Determination of techniques and methods given by caregivers in chronic wound healing, and the knowledge of caregivers at home

This study aimed to evaluate the knowledge of the caregivers about chronic wound healing and to determine the techniques which are applied. All the data in study collected from the patients registered to the Home Care Center of Izzet Baysal University Hospital (originally İzzet Baysal Devlet Hastanesi Evde Bakım Merkezi) in Bolu region between June 1, 2018 and November 30, 2018. Although the number of registered patients which fit for this research was 102, sample pool was constructed by 90 volunteer caregivers of the patients with chronic wound older than 18 years old. A survey which was created by the researchers was used to gather all the data used in this research. Data were collected from the caregivers themselves by face to face discussion during the visit of employees which belong to the Home Care Center. Data analysis was made by statistics program. Data evaluated as real values, percentages, and degree of freedom and significance are determined by Pearson's chi-squared test (χ2). According to the results we obtained, 65.6% of caregivers are female while 34.4% is male. Also, 52.2 % were mid-aged adults (36-55), 87.8% is married and 51.1% of all caregivers have just graduated from primary school. Furthermore, 47.5% of female caregivers were housewives. From all the caregivers, 47.8% were the children of the patients, and 92.2% of all the caregivers share the same house with patients. Moreover, we determined that 75.5% of the caregivers has social security, 61.1% of them does not have any chronic disease and 63.3% does not take any medication continuously for any disease. We have found out that 38.9% of the caregivers were already been caring with the patients for 3 years and more and 75.6% of the caregivers have not taken a salary from the government. We tought that the reason might be that they have already possessed a proper employment, or they have been waiting to get approvement from the government. According to our findings, employees which belong to the Home Care Center visit twice per week for the 34.4% of the patients with chronic wound. We found out that 80.0% of the caregivers do not believe any other methods are performing better than the one they use. We have observed several different methods they applied for chronic wound care. 68.9% of the caregivers use 0.9%NaCl solution to clean up the wound and cover with a sterile cloth. We observed major differences among the caregivers in the way to understand the healing process of a wound. 43.3% of the caregivers believe that wound becomes worst if it becomes dark (dark brown and black) while 91.1% believes that there must be an infection if the wound becomes yellowish. Also, 87.8% of them believed that a wound is becoming better if it looks pink or reddish. We have observed different understanding of the cleaning and sterilization in caregivers. 91.1% of the caregivers wash their hands before any operation. We have found out that more than half of the caregivers (61.1%) do not have any knowledge about sterilization while only 14.4% of them was able to defıne what is sterilization. Hereby, we demonstrated that minorty of the careivers applies the right methodology for the wound care. We also expectedly found out that only 12.2% of the caregivers use sterile gloves. We determined that 66.7% of all the caregivers apply a 0.9 % NaCl solution to clean up the chronic wounds. Interestingly, 28.9%of the caregivers use the methods ( certain creams, rivanol, hydrogen peroxide, boric acid solution... etc.) which are dangerous for the patients. We have observed that only 7 caregivers out of 90 (7.8%) applies the advised technique properly. From all the caregivers, 11.1% of them applies relatively helpfull different methods (wound cleaning with 0.9 % NaCl solution + various wound creams + gauze closure) which are not advised by a clinician, and 12.2% of them applies other methods (wound cleaning with oxygenated water, boric acid, povidone iodine, rivanol, etc. + gauze closure) which are not fit for wound handling. Finally, although 87.8% of the caregivers use a sterile cloth (or similar derivatives) to cover the chronic wound, 14.4% of them has no knowledge of sterilization. Hereby, we demonstrated that the majority caregivers in our research was not capable of caring with a chronic wound. We also found out that their general knowlegde for wound healing and care was not sufficient.