Dejavniki tveganja za nastanek okužbe sečil pri starostniku

(diplomsko delo)

Robert Kurnik (Avtor), Ana Habjanič (Mentor)

Povzetek

Okužba sečil je definirana kot vnetni odziv epitelija sečil na vdor mikroorganizmov v sicer sterilno okolje. Ta vnetni odziv običajno povzroči pojav tipičnih znakov okužbe. Okužba sečil je poleg respiratornih infekcij najpogostejša okužba pri ljudeh vseh generacij. Njihova pogostnost se razlikuje glede na spol in starost. V odrasli dobi najpogosteje zbolevajo ženske. Ocenjeno je, da najmanj 20 % celotne ženske populacije vsaj enkrat v življenju preboli okužbo urinarnega trakta. Okužba sečil je v moški populaciji do petdesetega leta skoraj neznana, potem zaradi večanja prostate začne prihajati do motenega odtoka urina iz sečnega mehurja in posledičnega porasta pojava primerov okužb. Pogostnost okužb sečil s starostjo narašča. Pri starostnikih, ne glede na spol, ginekološke in urološke operacije, inkontinentnost, invazivni posegi na sečilih in trajna urinska katetrizacija znatno zvišajo pojavnost okužb urinarnega trakta in lahko incidenca poraste celo do vrednosti med 30 % in 40 %. Prepoznavanje prisotnosti okužbe sečil je pri starostnikih oteženo, saj se številni simptomi prekrijejo v normalnih fizioloških spremembah zaradi staranja ali so povsem odsotni. Z raziskavo smo ocenjevali pomen znanih dejavnikov tveganja za nastanek okužbe sečil pri starostniku. V ta namen smo podrobno preučili zdravstveno in negovalno dokumentacijo 101 pacienta, ki je bil sprejet v bolnišnično obravnavo na Oddelku za nalezljive bolezni in vročinska stanja. Potrebne podatke smo pridobili s pomočjo načrtno izdelanega raziskovalnega kriterija. Ocenjevali smo 9 potencialnih dejavnikov tveganja, hkrati smo v namen smiselnega razvrščanja podatkov raziskali še 6 splošno naravnanih parametrov. Pridobljene podatke smo obdelali in analizirali s programsko opremo za urejanje baz podatkov Microsoft Access in rezultate grafično predstavili v obliki grafov in tabel. V namen ocene posameznega dejavnika tveganja in vpliva, ki ga ima dani dejavnik na nastanek okužbe sečil, smo samostojno razvili posebno metodologijo. Osnovna ideja uporabljene metodologije je, da dejavniki tveganja, ki se v celotnem raziskovalnem vzorcu pojavljajo pogosteje, predstavljajo višje tveganje za nastanek okužbe sečil. Kot poglavitna dejavnika tveganja za nastanek okužbe sečil sta se izkazala nepomičnost in bivanje v domu starejših občanov. Visok indeks tveganja prav tako predstavljata uporaba antibiotikov v tromesečju pred dano hospitalizacijo in prisotnost urinske inkontinence. V zaključnih delih diplomskega dela smo ponudili strategije zmanjševanja tveganja za nastanek okužbe sečil, ki izhajajo iz dobljenih rezultatov raziskave. Tako predlagamo, da bi se večji poudarek namenil ohranjanju fizične mobilnosti pacientov, kar bi lahko dosegli z dodatnim zaposlovanjem fizioterapevtov. Hkrati bi bilo smiselno omejiti uporabo antibiotikov, ki so se izkazali kot pomemben dejavnik tveganja in pozornost ter napore usmeriti v delo z inkontinentnimi pacienti. Izreden pomen dajemo tudi pravočasnemu odkrivanju tveganja za nastanek okužbe pri pacientu in smo iz tega razloga izdelali poseben kriterij, ki nam omogoča oceno ogroženosti pacienta za nastanek okužbe sečil. S pomočjo uporabe takšnega kriterija lahko v klinični praksi hitro in učinkovito prepoznamo tveganje ter pravočasno izvedemo potrebne ukrepe, da do nastanka okužbe sečil ne bi prišlo.

Ključne besede

okužba sečil;starostnik;urinski kateter;dejavniki tveganja;

Podatki

Jezik:	Slovenski jezik
Leto izida:	2012
Izvor:	Maribor
Tipologija:	2.11 - Diplomsko delo
Organizacija:	UM FZV - Fakulteta za zdravstvene vede
Založnik:	[R. Kurnik]
UDK:	616.6-053.9
COBISS:	1878436
Št. ogledov:	2142
Št. prenosov:	628
Ocena:	0 (0 glasov)
Metapodatki:

Ostali podatki

Sekundarni jezik:	Angleški jezik
Sekundarni naslov:	Risk factors for development of urinary tract infection in elderly
Sekundarni povzetek:	Urinary tract infection (UTI) is currently defined as the inflammatory response of the urothelium to microbial invasion. This inflammatory response causes a constellation of typical symptoms. UTI is next to respiratory infections most common inflammatory disease in all age stages. Most frequently affected among adults are woman. Prevalence is dependent of age and sex. Usually are women more affected by UTIs. It is estimated that 20 % or more of the female population suffers some form of UTI in their lifetime. Infection in the male population remains uncommon through the fifth decade of life, when enlargement of the prostate begins to interfere with emptying of the bladder. Incidence is rising with age. In the elderly of both sexes, gynecologic or prostatic surgery, incontinence, instrumentation, and chronic urethral catheterization push UTI rates to 30 to 40 %. Detection of the presence of urinary tract infection in the elderly is difficult, since many of the symptoms overlap with the normal physiological changes of aging, or are completely absent. The research assessed the importance of known risk factors for urinary tract infections in the elderly. To this end, we examine in detail the medical and nursing documentation of 101 patient, admitted for hospital treatment on ward for infectious diseases and febrile states. The necessary data were obtained by manufacture of a systematic research criterion with which we evaluated nine potential risk factors. For more meaningful grouping of data we also studied 6 generally oriented parameters. Acquired data were processed and analyzed with software for database editing - Microsoft Access and the results were graphically presented in the form of graphs and tables. For the purpose of the assessment of individual risk factor and the impact of this factor on the formation of urinary tract infections, we have developed a special methodology. Basic idea of used methodology is that higher incidence of specific risk factor in research sample correlates with higher risk for urinary tract infection. The major risk factor proved to be the immobility followed by staying in the long term care facility. As also relevant risk factors was given use of antibiotics in three months period before hospital admission and presence of urinary incontinence. In final chapters of the thesis we offer strategies to reduce the risk of urinary tract infections in the clinical surroundings, resulting from the research results. Thus we suggest that more attention is given to maintaining of patient physical mobility. This could be achieved with employment of more physical therapists. There is also important to rationale use of antibiotics, which is proven as major risk factor for development of urinary tract infection. We also suggest putting more attention and efforts in caring for patients with urinary incontinence. Utmost importance is given to the preventive work. Thus we have produced a special criterion that allows us to assess the risk to patients of developing urinary tract infections. Through the use of these criteria in clinical practice can be quickly and efficiently identify risks and take the necessary measures in time.
Sekundarne ključne besede:	urinary tract infection;elderly;urinary catheter;risk factors;
URN:	URN:SI:UM:
Vrsta dela (COBISS):	Diplomsko delo
Strani:	IV, 74 f., 4 f. pril.
Ključne besede (UDK):	applied sciences;medicine;technology;uporabne znanosti;medicina;tehnika;medical sciences;medicina;pathology;clinical medicine;patologija;klinična medicina;pathology of the urogenital system;urinary and sexual (genital) complaints;urology;patologija urogenitalnega sistema;bolezni sečil in spolnih organov;urologija;
ID:	16098