Skin Ulcer Development and Deterioration of Social Engagement among Nursing Home Residents.
Anyah Prasad, Anthony P Nunes, Bill M Jesdale and 7 others
PMID 39892876WHAT IT FOUND
Nursing home residents who developed stage 2 or higher skin ulcers were more likely to have worsening social engagement over one year than residents who remained ulcer-free.
Persistent ulcers showed the highest risk; resolved ulcers showed lower risk.
Key findings
01After demographic adjustment, residents in the new, persistent, and resolved ulcer groups had 26%, 32%, and 12% higher risks of deteriorating social engagement than the reference group.
02Among residents with ulcers, 2,390 had them resolved by annual assessment, 657 first appeared at annual, and 646 persisted.
03In sensitivity analysis, the risk for new ulcers was 18%, while persistent and resolved risks were 32% and 12%.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The social engagement measure was only available from 2010, so it may not reflect current nursing home populations or care. The study was observational, so it cannot show that skin ulcers caused social engagement to decline; reduced engagement may have come first. Residents who died during the observation period were not included, which may hide worse outcomes. Social engagement was measured only at admission and one year, while ulcers were checked quarterly, so the timing of change is limited. Stage 1 ulcers may be under-detected, especially in residents with darkly pigmented skin, which affected the sensitivity analysis. Other clinical variables did not change the estimate by the pre-set threshold and were not retained, so some potential confounders were not included in the main model.
Declared interests
The authors reported no conflicts of interest. The article is tagged as supported by NIH extramural and non-U.S. government research funding.
The easy way to misread this
Do not conclude that skin ulcers caused residents to become less socially engaged. This was an observational cohort, and social engagement was measured only at admission and one year, so the decline may have started before the ulcers appeared.