Comparative analysis of clinical characteristics and self-management among patients with chronic wounds across different altitudes
摘要
To compare the clinical characteristics and self-management status of patients with chronic wounds across different altitudes and to identify factors associated with self-management. A cross-sectional design was used. Using convenience sampling, 113 patients with chronic wounds were recruited from the Hospital of the Tibet Autonomous Region Chengdu Office and categorized by long-term residential altitude into a high-altitude group (≥ 3000 m, n = 76) and a low-altitude group (< 3000 m, n = 37). Data were collected using a general information questionnaire and the Chronic Wound Self-Management Scale. Between-group comparisons were performed using the independent-samples t test, χ² test, or the Mann–Whitney U test according to data distribution. Multiple linear regression was conducted to explore factors associated with each dimension of self-management. The mean residential altitude was 3644.6 ± 118.2 m in the high-altitude group and 432.98 ± 172.3 m in the low-altitude group. Compared with the low-altitude group, the high-altitude group had higher proportions of Tibetan ethnicity, lower educational attainment, chronic refractory wounds, lower-limb wounds, yellow or black necrotic tissue, moderate-to-severe malodor, larger wound surface area, and polymicrobial infection, and lower proportions of complete independence in mobility and red granulation tissue (all P < 0.05). Regression analysis showed that sex, health insurance status, annual household income, wound duration, wound odor, mobility, and self-dressing behavior were associated with scores for living-arrangement management (P < 0.05), while sex, annual household income, and occupation were associated with nutrition-management scores (P < 0.05). Marked differences exist in clinical characteristics and self-management among chronic wound patients living at different altitudes, and self-management is jointly influenced by multiple factors. Tailored, precision health education and interventions should be implemented with consideration of lower educational levels and more complex wounds among patients living at high altitude to enhance self-management and improve outcomes.