| ObjectiveThis research uses Compound Phellodendron Liquid and Skin Protective Film for treatment of Incontinence Associated Dermatitis(Incontinence Associated Dermatitis,IAD),three methods of nursing intervention was designed,by comparing single Compound Phellodendron Liquid,a separate application Skin Protective Film,and both the effect of combined use of treatment of Incontinence Associated Dermatitis,compare the three groups of patients before and after the intervention Incontinence Associated Dermatitis severity score,healing time,the differences between the cost of treatment,pain score,to explore the effectiveness,feasibility and safety of the three nursing intervention methods,and to provide clinical practice experience for the further prevention and treatment of Incontinence Associated Dermatitis,and to provide scientific reference for the formulation of structured skin treatment and care program in China.MethodsIn this study,a large number of domestic and foreign literatures related to the prevention and treatment of Incontinence Associated Dermatitis were searched by bibliometrics,which provided a theoretical basis for this study.On the basis of literature retrieval,the specific nursing intervention methods were developed by means of special group discussion and pre-experiment.In this study,108 inpatients with Incontinence Associated Dermatitis who met the requirements from October 2017 to February 2019 were selected and divided into three groups: 36 patients in Compound Phellodendron Liquid group(group A),36 patients in Skin Protective Film group(group B),and 36 patients in combination group(group C).Research team to collect the basic cases of patients with information(including age,gender,hospitalization,etc),to assess the patient’s state of consciousness,the types of incontinence,incontinence frequency and grade of Incontinence Associated Dermatitis,evaluate and record before intervention in patients with APACHE Ⅱ score,Braden score,Incontinence Associated Dermatitis severity score,pain score,to observe and compare the differences in severity score,healing time,treatment cost,pain score and other indicators of Incontinence Associated Dermatitis 7 days after intervention among the three groups.Results1.Comparison of general data of patientsIn this study,36 patients in the Compound Phellodendron Liquid group,excluding one death,were finally included in a total of 35 patients,including an average age of(64.37±11.54)years old,20 males and 15 females.36 patients in the Skin Protective Filmgroup completed the whole nursing intervention study,among which the average age(67.75±11.33)years old,19 males and 17 females.A total of 35 patients were included in the combined group,including 17 males and 18 females,with an average age of(65.77±11.72)years.The results showed that there was no significant difference in gender,age,consciousness status,incontinence type,incontinence frequency,Incontinence Associated Dermatitis grade and basic diseases among the three groups.P>0.05 was comparable.Three groups of patients before intervention APACHE Ⅱ score,Braden score,Incontinence Associated Dermatitis severity score,pain score,P>0.05,there was no statistically significant difference,comparable.2.Comparison of severity of Incontinence Associated Dermatitis among three groupsAfter examination,the scores of Incontinence Associated Dermatitis severity in the three groups were not normally distributed,and non-parametric tests were used for statistical analysis.The median of the three groups was 10 points in group A,8 points in group B,and 0 points in group C,respectively.After 7 days of intervention,the severity of Incontinence Associated Dermatitis in the three groups was compared,and the difference was statistically significant(P<0.05).Further parewise comparison showed that the difference between group A and group B was P=0.998,showing no statistical significance.The difference between group B and group C was statistically significant(P=0.025).The difference between group A and group C was statistically significant(P=0.025).These results suggest that in the intervention of Incontinence Associated Dermatitis,the combination group can reduce the severity of Incontinence Associated Dermatitis more than the combination group and the Skin Protective Film group.3.Comparison of healing time among the three groupsThe order of healing time from short to long in the three groups was the combination group(6.03±1.98)d,the Compound Phellodendron Liquid group(7.23±2.25)d,and the Skin Protective Film group(7.28±1.75)d.The healing time between the three groups was compared,and the difference was statistically significant(P<0.05).Further pairwise comparison showed that there was no significant difference between single intervention methods(P>0.05).The single intervention method(Compound Phellodendron Liquid group or Skin Protective Film group)was compared with the combined group(P<0.05),and the differences were statistically significant.It indicates that in the intervention process of Incontinence Associated Dermatitis,the combination group can promote the healing of dermatitis faster than the Compound Phellodendron Liquid group and the Skin Protective Film group,and there is no significant difference in the healing time between the Compound Phellodendron Liquid group and the Skin Protective Film group.4.Comparison of costs among the three groupsAfter examination,the treatment costs of the three groups of patients were not normally distributed,and non-parametric test was used for statistical analysis.The median cost of treatment in the three groups was 184 yuan in group A,220 yuan in group C and265 yuan in group B.Comparison of treatment costs among the three groups showedstatistically significant differences(P<0.05).Further pairwise comparison showed that the difference between group A and group B was statistically significant(P=0.000).Comparing group B with group C,P=0.000,the difference was statistically significant.There was no statistically significant difference between group A and group C(P=0.505).This indicates that from the perspective of health economics,the combination group and the Compound Phellodendron Liquid group are more economical than the Skin Protective Film group.5.The three groups were compared on the second,fourth and sixth days after the intervention in the incidence of pain of various degrees and pain scoresOn day 2,the incidence of various degrees of pain(painless,mild pain,moderate pain and severe pain)was compared among the three groups,and the difference was not statistically significant(P>0.05).On day 4 and day 6,the incidence of various degrees of pain was compared among the three groups,and the difference was statistically significant(P<0.05).The results of repeated measures anova showed that on the second day after the intervention,the pain scores of the three groups were from low to high: C group(5.54±1.22),A group(5.86±1.57),and B group(6.09±1.38).The differences among the three groups were not statistically significant(P>0.05).On the fourth day after the intervention,the pain scores of the three groups were from low to high: C group(2.08±1.82),A group(3.77±2.12),and B group(4.29±1.27).On the 6th day after the intervention,the pain scores of the three groups were from low to high: C group(0.74±1.07),B group(1.94±1.84),and A group(2.09±1.92).The three groups were compared in terms of pain scores,P<0.05,and the difference between them was statistically significant.Time effect(that is to say,the pain scores of the three groups all changed with different time points without considering the group factors)was compared,and the difference was statistically significant(P<0.05).Group effect(that is to say,without considering the time factor,the pain score will be different from group to group)was compared,and the difference was statistically significant(P<0.05).On the interaction effect(the pain scores of the three groups were significantly different at different time points),the difference was statistically significant(P<0.05).ConclusionThe combination of Compound Phellodendron Liquid and Skin Protective Film can shorten the healing time of dermatitis,reduce the severity of Incontinence Associated Dermatitis and reduce the patients’ pain sensation.From the perspective of health economics,the combination group and Compound Phellodendron Liquid group are more economical than the Skin Protective Film group,and can reduce the psychological and economic burden of patients’ families.To sum up,the combination of the three intervention methods is optimal.It has been proved to be safe,effective and feasible to apply Compound Phellodendron Liquid and Skin Protective Film to intervene Incontinence Associated Dermatitis. |
