A path analysis study of factors influencing decubitus in a geriatric nursing home: a preliminary study

Background
33.3% of the elderly who stayed and were treated at a geriatric nursing home in Dewanata, Cilacap, Indonesia, experienced decubitus. Nutritional status, length of bed rest, inappropriate use of mattresses, immobilization, and skin moisture due to frequent incontinence are considered to be a factor influencing the high incidence of decubitus in this area.

Objectives
The study aims to analyze the effect of nutritional status and bed rest on pressure, humidity, and friction and its effect on decubitus.

Material and methods
This case-control study involved 30 respondents who experienced decubitus as a case group and 30 respondents as a control group with no decubitus. Nutritional status, bed rest, pressure, humidity, and friction were observed and measured one by one through standard instruments. Data were analyzed by path analysis. Furthermore, the results were selected as a model to obtain an overview of the correlation between variables.

Results
There was a direct effect of nutritional status (p_zX1: -0.347) and duration of bed rest (p_zX2: 0.347) toward decubitus incidents, and there was an indirect effect of nutritional status and bed rest on decubitus incidents by pressure factor (p_Y1z: 0.327), humidity (p_Y2z: 0.264) and friction (p_Y3z: 0.230).

Conclusions
Nutritional status and bed rest have an effect on pressure, humidity, and friction, which increases the incidence of decubitus in older people who stay in a geriatric nursing home.