P<0.05 and OR <1). Conclusion The result of this study found that type of diet, number of stool passage, and days of admission in the postpartum center are the risk factors of diaper dermatitis seen in newborns that are residing at postpartum care. Thus, we suggest that nurses should intervene initially in order to prevent risk factors of diaper dermatitis.