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Shogenji M, Yoshida M, Kakuchi T, Hirako K. Physical, emotional, and financial burdens of toileting assistance for family caregivers in home care settings and factors associated with each burden: A cross-sectional study. Jpn J Nurs Sci 2024; 21:e12615. [PMID: 39138022 DOI: 10.1111/jjns.12615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 07/12/2024] [Accepted: 07/15/2024] [Indexed: 08/15/2024]
Abstract
AIM Caregivers in home care settings may experience significant physical, emotional, and financial burdens in providing toileting assistance. However, few studies have evaluated these three aspects of caregiver burden. Therefore, this study aimed to clarify the physical, emotional, and financial burdens of toileting assistance and examine the factors associated with each burden. METHODS A self-administered postal questionnaire was distributed to 405 family caregivers of older adults receiving home care and subsidies for incontinence products in Japan in 2019. Family caregivers answered questions about toileting assistance, the perceived physical, emotional, and financial burdens of providing toileting assistance at home, and the urinary/fecal symptoms of older adults. RESULTS Of the 242 family caregivers who reported each burden, 213 (88%) had experienced at least one physical, emotional, or financial burden. The prevalence of physical, emotional, and financial burdens was 77.3%, 78.1%, and 70.7%, respectively. Approximately 60% of respondents reported experiencing all three burdens. Physical burden was associated with spouses acting as primary caregivers, nocturia, fecal incontinence, and the odor of urine/feces from toileting assistance. Emotional burden was associated with nighttime assistance, urinary/fecal leakage from absorbent incontinence products, and the odor of urine/feces. Financial burden was associated with frequent assistance, disposal costs of absorbent incontinence products, and the degree of toileting assistance. CONCLUSIONS The results revealed a high prevalence of the three burdens of toileting assistance among family caregivers, suggesting the need to assess these burdens. Furthermore, they suggested the importance of providing guidance to family members, which may help reduce these burdens.
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Affiliation(s)
- Miho Shogenji
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Mikako Yoshida
- Department of Women's Health Nursing & Midwifery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Kohei Hirako
- The Establishment Preparation Office for The Faculty of Interdisciplinary Economics, Kinjo University, Hakusan, Japan
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2
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Kido Y, Yoshimura Y, Wakabayashi H, Nagano F, Bise T, Matsumoto A, Shimazu S, Shiraishi A, Yoneda K, Hamada T, Kuzuhara A. Effect of Chair-stand Exercise on Improving Urinary and Defecation Independence in Post-stroke Rehabilitation Patients with Sarcopenia. Prog Rehabil Med 2024; 9:20240029. [PMID: 39280961 PMCID: PMC11393472 DOI: 10.2490/prm.20240029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 08/29/2024] [Indexed: 09/18/2024] Open
Abstract
Objectives There is a lack of evidence regarding the association between whole-body exercise and independence in urination and defecation. This study aimed to evaluate the effect of chair-stand exercise on improving urination and defecation independence in post-stroke patients with sarcopenia. Methods A retrospective study was conducted on stroke patients admitted to a community rehabilitation hospital between 2015 and 2021. Patients diagnosed with sarcopenia who required assistance with bladder and bowel management were included. The primary outcomes were the Functional Independence Measure (FIM) scores for urination (FIM-Bladder) and defecation (FIM-Bowel) at discharge. Multiple regression analysis was used to examine the association between chair-stand exercise and the outcomes, adjusting for potential confounders. Results Of 586 patients, 187 patients (mean age 79.3 years, 44.9% male) were included in the urination analysis, and 180 patients (mean age 79.3 years, 44.4% male) were included in the defecation analysis. Multiple regression analysis showed that the number of chair-stand exercises was independently positively associated with FIM-Bladder at discharge (β=0.147, P=0.038) and FIM-Bladder gain (β=0.168, P=0.038). Similarly, the number of chair-stand exercises was independently positively associated with FIM-Bowel at discharge (β=0.149, P=0.049) and FIM-Bowel gain (β=0.166, P=0.049). Conclusions Chair-stand exercise was positively associated with improved urination and defecation independence in post-stroke patients with sarcopenia. Incorporating whole-body exercises, such as chair-stand exercise, in addition to conventional rehabilitation programs may help improve voiding independence, reduce incontinence, and enhance quality of life in these patients.
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Affiliation(s)
- Yoshifumi Kido
- Department of Rehabilitation, Kumamoto Rehabilitation Hospital, Kikuyo, Japan
| | - Yoshihiro Yoshimura
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kikuyo, Japan
| | - Hidetaka Wakabayashi
- Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Fumihiko Nagano
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kikuyo, Japan
| | - Takahiro Bise
- Department of Rehabilitation, Kumamoto Rehabilitation Hospital, Kikuyo, Japan
| | - Ayaka Matsumoto
- Department of Pharmacy, Kumamoto Rehabilitation Hospital, Kikuyo, Japan
| | - Sayuri Shimazu
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kikuyo, Japan
| | - Ai Shiraishi
- Department of Dental Office, Kumamoto Rehabilitation Hospital, Kikuyo, Japan
| | - Kouki Yoneda
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kikuyo, Japan
| | - Takenori Hamada
- Department of Rehabilitation, Kumamoto Rehabilitation Hospital, Kikuyo, Japan
| | - Aomi Kuzuhara
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kikuyo, Japan
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Shogenji M, Yoshida M, Kakuchi T, Hirako K. Factors associated with caregiver burden of toileting assistance at home versus in a nursing home: A cross-sectional study. PLoS One 2024; 19:e0299721. [PMID: 38452135 PMCID: PMC10919849 DOI: 10.1371/journal.pone.0299721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/13/2024] [Indexed: 03/09/2024] Open
Abstract
This study aimed to identify differences in caregiver burden related to toileting assistance, and examine the factors associated with the most burdensome aspects of providing toileting assistance. In 2019, a self-administered postal survey was conducted with 743 caregivers of older adults who received subsidies for continence products in Komatsu City, Japan. Both family caregivers and nursing home staff answered questions regarding older adults' urinary/fecal symptoms, toileting assistance, and perceived caregiver burden. Older adults living at home had less need for toileting assistance than those in nursing homes. However, family caregivers experienced more burden than nursing home staff. The most frequent physical burden associated with toileting assistance for family caregivers was urinary/fecal leakage from absorbent incontinence products. This burden was linked to family caregivers providing care at home, using a combination of urinary pads and diapers, and symptoms that caused burdens on caregivers including urinary/fecal incontinence, nocturia, and no desire to urinate. These results suggest that leakage caused by the inappropriate use of urinary pads combined with diapers is a source of caregiver burden. Continence care experts should provide guidance to family caregivers of older adults, particularly those who are underweight and frail, regarding the selection and fitting of absorbent incontinence products.
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Affiliation(s)
- Miho Shogenji
- Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa City, Ishikawa, Japan
| | - Mikako Yoshida
- Department of Women’s Health Nursing & Midwifery, Tohoku University Graduate School of Medicine, Sendai City, Miyagi, Japan
| | - Takahiro Kakuchi
- Graceful Aging Division, Health & Welfare Department, Komatsu City Hall, Komatsu City, Ishikawa, Japan
| | - Kohei Hirako
- The Establishment Preparation Office for The Faculty of Interdisciplinary Economics, Kinjo University, Hakusan City, Ishikawa, Japan
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Shaw NM, Breyer BN, Walter LC, Sudore RL, Suskind AM, Baussan C, Quanstrom K, Allen IE, Cooperberg MR, Dohan D, Hampson LA. How older men live with stress urinary incontinence: Patient experience and navigation to treatment. Neurourol Urodyn 2024; 43:11-21. [PMID: 38014566 PMCID: PMC10866353 DOI: 10.1002/nau.25325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/29/2023] [Accepted: 10/22/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVES To explore the context in which older men navigate treatment for stress urinary incontinence (SUI) following prostate surgery by characterizing lived experience of men with symptomatic SUI. SUBJECTS/PATIENTS AND METHODS Mixed method study using surveys and semistructured interviews to examine a cohort of men who underwent evaluation for treatment of postprostatectomy SUI. RESULTS Thirty-six men were interviewed after consultation for SUI and 31 had complete quantitative clinical data. Twenty-six underwent surgery and 10 chose no surgical intervention. In qualitative interviews, respondents experienced substantial decline in quality of life due to incontinence citing concerns associated with use of pads and worrying about incontinence. Most patients reported "workarounds"-efforts to mitigate or manage incontinence including Kegels, physical therapy, and garments. Participants also reported lifestyle changes including less strenuous physical activity, less sexual activity, and/or fewer social gatherings. Patients then described a "breaking point" where incontinence workarounds were no longer sufficient. After seeking evaluation, men described challenges in exploring treatment for SUI, including access to care and provider knowledge of treatment options. CONCLUSION In a novel study of patients living with SUI a predictable lived experience was observed that culminated in a desire for change or "breaking point." In all men, this led to treatment-seeking behaviors and for many it led to SUI intervention. Despite effective treatments, patients continue to meet barriers gaining access to SUI evaluation and treatment.
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Affiliation(s)
- Nathan M Shaw
- Department of Urology, School of Medicine, University of California San Francisco, San Francisco, California, USA
- Department of Urology, MedStar Georgetown, Washington, District of Columbia, USA
| | - Benjamin N Breyer
- Department of Urology, School of Medicine, University of California San Francisco, San Francisco, California, USA
- Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Louise C Walter
- Department of Medicine, School of Medicine, University of California San Francisco, San Francisco, California, USA
- Department of Medicine, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Rebecca L Sudore
- Department of Medicine, School of Medicine, University of California San Francisco, San Francisco, California, USA
- Department of Medicine, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Anne M Suskind
- Department of Urology, School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Caitlin Baussan
- Department of Urology, School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Kathryn Quanstrom
- Department of Urology, School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Isabel E Allen
- Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Matthew R Cooperberg
- Department of Urology, School of Medicine, University of California San Francisco, San Francisco, California, USA
- Department of Surgery, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Dan Dohan
- Institute for Health Policy Studies, University of California San Francisco, San Francisco, California, USA
| | - Lindsay A Hampson
- Department of Urology, School of Medicine, University of California San Francisco, San Francisco, California, USA
- Department of Surgery, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
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Bektas Akpinar N, Unal N, Akpinar C. Urinary Incontinence in Older Adults: Impact on Caregiver Burden. J Gerontol Nurs 2023; 49:39-46. [PMID: 36989470 DOI: 10.3928/00989134-20230310-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
The objective of the current descriptive, cross-sectional, and relationship-seeking study was to evaluate the severity of urinary incontinence (UI) in older adults and its impact on care burden of their family caregivers. This study was performed prospectively with 80 older adults (aged ≥65 years) with UI and their family caregivers who attended a urology clinic between June and December 2021. UI was assessed using the International Consultation on Incontinence Questionnaire Short Form (ICIQ-UI-SF), and caregiver burden using the Zarit Burden Interview (ZBI). Increase in care time was associated with higher burden of care (p = 0.018). Post-hoc analyses suggested that caregivers' burden of care gradually increased up to the first 9 months. Daily care time >9 hours had a higher burden compared to care times <9 hours (p < 0.001). Mean ZBI score of caregivers was 41.47 (SD = 10.18) and mean ICIQ-UI-SF score of older adults was 15.02 (SD = 3.9). A significant correlation was observed between increased ICIQ-UI-SF scores of older adults and ZBI scores of caregivers (r = 0.354, p = 0.001). Caring for older adults with UI is associated with a significant burden of care and an increase in severity of UI is associated with increased burden of care. Female sex, lower educational level, presence of comorbidities, increased care time, and daily care hours were factors associated with increased burden of care among caregivers. [Journal of Gerontological Nursing, 49(4), 39-46.].
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Huang J, Chan CK, Yee S, Deng Y, Bai Y, Chan SC, Tin MS, Liu X, Lok V, Zhang L, Xu W, Zheng ZJ, Teoh JYC, Ng CF, Wong MCS. Global burden and temporal trends of lower urinary tract symptoms: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis 2022:10.1038/s41391-022-00610-w. [DOI: 10.1038/s41391-022-00610-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/25/2022] [Accepted: 10/31/2022] [Indexed: 11/23/2022]
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Relationship between Activities of Daily Living of Home-Based Rehabilitation Users and Caregiver Burden-Induced Depression: A Retrospective Study. Occup Ther Int 2022; 2022:4524985. [PMID: 35821709 PMCID: PMC9232300 DOI: 10.1155/2022/4524985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/29/2022] [Accepted: 06/11/2022] [Indexed: 11/17/2022] Open
Abstract
This study was aimed at determining the cutoff values of activities of daily living (ADL) and the combination of related factors associated with high caregiver burden that induces depression among caregivers. The study participants included 50 pairs of home-based rehabilitation users and their primary caregivers. They were classified into two groups: high-burden and low-burden groups according to the short version of the Japanese version of the Zarit Caregiver Burden Interview score of ≥13 or ≤12, respectively. The cutoff values of ADL and the combination of related factors associated with high caregiver burden were examined using the receiver operating characteristic curve and decision tree analyses. The cutoff value associated with high caregiver burden was 5 points for the controlling bladder item of the Barthel index (BI) (sensitivity: 90%, specificity: 70%). Regarding the decision tree, the controlling bladder item of BI (≤5 or 10 points) was selected as the first layer and the recipient's age (≤78 or ≥79 years) as the second layer. High caregiver burden was identified in 85.7% of the caregivers in whom the score of controlling bladder of BI was ≤5 points and the patient was aged ≤78 years. A score of ≤5 points for the controlling bladder item of BI along with young recipient age was associated with high caregiver burden that induces depression among caregivers. This approach is useful to identify caregivers with high caregiver burden who are at risk for depression.
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Russell D, Stoddard MD, Morgan N, McDonald MV, Dignam R, Bowles KH, Prigerson HG, Chughtai B. Nurse perspectives on the psychosocial care of patients with urinary incontinence in home hospice: A qualitative study. Palliat Med 2022; 36:135-141. [PMID: 34479463 DOI: 10.1177/02692163211043378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Urinary incontinence is prevalent among patients receiving home hospice and presents multiple care management challenges for nurses and family caregivers. AIM This study sought to understand how urinary incontinence influences the psychosocial care of patients receiving home hospice and the strategies that nurses employ to maximize patient and family comfort. DESIGN Qualitative descriptive study using semi-structured interviews. SETTING/PARTICIPANTS Nurses employed at a large not-for-profit hospice agency in New York City. RESULTS Analyses of 32 interviews revealed three primary themes. First, nurses considered urinary incontinence to be associated with multiple psychosocial issues including embarrassment for patients and caregiver burden. Second, nurses described urinary incontinence as a threat to patient dignity and took steps to preserve their continence function. Third, nurses assisted patients and their families to cope with urinary incontinence through normalization, reframing incontinence as part of the disease process, mobilizing caregiving assistance, and encouraging use of continence supplies such as diapers and liners. CONCLUSION Urinary incontinence influences the psychosocial care of patients receiving home hospice and nurses employ strategies to maximize patient and family comfort. Additional research is needed to examine the psychosocial benefits of facilitated discussions with patients and family members about incontinence, provision of caregiving support, and distribution of comprehensive incontinence supplies to patients with fewer resources.
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Affiliation(s)
- David Russell
- Department of Sociology, Appalachian State University, Boone, NC, USA.,Center for Home Care Policy & Research, Visiting Nurse Service of New York, New York, NY, USA
| | - Michelina D Stoddard
- Department of Urology, Weill Cornell Medicine/New York Presbyterian, New York, NY, USA.,Weill-Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD Program, New York, NY, USA
| | - Natalie Morgan
- Department of Sociology, Appalachian State University, Boone, NC, USA
| | - Margaret V McDonald
- Center for Home Care Policy & Research, Visiting Nurse Service of New York, New York, NY, USA
| | | | - Kathryn H Bowles
- Center for Home Care Policy & Research, Visiting Nurse Service of New York, New York, NY, USA.,Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | | | - Bilal Chughtai
- Department of Urology, Weill Cornell Medicine/New York Presbyterian, New York, NY, USA
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Habib MH, Arnold RM. Urinary Incontinence in Palliative Care Settings: Part 1: Etiology and Workup #425. J Palliat Med 2021; 24:1732-1733. [PMID: 34726522 DOI: 10.1089/jpm.2021.0372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kido Y, Yoshimura Y, Wakabayashi H, Momosaki R, Nagano F, Bise T, Shimazu S, Shiraishi A. Sarcopenia is associated with incontinence and recovery of independence in urination and defecation in post-acute rehabilitation patients. Nutrition 2021; 91-92:111397. [PMID: 34364264 DOI: 10.1016/j.nut.2021.111397] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/02/2021] [Accepted: 06/14/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The aim of this study was to examine the association between sarcopenia and recovery of independence in urination and defecation in patients undergoing convalescent rehabilitation. METHODS This single-center, retrospective cohort study included post-acute rehabilitation patients. Sarcopenia was diagnosed using the muscle mass index and handgrip strength according to the updated criteria of the Asian Working Group for Sarcopenia 2019. Study outcomes and the recovery of independence in urination and defecation were evaluated using the sphincter control items of the Functional Independence Measure (FIM) at discharge: urination (FIM-Bladder) and defecation (FIM-Bowel), respectively. Multivariate regression analyses were used to determine whether sarcopenia at baseline was associated with the study outcomes. Statistical significance was set at P < 0.05. RESULTS After enrollment, 917 patients (mean age 74.7 ± 13.5 y; 58% women) were included in the final analyses. Sarcopenia was present in 451 patients (49.2%). The median FIM-Bladder and FIM-Bowel scores at admission were 5 [2-7] and 5 [3-7], respectively. Multivariate analyses showed that the presence of sarcopenia at admission was independently and negatively associated with FIM-Bladder and FIM-Bowel at discharge (all P < 0.001), respectively, after adjusting for potential confounders including baseline outcome variables, FIM, and disease. CONCLUSIONS Sarcopenia was negatively associated with the recovery of independence in urination and defecation in a post-acute rehabilitation setting. This relationship was independent of physical and cognitive level and disease. Early detection of sarcopenia and treatment by rehabilitation nutrition should be implemented to predict and maximize improvement in toileting independence in this population.
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Affiliation(s)
- Yoshifumi Kido
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Yoshihiro Yoshimura
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan.
| | - Hidetaka Wakabayashi
- Department of Rehabilitation Medicine, Tokyo Women;s Medical University Hospital, Tokyo, Japan
| | - Ryo Momosaki
- Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, Mie, Japan
| | - Fumihiko Nagano
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Takahiro Bise
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Sayuri Shimazu
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
| | - Ai Shiraishi
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, Kumamoto, Japan
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Navigating through incontinence: A qualitative systematic review and meta-aggregation of the experiences of family caregivers. Int J Nurs Stud 2021; 123:104062. [PMID: 34461378 DOI: 10.1016/j.ijnurstu.2021.104062] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 06/30/2021] [Accepted: 08/08/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Community dwelling older adults who are care dependent are highly affected by incontinence, resulting in substantial informal caregiver burden. Understanding the experiences of these caregivers is needed to develop supportive programs that reduce caregiver burden and rates of institutionalization for care recipients. OBJECTIVES This systematic review aimed to critically appraise and synthesize the qualitative literature on the perceptions, experiences, and consequences of informal caregivers managing incontinence in community dwelling older adults. DESIGN A qualitative evidence synthesis using meta-aggregation. DATA SOURCES CINAHL, Embase, Ovid Medline, PsycInfo, Scopus, and ProQuest Dissertations and Theses. REVIEW METHODS A comprehensive search was conducted to identify qualitative studies of all designs, published in English from January 1970 to November 2020, reporting on the experiences of unpaid adult family members or friends providing care at home to an adult aged 60 or older with urinary and/or fecal incontinence. Screening, data extraction, and quality appraisal were conducted independently by two reviewers, with disagreements resolved by consensus with all team members. Joanna Briggs Institute (JBI) processes were used to assess study quality, and the dependability and credibility of both study findings and synthesized findings. All articles included met predetermined criteria. RESULTS Database searches yielded 1165 references, of which 117 full-text documents were screened. Seven articles of moderate to high methodological quality met eligibility criteria and were included. Studies occurred in nine countries with 134 participants who were mostly female spouses of the care recipient. From these eligible studies, 49 findings were extracted with 35 equivocal or credible findings eligible for meta-aggregation. Findings were synthesized into the following four categories: 1) emotional responses, 2) physical, financial, and social consequences, 3) family roles and caregiver support, and 4) management and coping strategies. CONCLUSIONS Informal caregivers experience many physical, psychosocial, and financial challenges in caring for an older family member with incontinence. Educational and supportive programs for managing incontinence should be multi-component and tailored to meet the individual needs of informal caregivers. Future research should incorporate strategies to cope with emotional responses and offer practical strategies for managing incontinence. PROSPERO REGISTRATION CRD42017069185.
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13
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Zachariou A, Filiponi M, Kaltsas A, Dimitriadis F, Champilomatis I, Paliouras A, Tsounapi P, Mamoulakis C, Takenaka A, Sofikitis N. Mirabegron Alleviates the Degree of Burden Experienced by Caregivers of Older Females with Mixed or Urge Incontinence: A Prospective Study. Clin Interv Aging 2021; 16:291-299. [PMID: 33628016 PMCID: PMC7897712 DOI: 10.2147/cia.s283737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 01/12/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose Older people, especially women, have the highest known prevalence of urinary incontinence (UI) of any other age-group. Continual care provision for elderly incontinent females is an incredibly arduous process, yet only very few studies have investigated the issue. Aim of the study was to evaluate the impact of mirabegron’s treatment on the degree of burden experienced by caregivers of elderly female patients with UI. Patients and Methods A hundred and eighty-six caregivers of older females with mixed or urgency UI besides various conditions (strokes, post-operative recovery after major surgery, etc.) were included in the study. Group A comprised 91 patients that did not want to receive any treatment for UI. Group B consisted of 95 elderly females treated for UI with mirabegron 50 mg/daily for three months. All caregivers completed the Zarit Burden Scale (ZBS) questionnaire at the outset and after the three months. All patients completed a bladder diary at the beginning and at the end of the observation/medication period. Results Patients receiving mirabegron presented a statistically significant improvement in UI parameters. Their caregivers showed a statistically significant decrease in the ZBS total score as well as separate domains. Conclusion This pilot study confirms that mirabegron administration can improve the quality of life of older females suffering from UI while substantially relieving caregiver burden. Recognizing the physical and emotional reactions of caregivers may help health providers deliver better support and resources to meet the needs of caregivers and patients alike.
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Affiliation(s)
- Athanasios Zachariou
- Urology Department, School of Medicine, Ioannina University, Ioannina, Greece.,Incontinence Unit, Physical Medicine and Rehabilitation Centre EU PRATTEIN, Volos, Greece
| | - Maria Filiponi
- Incontinence Unit, Physical Medicine and Rehabilitation Centre EU PRATTEIN, Volos, Greece
| | - Aris Kaltsas
- Urology Department, School of Medicine, Ioannina University, Ioannina, Greece.,Incontinence Unit, Physical Medicine and Rehabilitation Centre EU PRATTEIN, Volos, Greece
| | - Fotios Dimitriadis
- 1 Urology Department, School of Medicine, Aristotle University, Thessaloniki, Greece
| | | | | | - Panagiota Tsounapi
- Urology Department, School of Medicine, Tottori University, Yonago, Japan
| | | | - Atsushi Takenaka
- Urology Department, School of Medicine, Tottori University, Yonago, Japan
| | - Nikolaos Sofikitis
- Urology Department, School of Medicine, Ioannina University, Ioannina, Greece
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14
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Cross-Sectional Study of the Prevalence and Symptoms of Urinary Incontinence among Japanese Older Adults: Associations with Physical Activity, Health-Related Quality of Life, and Well-Being. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020360. [PMID: 33418845 PMCID: PMC7824891 DOI: 10.3390/ijerph18020360] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/30/2020] [Accepted: 01/01/2021] [Indexed: 11/16/2022]
Abstract
Urinary incontinence (UI) is a major social problem for older adults and leads to a decline in health-related quality of life (HRQoL), mental health, and physical activity. This study assessed the prevalence and symptoms of UI among older adults discharged from the hospital in Japan and investigated the association of UI symptoms with physical activity, HRQoL, and subjective well-being (SWB). By an international consultation, the Incontinence Questionnaire Short Form (ICIQ-SF) that assesses UI severity, was developed. Self-administered questionnaires were used to assess physical activity, HRQoL, SWB, and social demographic characteristics of the participants. In total, 145 participants (valid response rate, 48%; mean age, 78.6 ± 7.6 years) were included in the analysis. Multivariate logistic regression analysis was performed to identify significant factors associated with the presence of UI. Significant decreases in physical activity, HRQoL, and SWB were observed in patients with UI compared with those without UI (p < 0.05). Multivariate analysis revealed that age, number of reported conditions, and decreased SWB were associated with UI (p < 0.05). UI was associated with less physical activity and decreased mental health status in older adults (especially decreased SWB). Health-promoting measures for older adults with UI are essential for maintaining their well-being and extending healthy life expectancy.
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Manuelyan Z, Siomara Muñiz K, Stein E. Common Urinary and Bowel Disorders in the Geriatric Population. Med Clin North Am 2020; 104:827-842. [PMID: 32773048 DOI: 10.1016/j.mcna.2020.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The prevalence of urinary incontinence and other lower urinary tract symptoms increases with older age. These symptoms are more noticeable in men after the seventh decade of life and in women after menopause. Constipation and fecal incontinence are major causes of symptoms in elderly patients and can significantly impair quality of life. This article summarizes the current literature regarding the occurrence and implications of lower urinary tract and bowel symptoms in the geriatric population.
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Affiliation(s)
- Zara Manuelyan
- Department of Gastroenterology, Johns Hopkins University School of Medicine, 4940 Eastern Avenue, 3rd Floor, A Building Johns Hopkins Bayview, Baltimore, MD 21224, USA
| | - Keila Siomara Muñiz
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, 4940 Eastern Avenue, 301 Building, Suite 3100, Baltimore, MD 21224, USA
| | - Ellen Stein
- Department of Gastroenterology, Johns Hopkins University School of Medicine, 4940 Eastern Avenue, 3rd Floor, A Building Johns Hopkins Bayview, Baltimore, MD 21224, USA.
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Socio-demographic, Health and Functional Status Correlates of Caregiver Burden Among Care Recipients Age 60 Years and Older in Jamaica. J Community Health 2020; 46:174-181. [PMID: 32588297 DOI: 10.1007/s10900-020-00865-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The provision of care to older persons can impose significant burden on those providing care, burdens influenced by care recipient characteristic, caregiver attributes and availability of social support. This paper focuses on identifying relationships between caregiver burden and the socio-demographic, health and functional status attributes of care recipients age 60 years and older in Jamaica. A nationally representative cross-sectional study was done among persons providing non-institutional care for a single person 60 years and older. Data were obtained from a total of 180 caregivers from the four geographic health regions of Jamaica using the Zarit Burden Interview and a 44-question structured questionnaire. Associations between caregiver burden and socio-demographic, health and functional status of care recipients were examined and logistic regression applied to ascertain independent predictors of caregiver burden. The results revealed statistically significant relationships between caregiver burden and care recipients' receipt of conditional cash transfer grants and the ability to toilet independently. In multivariate analysis, ability to toilet remained a significant predictor of caregiver burden-Caregivers who had care recipients who were able to toilet independently were 71% less likely to have mild to severe caregiver burden compared to those who had care recipients that were not able to toilet (OR 0.29; 95% CI 0.14-0.57). Families, health care providers, social workers, state actors and caregivers should take this into account as they develop strategies to mitigate associated caregiver burden.
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Abstract
This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home.The articles in this new installment of the series provide simple and useful instructions that nurses should reinforce with family caregivers. This article is the second of two that provide an update on urinary incontinence and its management in older adults. It includes an informational tear sheet-Information for Family Caregivers-that contains links to the instructional videos. To use this series, nurses should read the articles first, so they understand how best to help family caregivers, and then encourage caregivers to watch the videos and ask questions. For additional information, see Resources for Nurses.
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Santini S, Fabbietti P, Lamura G. The impact of the absorbent products distribution system on family caregivers of older people with incontinence in Italy: perception of the support received. BMC Geriatr 2019; 19:239. [PMID: 31464585 PMCID: PMC6716917 DOI: 10.1186/s12877-019-1254-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 08/20/2019] [Indexed: 12/23/2022] Open
Abstract
Background Urinary incontinence is a chronic, age-related disorder, likely to increase in the future due to global population ageing. In Italy, as in most countries, older people with incontinence are often cared for by family caregivers, whose burden might be worsened by the perception of receiving an inadequate support, due to the lack of customized services. The aim of this study was to evaluate the impact of the absorbent products distribution method on family caregivers’ perception of the support received. Methods The study compared the distribution of pads to homes and in pharmacy via a survey reaching 101 family caregivers of older people with incontinence living in two geographical areas of the Marche Region (Central Italy) with different distribution systems. The association between “Quality of perceived support” (the outcome variable) and two types of absorbent products delivery methods (i.e. pharmacy and home distribution) was analysed by means of a general linear model. Results Findings show that family caregivers receiving pads at home (HODs) perceived a higher support than those gaining them at the pharmacy (PHADs) (respectively 68.1% vs 35%). The association between perceived support level and distribution system remained even after correction for confounding factors. 70.2% of PHADs reported “Poor well-being”, versus only 53.7% of HODs. The latter are more satisfied with the type of products distribution and thus less inclined to experiment different systems for the supply of products for the urinary continence (e.g. by voucher). The results are virtually reversed among PHADs and the difference is statistically significant (p < 0.001). Conclusions When family caregivers feel supported by a more customized service delivery system, their perception of the care-related burden is mitigated. Thus, it is important to consider the needs of both family caregivers and cared for older people, and not only of the latter for designing a more suitable distribution of absorbent products. The best solution could be leaving end-users the freedom to choose how they want to get products (e.g. voucher or personal budget). This requires a reorganization of the current pads delivery systems adopted by the Marche and by other Italian Regional Health Systems.
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Affiliation(s)
- Sara Santini
- IRCCS INRCA - National Institute of Health and Science on Ageing, Centre for Socio-Economic Research on Ageing, Via S. Margherita 5, 60124, Ancona, Italy.
| | - Paolo Fabbietti
- Unit of Geriatric Pharmacoepidemiology, IRCCS INRCA - National Institute of Health and Science on Ageing, Contrada Muoio Piccolo, 87100, Cosenza, Italy
| | - Giovanni Lamura
- IRCCS INRCA - National Institute of Health and Science on Ageing, Centre for Socio-Economic Research on Ageing, Via S. Margherita 5, 60124, Ancona, Italy
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Grimsland F, Seim A, Borza T, Helvik A. Toileting difficulties in older people with and without dementia receiving formal in-home care-A longitudinal study. Nurs Open 2019; 6:1055-1066. [PMID: 31367431 PMCID: PMC6650701 DOI: 10.1002/nop2.289] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 02/21/2019] [Accepted: 04/04/2019] [Indexed: 12/17/2022] Open
Abstract
AIM To estimate the prevalence of toileting difficulties over time among older people (≥70 years) with and without dementia receiving formal in-home care at baseline and to explore whether dementia at baseline was associated with toileting difficulties at the last assessment when adjusting for relevant covariates. We hypothesize that those with dementia have a higher prevalence and that baseline dementia is associated with toileting difficulties at last follow-up. DESIGN A longitudinal observational study with three assessments over 36 months. Older people (≥70 years) from 19 Norwegian municipalities with in-home care needs were included. The participants and their next of kin were interviewed. METHOD In total, 1,001 (68% women) persons with a mean (SD) age 83.4 (5.7) years participated at baseline. Toileting difficulties were assessed using Lawton and Brody's Physical Self-Maintenance Scale and Individual Nursing and Care Statistics. Information on physical comorbidity, number of prescribed drugs, cognitive function and formal care given was included. Dementia was diagnosed based on all information gathered. RESULTS At all time points, toileting difficulties were more prevalent in people with than without dementia. In adjusted analyses, dementia at baseline was associated with toileting difficulties at the last assessment. Nursing home admission was associated with increased odds for toileting difficulties.
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Affiliation(s)
- Frida Grimsland
- Department of Public Health and Nursing, Faculty of Medicine and Health SciencesNorwegian University of Science and Technology (NTNU)TrondheimNorway
| | - Arnfinn Seim
- Department of Public Health and Nursing, Faculty of Medicine and Health SciencesNorwegian University of Science and Technology (NTNU)TrondheimNorway
| | - Tom Borza
- Centre for Old Age Psychiatric ResearchInnlandet Hospital TrustOttestadNorway
| | - Anne‐Sofie Helvik
- General Practice Research Unit, Department of Public Health and Nursing, Faculty of Medicine and Health SciencesNorwegian University of Science and Technology (NTNU)TrondheimNorway
- St Olavs University HospitalTrondheimNorway
- Norwegian National Advisory Unit on Ageing and HealthVestfold Health TrustTønsbergNorway
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Sleep Quality and Daytime Sleepiness Among Women With Urgency Predominant Urinary Incontinence. Female Pelvic Med Reconstr Surg 2019; 24:76-81. [PMID: 29300259 DOI: 10.1097/spv.0000000000000547] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this study was to examine the strength and direction of the association between urinary symptoms and both poor quality sleep and daytime sleepiness among women with urgency urinary incontinence. METHODS A planned secondary analysis of baseline characteristics of participants in a multicenter, double-blinded, 12-week randomized controlled trial of pharmacologic therapy for urgency-predominant urinary incontinence in ambulatory women self-diagnosed by the 3 Incontinence Questions was performed. Urinary symptoms were assessed by 3-day voiding diaries. Quality of sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI) and daytime sleepiness using the Epworth Sleepiness Scale. RESULTS Of the 640 participants, mean (SD) age was 56 (±14) years and 68% were white. Participants reported an average of 3.9 (±3.0) urgency incontinence episodes per day and 1.3 (±1.3) episodes of nocturia per night. At baseline, 57% had poor sleep quality (PSQI score, >5) and 17% reported daytime sleepiness (Epworth Sleepiness Scale score, >10). Most women (69%) did not use sleeping medication during the prior month, whereas 13% reported use of sleeping medication 3 or more times per week. An increase in total daily incontinence episodes, total daily urgency incontinence episodes, total daily micturitions, and moderate to severe urge sensations were all associated with higher self-report of poor sleep quality according to the PSQI (all P ≤ 0.01). Higher scores on the Bother Scale and the Health-Related Quality of Life for overactive bladder on the Overactive Bladder Questionnaire were similarly associated with higher rates of poor sleep quality (both P ≤ 0.01). In subgroup analysis of those who took sleeping medications less than twice a week, there was still a significant relationship between incontinence measures and quality of sleep as measured by the PSQI. In multivariable analyses, greater frequency of nighttime urgency incontinence was associated with poor sleep quality (P = 0.03). CONCLUSIONS Among ambulatory women with urgency urinary incontinence, poor sleep quality is common and greater frequency of incontinence is associated with a greater degree of sleep dysfunction. Women seeking urgency urinary incontinence treatment should be queried about their sleeping habits so that they can be offered appropriate interventions.
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Zhang AY, Xu X. Prevalence, Burden, and Treatment of Lower Urinary Tract Symptoms in Men Aged 50 and Older: A Systematic Review of the Literature. SAGE Open Nurs 2018; 4:2377960818811773. [PMID: 33415211 PMCID: PMC7774430 DOI: 10.1177/2377960818811773] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 10/17/2018] [Indexed: 11/18/2022] Open
Abstract
We conducted a systematic review of literature from the years 2000 through 2017 on the prevalence and burden of lower urinary tract symptoms (LUTS) in men aged 50 and older, and medical treatments of and alternative nonmedical approaches to LUTS. EBSCOhost (Medline with Full Text) was searched for observational, experimental, and review studies in peer-reviewed journals in the English language. Our review found that LUTS were highly prevalent in the world and estimated to affect 2.3 billion people in 2018, with 44.7% being men. Men with LUTS suffer from not only burdensome symptoms such as nocturia and urgency but also adverse psychological consequences (e.g., anxiety and depression) and financial burden. Current medical treatments are clinically effective, but their efficacy is compromised by side effects and low compliance rates. Alternative nonmedical treatments for LUTS were also sought worldwide. There is evidence that lifestyle modifications such as pelvic muscle exercises and bladder training, physical activity, dietary modification, and nutritional supplements can alleviate LUTS and improve patient quality of life; however, evidence based on rigorous methodology remains minimal and cannot be generalized across populations. Evidence of effectiveness of weight loss programs to reduce LUTS is inconclusive. We conclude that although behavioral treatment is a promising approach to alleviating LUTS, especially when combined with medical treatments, well-designed randomized controlled and longitudinal clinical trials on behavioral treatments of LUTS are still needed. Minimally invasive procedures and neuromodulation therapy also show positive results of alleviating LUTS but require further research as well.
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Affiliation(s)
- Amy Y Zhang
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Xinyi Xu
- University Hospitals Cleveland Medical Center Seidman Cancer Center, Cleveland, OH, USA
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Experiences Related to Urinary Incontinence of Stroke Patients: A Qualitative Descriptive Study. J Neurosci Nurs 2018; 50:42-47. [DOI: 10.1097/jnn.0000000000000336] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Urinary incontinence symptoms are highly prevalent among women, have a substantial effect on health-related quality of life and are associated with considerable personal and societal expenditure. Two main types are described: stress urinary incontinence, in which urine leaks in association with physical exertion, and urgency urinary incontinence, in which urine leaks in association with a sudden compelling desire to void. Women who experience both symptoms are considered as having mixed urinary incontinence. Research has revealed overlapping potential causes of incontinence, including dysfunction of the detrusor muscle or muscles of the pelvic floor, dysfunction of the neural controls of storage and voiding, and perturbation of the local environment within the bladder. A full diagnostic evaluation of urinary incontinence requires a medical history, physical examination, urinalysis, assessment of quality of life and, when initial treatments fail, invasive urodynamics. Interventions can include non-surgical options (such as lifestyle modifications, pelvic floor muscle training and drugs) and surgical options to support the urethra or increase bladder capacity. Future directions in research may increasingly target primary prevention through understanding of environmental and genetic risks for incontinence.
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Affiliation(s)
- Yoshitaka Aoki
- Department of Urology, University of Fukui Faculty of Medical Sciences, Fukui, Japan
| | - Heidi W Brown
- Departments of Obstetrics and Gynecology &Urology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Linda Brubaker
- Department of Reproductive Medicine, University of California San Diego, San Diego, California, USA
| | - Jean Nicolas Cornu
- Department of Urology, Charles Nicolle Hospital, University of Rouen Normandy, Rouen, France
| | - J Oliver Daly
- Department of Obstetrics and Gynaecology, Western Health, Victoria, Australia
| | - Rufus Cartwright
- Department of Urogynaecology, St Mary's Hospital, London, UK
- Department of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, London W2 1PG, UK
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Alas A, Chinthakanan O, Espaillat L, Plowright L, Aguilar V, Davila GW. Are suburethral slings less successful in the elderly? Int Urogynecol J 2016; 28:553-559. [PMID: 27629119 DOI: 10.1007/s00192-016-3132-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 08/18/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION AND HYPOTHESIS We aimed to evaluate the success of suburethral slings in women ≥70 years of age. METHODS This was a retrospective cohort study of women who underwent suburethral sling placement. Subjects were separated into three groups: ≤50 years of age (group 1), 51 to 69 years of age (group 2), and ≥70 years of age (group 3). The primary aim was to evaluate success as defined by ≥ improved on a validated patient improvement satisfaction score and a negative postoperative standardized stress test. RESULTS There were 1,464 subjects. Mean age was 44.51 ± 4.25 (n = 296) for group 1, 60.5 ± 5.28 (n = 680) for group 2, and 77.68 ± 5.41 (n = 488) for group 3. The median follow-up was 26 (6-498) weeks, 45 (6-498) weeks, and 42 (6-543) weeks, for groups 1, 2, and 3 respectively. Multiple logistic regression analysis demonstrated no difference in sling success according to age stratification. Lower success was associated with having had a previous sling (adjusted OR 0.25, 95 % CI 0.12-0.5), having detrusor overactivity (adjusted OR 0.44, 95 % CI 0.28-0.69), and having a history of urge urinary incontinence (UUI) for ≥ 4 years (adjusted OR 0.54, 95 % CI 0.31-0.95). CONCLUSIONS There is no difference in sling success between the elderly and younger populations. However, those with previous sling surgery or a long standing history of UUI may be at a higher risk of failure.
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Affiliation(s)
- Alexandriah Alas
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL, 33331, USA
| | - Orawee Chinthakanan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Luis Espaillat
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL, 33331, USA
| | - Leon Plowright
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL, 33331, USA
| | - Vivian Aguilar
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL, 33331, USA
| | - G Willy Davila
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL, 33331, USA.
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Suzuki M, Iguchi Y, Igawa Y, Yoshida M, Sanada H, Miyazaki H, Homma Y. Ultrasound‐assisted prompted voiding for management of urinary incontinence of nursing home residents: Efficacy and feasibility. Int J Urol 2016; 23:786-90. [DOI: 10.1111/iju.13156] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 05/31/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Motofumi Suzuki
- Department of Urology Tokyo Teishin Hospital Tokyo Japan
- Department of Urology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Yasuhiro Iguchi
- Megumi Long‐Term Care Health Facility Departments of Continence Medicine Tokyo Japan
| | - Yasuhiko Igawa
- Department of Continence Medicine Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Mikako Yoshida
- Life Support Technology (Molten) Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Hiromi Sanada
- Gerontological Nursing/Wound Care Management Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Hideyo Miyazaki
- Department of Urology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Yukio Homma
- Department of Urology Graduate School of Medicine The University of Tokyo Tokyo Japan
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Lobchuk MM, Rosenberg F. A qualitative analysis of individual and family caregiver responses to the impact of urinary incontinence on quality of life. J Wound Ostomy Continence Nurs 2016; 41:589-96. [PMID: 25377110 DOI: 10.1097/won.0000000000000064] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of the original mixed-design study was to compare affected individual and family caregiver perceptions of urinary incontinence quality of life in relation to their empathic responses toward one another and to explore their qualitative responses of factors that hinder or facilitate these responses. The aim of this secondary analysis is to report responses shared by affected individuals and family caregivers on how their lives have been impacted by urinary incontinence. DESIGN Qualitative study with content analysis. SUBJECTS AND SETTING The sample comprised 13 persons with urinary incontinence and 13 family caregivers. Their mean age was 78 years and the mean age for caregivers was 67 years. Caregivers were mainly the spouses or daughters of affected respondents. Interviews were conducted in participants' homes in Winnipeg, Manitoba, Canada. METHODS Data were collected via 26 audio-recorded interviews. Content analysis was used to capture major themes arising from the data. RESULTS Five major themes with respective subthemes highlight how urinary incontinence influenced the quality of life of affected individuals and their family caregivers, including (1) life changes, (2) psychological responses and coping, (3) painful responses of others, (4) reticence to seek medical attention, and (5) advice to health care professionals. CONCLUSIONS Health care professionals should recognize that dealing with urinary incontinence in the home is a "team effort" between affected individuals and family caregivers. Educational efforts need to counter attitudes in care providers who avoid talking about urinary continence and enhance sensitivities toward affected individuals' and family caregivers' ongoing need for control in continence care based on their unique needs and preferences.
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Affiliation(s)
- Michelle M Lobchuk
- Michelle M. Lobchuk, RN, PhD, Associate Professor and Manitoba Research Chair in Caregiver Communication, Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada. Fran Rosenberg, RN, BN, GNC(c), CRN(c), Nurse Continence Advisor, Continence Care Clinic, Riverview Health Centre, Winnipeg, Manitoba, Canada
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Anterior Urethral Stricture Disease Negatively Impacts the Quality of Life of Family Members. Adv Urol 2016; 2016:3582862. [PMID: 27034658 PMCID: PMC4791496 DOI: 10.1155/2016/3582862] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 02/14/2016] [Indexed: 11/17/2022] Open
Abstract
Purpose. To quantify the quality of life (QoL) distress experienced by immediate family members of patients with urethral stricture via a questionnaire given prior to definitive urethroplasty. The emotional, social, and physical effects of urethral stricture disease on the QoL of family members have not been previously described. Materials and Methods. A questionnaire was administered prospectively to an immediate family member of 51 patients undergoing anterior urethroplasty by a single surgeon (SBB). The survey was comprised of twelve questions that addressed the emotional, social, and physical consequences experienced as a result of their loved one. Results. Of the 51 surveyed family members, most were female (92.2%), lived in the same household (86.3%), and slept in the same room as the patient (70.6%). Respondents experienced sleep disturbances (56.9%) and diminished social lives (43.1%). 82.4% felt stressed by the patient's surgical treatment, and 83.9% (26/31) felt that their intimacy was negatively impacted. Conclusions. Urethral stricture disease has a significant impact on the family members of those affected. These effects may last decades and include sleep disturbance, decreased social interactions, emotional stress, and impaired sexual intimacy. Treatment of urethral stricture disease should attempt to mitigate the impact of the disease on family members as well as the patient.
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Di Rosa M, Lamura G. The impact of incontinence management on informal caregivers' quality of life. Aging Clin Exp Res 2016; 28:89-97. [PMID: 25957737 DOI: 10.1007/s40520-015-0367-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 04/24/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND The presence of incontinence symptoms might affect the quality of life (QoL) of those providing informal care to people suffering from them, causing social isolation, financial problems, psychological and physical exhaustion. AIMS This study aimed at assessing whether urinary and/or fecal incontinence in people aged 60 and over affects the level of burden in their informal caregivers. METHODS QoL was assessed amongst 304 informal caregivers of older people suffering from urinary and/or fecal incontinence, and compared to that reported by 305 caregivers of non-incontinent older relatives, all living in Italy. All participants were administered a questionnaire focused on: characteristics and conditions of the cared for; details of the care activity; emotions experienced by caregivers; attitudes of caregivers; reasons for providing care; availability of information and support; demographics. RESULTS Findings show that, when no incontinence was reported, the longer was the caregiving situation, the better was the caregivers' QoL, which was instead negatively affected by the lack of a support network. As for caregivers' feelings, neither positive nor negative emotions influenced their QoL in a significant way. In terms of caregiver's role, those who felt overwhelmed or loaded with responsibility reported a lower QoL, while the opposite was found among those who felt rewarded and supported, even when incontinence-of any kind-was present. CONCLUSIONS The management of incontinence does have a negative impact on caregivers' QoL, but subjective factors might play a mitigating role on such an impact.
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Affiliation(s)
- Mirko Di Rosa
- Scientific Direction, National Institute of Health and Science on Aging-I.N.R.C.A., Via S. Margherita 5, 60124, Ancona, Italy.
| | - Giovanni Lamura
- Centre for Socio-Economic Research on Ageing, National Institute of Health and Science on Aging-I.N.R.C.A., Via S. Margherita 5, 60124, Ancona, Italy
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Santini S, Andersson G, Lamura G. Impact of incontinence on the quality of life of caregivers of older persons with incontinence: A qualitative study in four European countries. Arch Gerontol Geriatr 2015; 63:92-101. [PMID: 26620553 DOI: 10.1016/j.archger.2015.10.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 10/28/2015] [Accepted: 10/29/2015] [Indexed: 10/22/2022]
Abstract
The aim of this study was to assess the impact of incontinence management on informal caregivers of older persons with incontinence. In order to investigate this phenomenon in different welfare systems via qualitative interviews and a content analysis methodology, the study was carried out in four European countries (Italy, the Netherlands, Slovak Republic and Sweden). To this purpose, 50 semi-structured interviews were conducted with spouses and children of older people receiving their help to manage the consequences of involuntary urinary and/or faecal leakage. Findings show that incontinence has a remarkably strong effect on caregivers' quality of life, because it results in progressive social isolation, causing them financial problems as well as psychological and physical exhaustion. The lack of appropriate support and the general silence regarding the problem, which is still considered a taboo by many, aggravate the caregivers' situation. It is therefore crucial that caregivers can count on a strong public and private support network, appropriate information and suitable incontinent products, in order to better handle incontinence and care tasks in general.
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Affiliation(s)
- Sara Santini
- INRCA-National Research Centre on Aging, Via S. Margherita 5, 60124 Ancona, Italy.
| | | | - Giovanni Lamura
- INRCA-National Research Centre on Aging, Via S. Margherita 5, 60124 Ancona, Italy
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Cost-Effectiveness of Including a Nurse Specialist in the Treatment of Urinary Incontinence in Primary Care in the Netherlands. PLoS One 2015; 10:e0138225. [PMID: 26426124 PMCID: PMC4591337 DOI: 10.1371/journal.pone.0138225] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 08/27/2015] [Indexed: 11/19/2022] Open
Abstract
Objective Incontinence is an important health problem. Effectively treating incontinence could lead to important health gains in patients and caregivers. Management of incontinence is currently suboptimal, especially in elderly patients. To optimise the provision of incontinence care a global optimum continence service specification (OCSS) was developed. The current study evaluates the costs and effects of implementing this OCSS for community-dwelling patients older than 65 years with four or more chronic diseases in the Netherlands. Method A decision analytic model was developed comparing the current care pathway for urinary incontinence in the Netherlands with the pathway as described in the OCSS. The new care strategy was operationalised as the appointment of a continence nurse specialist (NS) located with the general practitioner (GP). This was assumed to increase case detection and to include initial assessment and treatment by the NS. The analysis used a societal perspective, including medical costs, containment products (out-of-pocket and paid by insurer), home care, informal care, and implementation costs. Results With the new care strategy a QALY gain of 0.005 per patient is achieved while saving €402 per patient over a 3 year period from a societal perspective. In interpreting these findings it is important to realise that many patients are undetected, even in the new care situation (36%), or receive care for containment only. In both of these groups no health gains were achieved. Conclusion Implementing the OCSS in the Netherlands by locating a NS in the GP practice is likely to reduce incontinence, improve quality of life, and reduce costs. Furthermore, the study also highlighted that various areas of the continence care process lack data, which would be valuable to collect through the introduction of the NS in a study setting.
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Abstract
OBJECTIVES The aim of this study was to assess effect of adult diapers on health-related quality of life (HRQOL) and the independent level of performing activities of daily living (ADLs) in people with urinary or fecal incontinence. Psychological consequences of patients' caregivers were also measured. METHODS This quasi-experimental study was conducted at two rehabilitation centers in Thailand. People aged 15 years or greater with chronic urinary or fecal incontinence were eligible. Study participants received adult diapers for 10 weeks after recruitment. Thai EuroQol Five Dimensions (EQ-5D) and the Barthel Index were measured at baseline and weeks 2, 6, and 10 to evaluate HRQOL and the independent level of performing ADLs, respectively. The Braden Scale was used to assess the risk of having pressure ulcers. Mean differences in the Thai EQ-5D, the Barthel Index, and the Braden Scale, before and after receiving adult diapers, were estimated using a multilevel linear regression model. RESULTS There were ninety patients and forty-eight caregivers who took part in this study. HRQOL and independent level of performing ADLs had improved significantly by week 10 after receiving adult diapers with mean differences of 0.102 (95% confidence interval [CI], 0.046-0.158) and 4.40 (95% CI, 1.74-7.07), respectively. The risk of having pressure ulcers had significantly decreased by 67 percent (95% CI, 16 percent-78 percent) by week 10 after receiving adult diapers. CONCLUSIONS The results indicate a significant improvement of HRQOL and the independent level of performing ADLs among incontinent patients after receiving adult diapers. These results were used to inform the development of the health benefits package under the Universal Health Coverage Scheme in Thailand.
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Remes-Troche JM, Torres-Aguilera M, Montes-Martínez V, Jiménez-García VA, Roesch-Dietlen F. Prevalence of irritable bowel syndrome in caregivers of patients with chronic diseases. Neurogastroenterol Motil 2015; 27:824-31. [PMID: 25817438 DOI: 10.1111/nmo.12556] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 02/26/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Caregivers are an at-risk population for psychic and physical diseases such as irritable bowel syndrome (IBS). However, it is not known whether providing care for the chronically ill patient can be considered a risk factor for developing IBS. In this study, our aim was to evaluate the prevalence of IBS according to the Rome II criteria in a group of caregivers. METHODS A cross-sectional study was conducted through an evaluation of caregivers of chronically ill patients. Subjects completed questionnaires including the Rome II Modular Questionnaire, the Hospital Anxiety and Depression Scale, the Zarit Caregiver Burden Interview (ZCBI) (an instrument for evaluating the burden experienced by caregivers), and the irritable bowel syndrome quality of life (IBS-QoL) questionnaire. KEY RESULTS Ninety-six primary caregivers (mean age was 43.6 ± 13.7 years and 87% were women) were evaluated. The mean length of time providing care was 37.6 months (3-288 months). Forty-seven caregivers (49%) presented with IBS. The caregivers with IBS had higher scores in the global ZCBI score (47 ± 8 vs 28 ± 8, p = 0.001) and on the anxiety and depression scale (p = 0.001) than those that did not have IBS. A total of 72% were diagnosed with caregiver stress syndrome; 42 of them had IBS according to the Rome II questionnaire (60% vs 18%, p = 0.001, relative risk 3.28, 95% CI: 1.4-7.4). CONCLUSIONS & INFERENCES Caregivers of chronically ill patients have a high prevalence of IBS, which is associated with depression, anxiety, and poor QoL.
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Affiliation(s)
- J M Remes-Troche
- Digestive Physiology and Gastrointestinal Motility Laboratory, Instituto de Investigaciones Medico Biológicas, Universidad Veracruzana, Veracruz, Mexico
| | - M Torres-Aguilera
- Digestive Physiology and Gastrointestinal Motility Laboratory, Instituto de Investigaciones Medico Biológicas, Universidad Veracruzana, Veracruz, Mexico
| | - V Montes-Martínez
- Department of Internal Medicine, Hospital Regional de Alta Especialidad de Veracruz, Veracruz, Mexico
| | - V A Jiménez-García
- Digestive Physiology and Gastrointestinal Motility Laboratory, Instituto de Investigaciones Medico Biológicas, Universidad Veracruzana, Veracruz, Mexico
| | - F Roesch-Dietlen
- Digestive Physiology and Gastrointestinal Motility Laboratory, Instituto de Investigaciones Medico Biológicas, Universidad Veracruzana, Veracruz, Mexico
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Concomitant use of acetylcholine esterase inhibitors and urinary antispasmodics among Finnish community-dwelling persons with Alzheimer disease. J Clin Psychopharmacol 2014; 34:722-7. [PMID: 25207860 DOI: 10.1097/jcp.0000000000000218] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Concomitant use of acetylcholine esterase inhibitors (AChEIs) and anticholinergic drugs, such as urinary antispasmodics (UA), is generally considered as inappropriate because of their opposite pharmacological actions. However, prevalence and the duration or factors associated with concomitant use have not been previously studied among community-dwelling persons with Alzheimer disease (AD). The aim of this study was to examine the prevalence and duration of concomitant use of AChEIs and UAs among community-dwelling persons with AD and factors associated with concomitant use. Register-based data of the MEDALZ-2005 Study included all community-dwelling persons with clinically diagnosed AD at the end of year 2005 in Finland. Persons using AChEI drugs during the 4-year follow-up (2006-2009) were included in the present study (n = 20,442). Among AChEI users, 1576 persons used UA during the follow-up. Prevalence of concomitant use of AChEIs and UAs was 7.3% (n = 1491) during the 4-year follow-up. The median duration of concomitant use was 236 days. Factors associated with concomitant use were age younger than 80 years (odds ratio [OR], 1.20; 95% confidence interval [CI], 1.08-1.34), male sex (OR, 1.16; 95% CI, 1.04-1.30), Parkinson disease (OR, 1.98; 95% CI, 1.55-2.52), diabetes (OR, 1.25; 95% CI, 1.08-1.45), and prostatic cancer (OR, 1.54; 95% CI, 1.13-2.09). Despite their antagonizing action, concomitant use of AChEIs and UAs was quite common among Finnish community-dwelling persons with AD. In addition, duration of concomitant use was comparatively long. It is recommended to consider some other options than UAs to treat urinary incontinence among persons with AD.
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Wagg AS, Newman DK, Leichsenring K, van Houten P. Developing an internationally-applicable service specification for continence care: systematic review, evidence synthesis and expert consensus. PLoS One 2014; 9:e104129. [PMID: 25121511 PMCID: PMC4133406 DOI: 10.1371/journal.pone.0104129] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 07/09/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Global demographic trends suggest that the incidence of both urinary and faecal incontinence will rise in the coming years, bringing significant health and economic implications for both patients and payers. There is limited organisational evidence to guide payers and providers about service configuration which will deliver efficient guideline-compliant, high-quality patient care. OBJECTIVES To create, using evidence from a systematic review, qualitative data and expert consensus an internationally applicable service specification for continence care. METHOD Evidence was obtained from a systematic and grey literature review of published randomised controlled trials and quasi-experimental studies reporting efficacy of continence service design at the level of the community dwelling patient with either bladder or bowel incontinence, governmental reports and policy frameworks supplemented by data from 47 semi-structured interviews with clinicians, patients, patient-representatives and policy experts from four geographies broadly representative of different healthcare systems. RESULTS A number of themes related to current and potential future organisation of continence care were identified from the data. A modular service specification with eight core components was created including case detection, initial assessment and treatment, case co-ordination, caregiver support, community-based support, specialist assessment and treatment, use of containment products, and use of technology. Within this framework important key recommendations are: ensure robust referral pathways, shift assessment for case coordination to nurses specializing in continence care, promote self-management and technology, use comprehensive assessment tools and service performance targets based on outcome and operational measures. CONCLUSIONS This study has defined practice gaps in the provision of continence services and described eight core components of a service specification for incontinence that commissioners and payers of health and social care could consider using to provide high-quality continence care. A shift towards a community-delivered, nurse-led model appears to be associated with clinical and cost-effective care for people with bladder and bowel incontinence.
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Affiliation(s)
- Adrian S. Wagg
- University of Alberta, Department of Medicine, Edmonton, AB, Canada
| | - Diane K. Newman
- University of Pennsylvania, Division of Urology, Philadelphia, Pennsylvania, United States of America
| | - Kai Leichsenring
- European Centre for Social Welfare Policy and Research, Vienna, Austria
| | - Paul van Houten
- Zonnhuisgroep Amstelland, Elderly Medicine, Amstelveen, the Netherlands
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Radstaake M, Didden R, Giesbers S, Korzilius H, Peters-Scheffer N, Lang R, von Gontard A, Curfs LMG. Incontinence in individuals with Angelman syndrome: a comparative study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:4184-4193. [PMID: 24076983 DOI: 10.1016/j.ridd.2013.09.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Revised: 09/02/2013] [Accepted: 09/03/2013] [Indexed: 06/02/2023]
Abstract
Frequency and type of incontinence and variables associated with incontinence were assessed in individuals with Angelman syndrome (AS; n=71) and in a matched control group (n=69) consisting of individuals with non-specific intellectual disability (ID). A Dutch version of the "Parental Questionnaire: Enuresis/Urinary Incontinence" (Beetz, von Gontard, & Lettgen, 1994) was administered and information on primary caretakers' perspectives regarding each individual's incontinence was gathered. Results show that diurnal incontinence and fecal incontinence during the day more frequently occurred in the control group than in the AS group. In both groups, nocturnal enuresis was the most common form of incontinence. More incontinence was seen in individuals with AS who were younger, had a lower level of adaptive functioning and/or had epilepsy. Individuals with AS were able to stay dry for longer periods of time than the controls and often showed both in-toilet urination and urinary accidents during the day, whereas accidents and correct voids during the day were more set apart in the control group. Also, persons with AS had a lower micturition frequency implying possible voiding postponement. Both groups showed high rates of LUTS (lower urinary tract symptoms) possibly indicative of functional bladder disorders such as voiding postponement, dysfunctional voiding, or even an underactive bladder. In general, most primary caretakers reported severe intellectual disability as the main cause for urinary incontinence. Based on these results incontinence does not appear to be part of the behavioral phenotype of Angelman syndrome. Therefore, pediatric or urologic diagnostics and treatment are recommended for all persons with incontinence and intellectual disability. Further implications for practice and research are given.
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Affiliation(s)
- Maartje Radstaake
- Department of Special Education, Radboud University Nijmegen, The Netherlands; Daelzicht, Heel, The Netherlands.
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Ostaszkiewicz J, Eustice S, Roe B, Thomas LH, French B, Islam T, O'Connell B, Cody JD. Toileting assistance programmes for the management of urinary incontinence in adults. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2013. [DOI: 10.1002/14651858.cd010589] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Joan Ostaszkiewicz
- Deakin University; School of Nursing and Midwifery; 221 Burwood Hwy Burwood Victoria Australia 3125
| | - Sharon Eustice
- Peninsula Community Health; Truro Health Park; Infirmary Hill Truro Cornwall UK TR1 2LA
| | - Brenda Roe
- Edge Hill University; Evidence based Practice Research Centre (EPRC); St Helens Road Ormskirk Lancashire UK L39 4QP
| | - Lois H Thomas
- University of Central Lancashire; School of Health; Room 434 Brook Building Preston Lancashire UK PR1 2HE
| | - Beverley French
- University of Central Lancashire; Department of Nursing and Caring Sciences; Room 434 Brook Building Preston Lancashire UK PR1 2HE
| | - Tasneem Islam
- Deakin University; School of Nursing and Midwifery; 221 Burwood Hwy Burwood Victoria Australia 3125
| | - Bev O'Connell
- University of Manitoba; Faculty of Nursing; Chancellor's Drive Winnipeg Manitoba Canada
| | - June D Cody
- University of Aberdeen; Cochrane Incontinence Review Group; 2nd Floor, Health Sciences Building Health Sciences Building Foresterhill Aberdeen UK AB25 2ZD
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Giesbers S, Didden R, Radstaake M, Korzilius H, von Gontard A, Lang R, Smeets E, Curfs LMG. Incontinence in Individuals with Rett Syndrome: A Comparative Study. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2012; 24:287-300. [PMID: 22639525 PMCID: PMC3345182 DOI: 10.1007/s10882-012-9271-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Frequency and type of incontinence and its association with other variables were assessed in females with Rett Syndrome (RS) (n = 63), using an adapted Dutch version of the 'Parental Questionnaire: Enuresis/Urinary Incontinence' (Beetz et al. 1994). Also, incontinence in RS was compared to a control group consisting of females with non-specific (mixed) intellectual disability (n = 26). Urinary incontinence (UI) (i.e., daytime incontinence and nocturnal enuresis) and faecal incontinence (FI) were found to be common problems among females with RS that occur in a high frequency of days/nights. UI and FI were mostly primary in nature and occur independent of participants' age and level of adaptive functioning. Solid stool, lower urinary tract symptoms and urinary tract infections (UTI's) were also common problems in females with RS. No differences in incontinence between RS and the control group were found, except for solid stool that was more common in RS than in the control group. It is concluded that incontinence is not part of the behavioural phenotype of RS, but that there is an increased risk for solid stool in females with RS.
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Affiliation(s)
- Sanne Giesbers
- Behavioural Science Institute, Radboud University Nijmegen, PO Box 9104, Nijmegen, 6500 HE The Netherlands
| | - Robert Didden
- Behavioural Science Institute, Radboud University Nijmegen, PO Box 9104, Nijmegen, 6500 HE The Netherlands
| | - Maartje Radstaake
- Behavioural Science Institute, Radboud University Nijmegen, PO Box 9104, Nijmegen, 6500 HE The Netherlands
| | - Hubert Korzilius
- Institute for Management Research, Radboud University Nijmegen, Nijmegen, the Netherlands
| | - Alexander von Gontard
- Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg, Germany
| | - Russell Lang
- Clinic for Autism Research Evaluation and Support, Texas State University, San Marcos, TX USA
| | - Eric Smeets
- Department of Clinical Genetics, University of Maastricht, Maastricht, the Netherlands
| | - Leopold M. G. Curfs
- Department of Clinical Genetics, University of Maastricht, Maastricht, the Netherlands
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Fitz FF, Costa TF, Yamamoto DM, Magalhães Resende AP, Stüpp L, Ferreira Sartori MG, Castello Girão MJB, Castro RA. Impact of pelvic floor muscle training on the quality of life in women with urinary incontinence. Rev Assoc Med Bras (1992) 2012. [DOI: 10.1016/s0104-4230(12)70175-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Faní Fitz F, Fonseca Costa T, Mari Yamamoto D, Magalhães Resende AP, Stüpp L, Ferreira Sartori MG, Batista Castello Girão MJ, Aquino Castro R. Impacto do treinamento dos músculos do assoalho pélvico na qualidade de vida em mulheres com incontinência urinária. Rev Assoc Med Bras (1992) 2012. [DOI: 10.1590/s0104-42302012000200010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Tamanini JTN, Santos JLF, Lebrão ML, Duarte YAO, Laurenti R. Association between urinary incontinence in elderly patients and caregiver burden in the city of Sao Paulo/Brazil: Health, Wellbeing, and Ageing Study. Neurourol Urodyn 2011; 30:1281-5. [PMID: 21560151 DOI: 10.1002/nau.21040] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2010] [Accepted: 11/01/2010] [Indexed: 11/11/2022]
Abstract
AIM Some elderly patients with incontinence require the care of third parties, known as caregivers. Such care can occur on a daily basis leaving little opportunity for the caregiver to take care of himself/herself. The aims are to assess the association between urinary incontinence in elderly patients and caregiver burden and identify independent factors for caregiver's burden in the city of Sao Paulo, Brazil. METHODS The Pan-American Health Organization and World Health Organization coordinated a multicenter study named Health, Wellbeing and Aging (SABE Study) in elderly people living in seven countries of Latin America and the Caribbean. In Brazil, the study population carried out in São Paulo in the year 2000 and reassessed in 2006 (COHORT A). Urinary incontinence was assessed by ICIQ-SF and caregiver burden by means of Zarit Burden Scale. RESULTS A total of 327 patients with caregivers were included in the study. The general prevalence of urinary incontinence was 25.8%, higher among the women. There was a significant positive association between caregiver burden and incontinent patients, demonstrating that urinary incontinence in elderly patients produced greater caregiver burden. In the present study, the variables with significant correlations were assessed using the multivariate logistic regression model. Category 2 of the ICIQ-SF (incontinent patients) increased the chances of caregiver burden 1.96-fold in comparison to Category 1 (continent patients). Likewise, the category of impaired cognition increased the chances of caregiver burden 2.34-fold. CONCLUSIONS Urinary incontinence and cognitive impairment in elderly patients were associated to an increase in caregiver burden.
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Affiliation(s)
- José Tadeu Nunes Tamanini
- Departamento de Medicina, Centro de Ciências Biológicas de da Saúde, Universidade Federal de São Carlos, SP, Brazil.
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Abstract
Several recent population-based studies have provided insight into the clinical importance and impact of overactive bladder (OAB). Although OAB can affect anyone at any age, the prevalence tends to increase with advancing age. Diuretic use is also common among older adults, as the prevalence of clinical conditions such as hypertension and heart failure requiring its use increases markedly with age. By causing increased formation of urine by the kidneys, diuretics increase urinary frequency and may cause urinary urgency and incontinence. This review provides a summary of available data, focusing on the association between OAB and diuretic use in the elderly. Although there is very little research work in this area, available studies have provided insight into the possible contribution of diuretic use to OAB in the elderly. Based on a recent report, OAB symptoms are common among older adults using diuretics, particularly the loop-type, and are associated with poor quality of life. More studies are required to fully understand the association between diuretic use and OAB, particularly its impact on health-related quality of life.
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