A nomogram to predict skin barrier dysfunction induced by mechanical irritation during skincare in hospitalized Japanese older adults

Issei Konya; Rika Yano; Yoichi M Ito; Hiroaki Iwata; Mayumi Yoshida; Chiaki Watanabe; Akemi Morita

doi:10.1016/j.gerinurse.2024.10.031

A nomogram to predict skin barrier dysfunction induced by mechanical irritation during skincare in hospitalized Japanese older adults

Geriatr Nurs. 2024 Nov 9:S0197-4572(24)00351-3. doi: 10.1016/j.gerinurse.2024.10.031. Online ahead of print.

Authors

Issei Konya¹, Rika Yano², Yoichi M Ito³, Hiroaki Iwata⁴, Mayumi Yoshida⁵, Chiaki Watanabe⁵, Akemi Morita⁵

Affiliations

¹ Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan; Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan.
² Faculty of Health Sciences, Hokkaido University, Sapporo, Japan. Electronic address: r-yano@med.hokudai.ac.jp.
³ Data Science Center, Promotion Unit, Institute of Health Science Innovation for Medical Care, Hokkaido University Hospital, Sapporo, Japan.
⁴ Department of Dermatology, Graduate School of Medicine, Gifu University, Gifu, Japan.
⁵ Nursing Department, Yoichi Kyokai Hospital, Yoichi, Japan.

PMID: 39523129
DOI: 10.1016/j.gerinurse.2024.10.031

Abstract

Mechanical irritation during skincare poses a risk of causing skin barrier dysfunction in older patients. Adequate skin assessment is thus required before skincare; however, no validated assessment method exists. This study developed a nomogram to predict skin barrier dysfunction induced by mechanical irritation during skincare in Japanese older patients using a subset of a randomized controlled trial dataset. The volar forearms of 149 older patients (≥65 years) underwent a mechanical irritation test. Skin barrier dysfunction was defined based on transepidermal water loss before and after the test. Candidate variables were obtained from medical records and skin assessments. We found that 26.2 % of older patients experienced skin barrier dysfunction. The nomogram, comprising chronic kidney disease, purpura, dry skin, activities of daily living, and body mass index, demonstrated satisfactory discrimination, calibration, and clinical utility. This tool serves as an innovative and validated method for skin assessment, offering the potential to prevent skin disorders and deliver tailored, high-quality skincare.

Keywords: Aged; Hygiene; Risk factors; Skin barrier function; Skin care.