The experience of using a hospital bed alternative at home among individuals with spinal cord injury: A case series

To inform clinicians’ equipment recommendations by characterizing the experiences, skin integrity, and interface pressures in a series of recently discharged individuals with spinal cord injury (SCI) who chose to use an alternative adjustable bed system at home rather than a standard of care hospital bed with mattress overlay. Mixed methods, observational case series. Community based. Four individuals with cervical SCIs and one partner of a participant with SCI completed interviews about their experiences using an alternative adjustable bed system and their skin health. Participants also underwent pressure mapping on their alternative adjustable bed system and on a standard of care hospital bed with mattress overlay. Interview themes were identified using a consensus qualitative approach. Pressure readings at the sacrum and ischial tuberosities in supine and at the greater trochanter in side lying were compared between surfaces. Semi-structured interview, questionnaire, and pressure mapping. All participants reported positive experiences utilizing an alternative adjustable bed system and no episodes of bed-related skin breakdown. Reasons for wanting an alternative adjustable bed included a greater sense of normalcy and larger size. Participants perceived their alternative beds to be comfortable, and to have features that aided their function and assisted their caregivers. Features used included head of bed elevation, height elevation, and bed rails. All participants had clinically acceptable pressure mapping patterns on the alternative adjustable bed system. An adjustable bed system, combined with other skin protection strategies, may be appropriate for certain individuals with spinal cord injury.

本研究旨在通过对近期出院、选择居家使用可调节床替代系统（而非配备床垫衬垫的标准护理病床）的脊髓损伤（spinal cord injury, SCI）患者群体的使用体验、皮肤完整性与界面压力进行特征分析，为临床医师的设备推荐提供依据。本研究为混合方法设计的观察性病例系列研究，基于社区开展。4名颈段脊髓损伤患者与1名脊髓损伤受试者的家属参与了访谈，内容涉及该可调节床替代系统的使用体验与皮肤健康状况。所有受试者分别在其居家可调节床替代系统与配备床垫衬垫的标准护理病床完成压力图谱检测。采用共识性质性分析方法识别访谈主题，并对比两种床具表面下，受试者仰卧位时骶骨与坐骨结节处、侧卧位时大转子处的压力读数。研究工具包括半结构化访谈、问卷调查与压力图谱检测。所有受试者均反馈使用可调节床替代系统的体验良好，未出现与床具相关的皮肤破损事件。受试者选择可调节床替代系统的原因包括获得更强的正常生活感与床体尺寸更大。受试者认为该替代床具舒适度良好，且具备辅助其日常功能与照护者工作的相关功能。受试者使用的床具功能包括床头抬升、床体高度调节与床栏。所有受试者在可调节床替代系统上的压力图谱检测结果均符合临床可接受标准。可调节床系统联合其他皮肤保护策略，或可适用于部分脊髓损伤患者。