The Big Squeeze (Lessening the Big Squeeze: The Effect of the Trunk Release on Interface Pressures of Individuals Seated in a High Fowler's Positions)
Lessening the Big Squeeze: The Effect of the Trunk Release on Interface Pressures of Individuals Seated in a High Fowler's Positions
Older adults with a disability tend to spend greater periods of time in bed each day and often over a mealtime. To make it safe for them to eat in bed, the patient is placed in a high Fowler's position. This means that the head and the foot of the bed are raised to sit the person up.
Sitting up in bed increases pressure over the buttocks which can lead to the development of a pressure ulcer. The purpose of this study is to evaluate the impact of the positional change called "the trunk release" on pressure over the buttocks, on breathing and on comfort.
Primary Hypothesis - Performing the trunk release with an older adult population at low risk for pressure ulcer will result in a 5mmHg decrease in the peak pressure index over the sacral-coccygeal area as measured by the peak pressure index using a Force Sensitive Applications (FSA) Pressure Mapping System.
Secondary Hypotheses - Performing the trunk release with an older adult population at low risk for pressure ulcer will result in:
- Improved ventilation as measured by a 0.5 liter increase in slow vital capacity.
- Greater comfort as measured by a two point change on a horizontal numeric scale with word anchors combined with the Wong-Baker faces scale (Appendix D).
- A four-centimetre displacement of the trunk as it extends up towards the head of the bed.
Обзор исследования
Подробное описание
Two research assistants will conduct the study. Experimenter A assists with recruitment of subjects, sets up the test environment and performs the trunk release. Experimenter B acts as the primary data collector and will be kept blind to the purpose of the study.
The randomized allocation indicates if the subject is in the intervention or control group. Experimenter A sets up the study hospital bed fitted with a visco-elastic foam mattress, a fitted sheet, a flat sheet and the torso pressure-sensing mat. For standardization, the mat is aligned with markers set on the bed frame. Subjects will wear hospital pajamas over undergarments. Experimenter B records height, weight, age and gender. Subject is seated in a chair and is instructed in the spirometry maneuver. Once the subject is comfortable with the maneuver, Experimenter A asks the subject to lie supine with their body centered on the bed and with their hands resting on their abdomen. Experimenter A reminds the subject to remain completely immobile for the duration of data collection. Experimenter B takes a baseline measure of discomfort as per protocol. Experimenter A places the subject in the High Fowler's position by raising the foot of the bed to its highest position, 50 degrees, and the head of the bed to its highest position, 60 degrees. Experimenter A sets the timer for 8 minutes as per pressure mapping protocol. For more stable values, a "settling time" of 8 minutes is required to factor in creep of the pressure mapping sensors and mattress. Experimenter A aims the laser beam to the top of the scapulae where the subject's shoulder meets the mattress surface. Experimenter B initiates a FSA file with the subject's number, takes a pressure reading once 8 minutes is up, measures the trunk displacement, obtains spirometry readings as per protocol, and takes a measure of discomfort. Experimenter B leaves the room, Experimenter A sets the timer for 5 minutes and opens the allocation envelope.
The Principal Investigator will conduct random spot checks to ensure consistency in set-up.
Тип исследования
Регистрация (Действительный)
Фаза
- Непригодный
Контакты и местонахождение
Места учебы
-
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British Columbia
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Vancouver, British Columbia, Канада, V5Z 1M9
- Vancouver General Hospital - Banfield Pavilion
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Vancouver, British Columbia, Канада, V6P 1S1
- George Pearson Centre
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Vancouver, British Columbia, Канада, V6P 6E8
- Dogwood Lodge
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Vancouver, British Columbia, Канада, V6T 2B5
- University of British Columbia Hospital - Purdy Pavilion
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-
Критерии участия
Критерии приемлемости
Возраст, подходящий для обучения
Принимает здоровых добровольцев
Полы, имеющие право на обучение
Описание
Inclusion Criteria:
- 65 years or older
- Residents, families, friends and volunteers of Vancouver Community Residential facilities
- Able to understand and follow instructions
- At low risk for bed sores
Exclusion Criteria:
- None
Учебный план
Как устроено исследование?
Детали дизайна
- Основная цель: Профилактика
- Распределение: Рандомизированный
- Интервенционная модель: Одногрупповое задание
- Маскировка: Одинокий
Оружие и интервенции
Группа участников / Армия |
Вмешательство/лечение |
|---|---|
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Экспериментальный: Intervention
Experimenter A places the subject in the High Fowler's position by raising the foot of the bed to its highest position, 50 degrees, and the head of the bed to its highest position, 60 degrees.
Experimenter A sets the timer for 8 minutes as per pressure mapping protocol.
For more stable values, a "settling time" of 8 minutes is required to factor in creep of the pressure mapping sensors and mattress.
Experimenter A aims the laser beam to the top of the scapulae where the subject's shoulder meets the mattress surface.
Experimenter B initiates a FSA file with the subject's number, takes a pressure reading once 8 minutes is up, measures the trunk displacement, obtains spirometry readings as per protocol, and takes a measure of discomfort.
Experimenter B leaves the room, Experimenter A sets the timer for 5 minutes and opens the randomization/ allocation envelope.
|
Trunk release as per MSIP protocol.
Standing at the foot of the bed, facing the subject, Experimenter A grasps both ends of the flat sheet to pull the trunk forward and away from the mattress surface.
As the trunk release procedure is performed, Experimenter A checks to verify that the laser beam shines through to the opposite wall to confirm that the shoulders have cleared the mattress.
|
|
Без вмешательства: Control group
Experimenter A reminds the subject to remain immobile. For both intervention and control group. After the five-minute period, experimenter A calls experimenter B to return. Experimenter B takes a pressure reading, measures the trunk displacement, obtains spirometry readings, and takes a measure of discomfort. |
Что измеряет исследование?
Первичные показатели результатов
Мера результата |
|---|
|
Performing trunk release with older adults at low risk for pressure ulcer results in 5mmHg decrease in peak pressure index over the sacral-coccygeal area measured by peak pressure index using Force Sensitive Applications Pressure Mapping System.
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Вторичные показатели результатов
Мера результата |
Временное ограничение |
|---|---|
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Ventilation as measured by a increase or decrease in slow vital capacity.
Временное ограничение: after 13 minutes of the treatment
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after 13 minutes of the treatment
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Comfort as measured by a horizontal numeric scale with word anchors combined with the Wong-Baker faces scale (Appendix D).
Временное ограничение: after 13 minutes of the treatment
|
after 13 minutes of the treatment
|
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A displacement of the trunk as it extends up towards the head of the bed.
Временное ограничение: after 13 minutes of the treatment
|
after 13 minutes of the treatment
|
Соавторы и исследователи
Спонсор
Следователи
- Главный следователь: Guylaine Desharnais, Vancouver Coastal Health
- Директор по исследованиям: William C. Miller, University of British Columbia
- Директор по исследованиям: Jeanette A. Boily, Vancouver Coastal Health
- Директор по исследованиям: Pat Camp, Vancouver Coastal Health
Даты записи исследования
Изучение основных дат
Начало исследования
Первичное завершение (Действительный)
Завершение исследования (Действительный)
Даты регистрации исследования
Первый отправленный
Впервые представлено, что соответствует критериям контроля качества
Первый опубликованный (Оценивать)
Обновления учебных записей
Последнее опубликованное обновление (Оценивать)
Последнее отправленное обновление, отвечающее критериям контроля качества
Последняя проверка
Дополнительная информация
Термины, связанные с этим исследованием
Ключевые слова
Другие идентификационные номера исследования
- H09-01370
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