title: Using an extreme bony prominence anatomical model to examine the influence of bed sheet materials and bed making methods on the distribution of pressure on the support surface.
abstract: Bed sheets generate high surface tension across the support surface and increase pressure to the body through a process known as the hammock effect. Using an anatomical model and a loading device characterized by extreme bony prominences, the present study compared pressure distributions on support surfaces across different bed making methods and bed sheet materials to determine the factors that influence pressure distribution. The model was placed on a pressure mapping system (CONFORMat; NITTA Corp., Osaka, Japan), and interface pressure was measured. Bed sheet elasticity and friction between the support surface and the bed sheets were also measured. For maximum interface pressure, the relative values of the following methods were higher than those of the control method, which did not use any bed sheets: cotton sheets with hospital corners (1.28, p = 0.02), polyester with no corners (1.29, p = 0.01), cotton with no corners (1.31, p = 0.003), and fitted polyester sheets (1.35, p = 0.002). Stepwise multiple regression analysis indicated that maximum interface pressure was negatively correlated with bed sheet elasticity (R(2) = 0.74). A statistically significant negative correlation was observed between maximum interface pressure and immersion depth, which was measured using the loading device (r = -0.40 and p = 0.04). We found that several combinations of bed making methods and bed sheet materials induced maximum interface pressures greater than those observed for the control method. Bed sheet materials influenced maximum interface pressure, and bed sheet elasticity was particularly important in reducing maximum interface pressure.
authors: Department of Clinical Nursing, Division of Health Sciences, Graduate Course of Nursing Science, Kanazawa University, Kanazawa, Japan.
authors: Terumi
authors: T
authors: Iuchi
authors: Department of Clinical Nursing, Division of Health Sciences, Graduate Course of Nursing Science, Kanazawa University, Kanazawa, Japan.
authors: Yukari
authors: Y
authors: Nakajima
authors: Department of Clinical Nursing, Division of Health Sciences, Graduate Course of Nursing Science, Kanazawa University, Kanazawa, Japan.
authors: Moriyoshi
authors: M
authors: Fukuda
authors: Faculty of Nursing, Osaka Medical College, Osaka, Japan.
authors: Junko
authors: J
authors: Matsuo
authors: Department of Quantum Medical Technology, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan.
authors: Hiroyuki
authors: H
authors: Okamoto
authors: Department of Gerontological Nursing/Wound Care Management, Division of Health Science and Nursing, Graduate School of Medicine, University of Tokyo, Japan.
authors: Hiromi
authors: H
authors: Sanada
authors: Department of Clinical Nursing, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942, Japan. Electronic address: junkosgm@mhs.mp.kanazawa-u.ac.jp.
authors: Junko
authors: J
authors: Sugama
mesh_terms: D001512:Bedding and Linens; D006801:Humans; D008953:Models, Anatomic; D011312:Pressure; D003668:Pressure Ulcer / Q000517:prevention & control*
keywords: Bed making; Bed sheets; Pressure distribution; Pressure ulcer; Support surface