Abstract:

Objective To analyze the facilitators and barriers of systemic skin cleaning behavior adherence in traumatic wound patients，and to identify potentially effective behavioral intervention strategies to reduce the risk of wound infection，promote wound healing，and improve patient comfort. Methods Totally 8 Chinese and English databases，including PubMed，Web of Science，Cochrane Library，CNKI，Wanfang Database and VIP Database，were searched from the establishment of the databases to April 2025. A mixed-method evaluation tool was used to assess the quality of the included studies. Potential barriers and facilitators were identified based on the capacity，opportunity，motivation，behavioral dimensions and theoretical domain framework of the theory of behavior change. Results A total of 32 studies were included，and 17 barriers，20 facilitators，and 35 potentially effective behavioral intervention strategies were identified. Conclusion Although the benefits of skin cleansing for trauma patients have been widely recognized，there are still many barriers to the implementation of cleansing behaviors in practice. In the future，it is necessary to further refine，evaluate and validate the influencing factors summarized in this study and develop a cleaning protocol to improve the adherence of cleaning behavior of trauma patients to achieve the goals of promoting healing and improving comfort.

Key words: Traumatic Wound, Skin Cleansing, Facilitators, Barriers, Integration Review, Nursing Care

摘要：

目的 分析创伤性伤口患者居家皮肤清洁行为的障碍和促进因素，并归纳可能有效的行为干预策略，为临床护理实践提供借鉴。方法 检索PubMed、Web of Science、Cochrane Library、Embase、中国知网、万方数据知识服务平台、维普数据库和中国生物医学文献数据库，检索时限为建库至2025年4月。采用混合方法评价工具评估纳入研究的质量。依据行为改变理论的能力、机会、动机、行为维度和理论领域框架识别潜在的障碍因素和促进因素，并归纳干预策略。结果 最终纳入32篇文献，确定了影响创伤性伤口患者居家皮肤清洁行为依从性的17条障碍因素和20条促进因素，以及35条可能有效的行为干预策略。结论 尽管皮肤清洁对创伤性伤口患者的益处已得到广泛认可，但在实际中，患者实施清洁行为仍存在诸多障碍因素。今后，需进一步完善、评估和验证该研究总结的影响因素并制订清洁方案，促进创伤性伤口患者居家皮肤清洁行为，以达到促进伤口愈合和提高舒适度的目标。

关键词: 创伤性伤口, 皮肤清洁, 促进因素, 障碍因素, 整合综述, 护理