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Matsumoto A, Yoshimura Y, Nagano F, Shimazu S, Shiraishi A, Kido Y, Bise T, Kuzuhara A, Hori K, Hamada T, Yoneda K, Maekawa K. Exploring the impact of anticholinergic burden on urinary independence: insights from a post-stroke cohort of older adults. Int J Clin Pharm 2024:10.1007/s11096-024-01725-x. [PMID: 38635116 DOI: 10.1007/s11096-024-01725-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 03/13/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Anticholinergic burden is associated with adverse events in the older adults. However, there is a lack of evidence regarding its effect on urinary independence in stroke patients. AIM This study examined the association between increased anticholinergic burden during hospitalization and urinary independence in post-stroke patients undergoing rehabilitation. METHOD This observational cross-sectional study included stroke patients admitted to a post-acute rehabilitation hospital between 2020 and 2022 who were not independently urinating. The degree of urinary independence was assessed using the Functional Independence Measure-Bladder (FIM-Bladder), a subscale of the motor domain of the FIM, and urinary independence was defined as FIM-Bladder ≥ 6. Anticholinergic burden was assessed using the anticholinergic risk scale (ARS), and changes in ARS during hospitalization were calculated by subtracting the value at admission from the value at discharge. The study outcome was urinary independence at discharge. Logistic regression analysis was used to examine whether change in ARS score was independently associated with the outcome. Statistical significance was set at P < 0.05. RESULTS Of the 573 patients enrolled, 312 patients (mean age 77.5 years, 51.9% male) were included in the analysis. ARS increased during hospitalization in 57 patients (18.3%). Change in ARS score was independently associated with urinary independence (odds ratio: 0.432, 95% confidence interval: 0.247-0.756, P = 0.003). CONCLUSION Increased anticholinergic burden in post-stroke patients who require assistance with urination is significantly associated with less independent urination. Anticholinergic agents may need to be introduced cautiously in patients who require assistance with urination.
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Affiliation(s)
- Ayaka Matsumoto
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo, Kikuchi, Kumamoto, 869-1106, Japan
| | - Yoshihiro Yoshimura
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo, Kikuchi, Kumamoto, 869-1106, Japan.
| | - Fumihiko Nagano
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo, Kikuchi, Kumamoto, 869-1106, Japan
| | - Sayuri Shimazu
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo, Kikuchi, Kumamoto, 869-1106, Japan
| | - Ai Shiraishi
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo, Kikuchi, Kumamoto, 869-1106, Japan
| | - Yoshifumi Kido
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo, Kikuchi, Kumamoto, 869-1106, Japan
| | - Takahiro Bise
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo, Kikuchi, Kumamoto, 869-1106, Japan
| | - Aomi Kuzuhara
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo, Kikuchi, Kumamoto, 869-1106, Japan
| | - Kota Hori
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo, Kikuchi, Kumamoto, 869-1106, Japan
| | - Takenori Hamada
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo, Kikuchi, Kumamoto, 869-1106, Japan
| | - Kouki Yoneda
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo, Kikuchi, Kumamoto, 869-1106, Japan
| | - Kenichiro Maekawa
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo, Kikuchi, Kumamoto, 869-1106, 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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Yan F, Xiao LD, Tang S, Guo Q, Huang H. Perceptions of primary health care nurses and general practitioners in the care of older people with urinary incontinence. J Adv Nurs 2024; 80:644-655. [PMID: 37650490 DOI: 10.1111/jan.15835] [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: 01/29/2023] [Revised: 07/21/2023] [Accepted: 08/14/2023] [Indexed: 09/01/2023]
Abstract
AIMS To identify the challenges and opportunities among primary health care nurses and general practitioners (GPs) in the care of older people with urinary incontinence (UI) and other chronic conditions in China. BACKGROUND UI is highly prevalent among community-dwelling older people with chronic conditions but is underreported and poorly managed. Understanding the factors that affect primary health care professionals' practices in their care for this population is imperative to foster nurse-led UI care services. DESIGN A qualitative descriptive study. METHODS Four focus groups were held with 24 primary health care nurses and GPs in Changsha, Hunan Province, China, between July and September 2021. A reflective thematic analysis was used to identify themes. RESULTS This study revealed misconceptions regarding older people living with UI and other chronic conditions in primary care health professional participants. Moreover, primary health care nurses had very limited autonomy in UI diagnosis and initiating care interventions for this patient population. By reflecting on practices, participants recognized various practical solutions to improve the detection and management of UI. Participants also identified barriers to accessing care services in older people with UI. They suggested changes in the health care system to achieve universal access to UI care services for older people. CONCLUSION Nurse-led UI care services in primary health care for community-dwelling older people with chronic conditions are in high demand but are underdeveloped due to professional and health care system factors. IMPACT Findings from this study provide new insights into challenges faced by primary health care professionals and illuminate practical solutions to address these challenges. REPORTING METHODS Adherence to COREQ guidelines was maintained. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Fang Yan
- Xiangya School of Nursing, Central South University, Changsha, China
- College of Nursing and Health Science, Flinders University, Adelaide, South Australia, Australia
| | - Lily D Xiao
- College of Nursing and Health Science, Flinders University, Adelaide, South Australia, Australia
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Qinqin Guo
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Hui Huang
- Department of Nursing, The Third Xiangya Hospital of Central South University, Changsha, China
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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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Schneider W, Sanaeifar N. Ergonomic comparison of different incontinence products and effects on time and physical demands on carers. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:936-942. [PMID: 37883322 DOI: 10.12968/bjon.2023.32.19.936] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
BACKGROUND Caregivers are at a high risk of musculoskeletal injuries. Efficiency in handling and changing patients' absorbent incontinence products may reduce the burden of caring. AIMS This study aimed to compare various types of absorbent incontinence products from an ergonomic perspective and assess the length of time required for handling these products and the physical demand on caregivers' backs, hands and fingers. METHODS A within-subject design was selected for two studies involving 64 experienced nurses. The first study was conducted at a test centre in Germany, while the second was performed at a hospital in France. Objective data, such as the time required to apply or change a product and physical stress on the back and hands/wrists, as well as users' subjective assessment of product handling were investigated. FINDINGS Both objective and subjective assessments showed that elastic slips were superior to other slip products. The traditional and belted slips were the second-best products in the objective and subjective assessments respectively. CONCLUSION Choice of incontinence product influences the time required and the physical demands associated with handling. Both aspects can be considerably reduced with the use of appropriate absorbent incontinence products.
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Affiliation(s)
| | - Niuosha Sanaeifar
- Manager, Clinical Application Studies, Paul Hartmann, Heidenheim, Germany
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Fu Y, Jackson C, Nelson A, Iles-Smith H, McGowan L. Exploring support, experiences and needs of older women and health professionals to inform a self-management package for urinary incontinence: a qualitative study. BMJ Open 2023; 13:e071831. [PMID: 37400236 DOI: 10.1136/bmjopen-2023-071831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/05/2023] Open
Abstract
OBJECTIVES Many women attempt to manage urinary incontinence (UI) independently with variable success while health professionals may be unaware of their needs. This study aimed to (1) understand older women's experiences of UI, their self-management strategies and support needs; (2) explore health professionals' experiences of supporting women and providing relevant services and (3) combine their experiences contribute to development of a theory-based and evidence-based self-management package for UI. DESIGN Qualitative semi-structured interviews were conducted with 11 older women with UI and 11 specialist health professionals. Data were analysed independently using the framework approach, then synthesised in a triangulation matrix to identify implications for content and delivery of the self-management package. SETTING Community centres, community continence clinic and urogynaecology centre of a local teaching hospital in northern England. PARTICIPANTS Women aged 55 years and over who self-reported symptoms of UI and health professionals delivering UI services. RESULTS Three overarching themes emerged. Older women see UI as a 'fact of life' but many struggle with it: women typically considered UI as part of ageing yet expressed annoyance, distress, embarrassment and had made significant lifestyle changes. Access to information and limited high-quality professional support: health professionals provided specialist UI care and information. Yet less than half of women accessed specialist services, those who had, highly valued these services. 'Trial and error' with different self-management strategies: women had tried or were using different strategies (continence pads, pelvic floor exercises, bladder management and training, fluid management and medication), with mixed success. Health professionals provided evidence-based, personalised support and motivation. CONCLUSIONS Findings informed the content of the self-management package that focused on providing facts, acknowledging challenges of living with/self-managing UI, sharing others' experiences, using motivational strategies and self-management tools. Delivery preferences were independent use by women or working through the package with a health professional.
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Affiliation(s)
- Yu Fu
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | | | - Andrea Nelson
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Heather Iles-Smith
- School of Health and Society, University of Salford, Salford, UK
- Corporate Nursing, Northern Care Alliance NHS Group, Salford, UK
| | - Linda McGowan
- School of Healthcare, University of Leeds, Leeds, UK
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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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Shaw C, Gibson W. Assessing Quality-of-Life of Patients Taking Mirabegron for Overactive Bladder. Ther Clin Risk Manag 2023; 19:27-33. [PMID: 36647532 PMCID: PMC9840370 DOI: 10.2147/tcrm.s269318] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/14/2022] [Indexed: 01/11/2023] Open
Abstract
Lower urinary tract symptoms (LUTS), including urgency, frequency, and urgency incontinence, are highly prevalent in the general population and increase in prevalence with increasing age. All LUTS, but notable urgency and urgency incontinence, are associated with negative impact on quality-of-life (QoL), with multiple aspects of QoL affected. Urgency and urgency incontinence are most commonly caused by overactive bladder (OAB), the clinical syndrome of urinary urgency, usually accompanied by increased daytime frequency and/or nocturia in the absence of infection or other obvious etiology, which may be treated with conservative and lifestyle interventions, bladder antimuscarinic drugs, and, more recently, by mirabegron, a β3 agonist. This narrative review describes the impact of OAB on QoL, quantifies this impact, and outlines the evidence for the use of mirabegron in the treatment of, and improvement in QoL in, people with OAB.
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Affiliation(s)
- Christina Shaw
- Division of Geriatric Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - William Gibson
- Division of Geriatric Medicine, University of Alberta, Edmonton, Alberta, Canada,Correspondence: William Gibson, Division of Geriatric Medicine, University of Alberta, 1-198 Clinical Sciences Building, 11350 83 Ave NW, Edmonton, Alberta, T6E 2K4, Canada, Tel +1 780 248 1969, Fax +1 780 492 2874, Email
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9
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Psychological distress in sons as resident carers of older mothers in Japan. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x22000721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
In Japan, care-giving sons are noted for their high rates of abuse of care recipients. This study revealed, for the first time, the difficulties unique to sons caring for their mothers. All sons used long-term care insurance services. However, they provided care that could not be covered by such public services while harbouring psychological distress. In this study, we interviewed 13 sons living with their older mothers as the primary carer and conducted a thematic analysis focusing on their psychological distress. As part of our study findings, we have identified nine themes during analysis: uncomfortable feelings that cannot be mitigated as a son; feeling of futility in being unrecognised as a carer; fear of losing something important; a strong sense of responsibility for one's mother's life; disappointment in being unable to obtain understanding and co-operation from one's siblings in providing care; irritation and anger towards one's wayward mother; guilt about treatment of one's mother; sense of exhaustion due to demanding care; and experiencing hopelessness and despair. Thus, it is important to understand what psychological distress carers experience and to consider possible approaches for their support. The study findings provide suggestions for long-term care support in regions, such as East Asia, where the numbers of son carers are increasing inevitably owing to declining birth rates and ageing population, as in Japan.
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Brady SS, Bavendam TG, Bradway CK, Conroy B, Dowling-Castronovo A, Epperson CN, Hijaz AK, Hsi RS, Huss K, Kim M, Lazar J, Lee RK, Liu CK, Loizou CN, Miran S, Mody L, Norton JM, Reynolds WS, Sutcliffe S, Zhang N, Hokanson JA. Noncancerous Genitourinary Conditions as a Public Health Priority: Conceptualizing the Hidden Burden. Urology 2022; 166:39-49. [PMID: 34536410 PMCID: PMC8924010 DOI: 10.1016/j.urology.2021.08.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 08/07/2021] [Accepted: 08/30/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To provide a conceptual framework to guide investigations into burdens of noncancerous genitourinary conditions (NCGUCs), which are extensive and poorly understood. METHODS The National Institute of Diabetes and Digestive and Kidney Diseases convened a workshop of diverse, interdisciplinary researchers and health professionals to identify known and hidden burdens of NCGUCs that must be measured to estimate the comprehensive burden. Following the meeting, a subgroup of attendees (authors of this article) continued to meet to conceptualize burden. RESULTS The Hidden Burden of Noncancerous Genitourinary Conditions Framework includes impacts across multiple levels of well-being and social ecology, including individual (ie, biologic factors, lived experience, behaviors), interpersonal (eg, romantic partners, family members), organizational/institutional (eg, schools, workplaces), community (eg, public restroom infrastructure), societal (eg, health care and insurance systems, national workforce/economic output), and ecosystem (eg, landfill waste) effects. The framework acknowledges that NCGUCs can be a manifestation of underlying biological dysfunction, while also leading to biological impacts (generation and exacerbation of health conditions, treatment side effects). CONCLUSION NCGUCs confer a large, poorly understood burden to individuals and society. An evidence-base to describe the comprehensive burden is needed. Measurement of NCGUC burdens should incorporate multiple levels of well-being and social ecology, a life course perspective, and potential interactions between NCGUCs and genetics, sex, race, and gender. This approach would elucidate accumulated impacts and potential health inequities in experienced burdens. Uncovering the hidden burden of NCGUCs may draw attention and resources (eg, new research and improved treatments) to this important domain of health.
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Affiliation(s)
- Sonya S Brady
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN.
| | - Tamara G Bavendam
- Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | - Christine K Bradway
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, PA
| | - Britt Conroy
- Urology Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH
| | | | - Cynthia Neill Epperson
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO
| | - Adonis K Hijaz
- Urology Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Ryan S Hsi
- Department of Urology, Vanderbilt University Medical Center, Nashville, TN
| | - Karen Huss
- Division of Extramural Science Programs, Symptom Science and Genetics, Self-Management Office, National Institute of Nursing Research, Bethesda, MD
| | - Michelle Kim
- Department of Urology, Massachusetts General Hospital, Boston, MA
| | - Jason Lazar
- Department of Medicine, SUNY Downstate Health Sciences University, New York, NY
| | - Richard K Lee
- Department of Urology, Weill Cornell Medical College, New York, NY
| | - Christine K Liu
- Section of Geriatrics, Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA; Geriatric Research and Education Clinical Center, Palo Alto VA Health Care System, Palo Alto, CA; Section of Geriatrics, Department of Medicine, Boston University, Boston, MA
| | | | - Saadia Miran
- Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | - Lona Mody
- Division of Geriatric and Palliative Medicine, University of Michigan Medical School, Ann Arbor, MI and VA Ann Arbor Healthcare System, Ann Arbor, MI
| | - Jenna M Norton
- Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | | | - Siobhan Sutcliffe
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO
| | - Nicole Zhang
- The Valley Foundation School of Nursing, College of Health and Human Sciences, San Jose State University, San Jose, CA
| | - James A Hokanson
- Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, WI
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11
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Managing incontinence in low-and middle income-countries: A qualitative case study from Pakistan. PLoS One 2022; 17:e0271617. [PMID: 35839232 PMCID: PMC9286225 DOI: 10.1371/journal.pone.0271617] [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: 02/11/2022] [Accepted: 07/04/2022] [Indexed: 11/20/2022] Open
Abstract
Background Incontinence is a complex health and social issue, which involves the involuntary loss of urine or faeces or both. Individuals with disabilities are particularly vulnerable to incontinence. The management of incontinence has largely been overlooked in low and middle-income settings (LMICs). This study aimed to explore the incontinence management strategies employed by disabled people with severe incontinence and their caregivers in Sindh Province, Pakistan. Methods Incontinence management was explored through in-depth interviews with people with incontinence (PWI) and their caregivers, photovoice, and a market survey and product attribute assessment. Data was analysed thematically through inductive coding and evaluated against existing disability and caregiver frameworks. Results Incontinence management affected all aspects of daily life for PWI and caregivers. Effective management of incontinence was prioritised because caregivers viewed it to be part of their familial duty and a requirement for the household to remain pure in the eyes of God. Coping strategies included strict adherence to routines, reducing food and drink intake, creative uses of locally available natural resources, and a heavy reliance on soap and water for maintaining hygiene. Products such as adult diapers were largely unavailable, costly and were not deemed suitable for regular use. There were no social or medical interventions in the region to support incontinence management. The main impacts of incontinence on the household were social isolation, stigma, role shifts within the family, the development of physical ailments among caregivers, and decreased income. Conclusion The complex health, psychological, social, economic, and cultural impacts of incontinence are exacerbated in LMICs due a lack of recognition of the condition, the absence of social or medical interventions and limited access to basic WASH infrastructure, and assistive devices or products. Appropriate solutions need to be developed in partnership with PWI and caregivers and need to be contextualised, affordable and sustainable.
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12
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Yan F, Xiao LD, Zhou K, Li Z, Tang S. Perceptions and help-seeking behaviours among community-dwelling older people with urinary incontinence: A systematic integrative review. J Adv Nurs 2022; 78:1574-1587. [PMID: 35150161 DOI: 10.1111/jan.15183] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/05/2021] [Accepted: 01/04/2022] [Indexed: 12/30/2022]
Abstract
AIM To synthesize research evidence on perceptions and help-seeking behaviours in community-dwelling older people with urinary incontinence based on the Capability-Opportunity-Motivation-Behaviours model. BACKGROUND Urinary incontinence is highly prevalent in community-dwelling older people, yet only a small proportion seek help from health professionals. Untreated urinary incontinence has a detrimental impact on older people's quality of life and distresses their caregivers. DESIGN Systematic integrative review. DATA SOURCES Ten databases were searched systematically between 9 November 2020 and 17 December 2020 including Medline (PubMed), CINAHL, Ageline, Web of Science, Scopus, ProQuest, Psyclnfo, CNKI, Wanfang and Vip. REVIEW METHODS Quality appraisal was applied to assess the quality of selected articles. Data relevant to the review aim were extracted from included articles for analysis. Convergent qualitative synthesis was used to synthesize findings. RESULTS Twenty articles were included and two main themes with six sub-themes were identified. Theme one described three common perceptions including urinary incontinence as a part of normal ageing, a stigma and a health problem. Each perception had a profound impact on older people's motivation to self-report the problem to health professionals. Theme two revealed three main help-seeking approaches comprising self-help, help from friends and help from health professionals. Of these, self-help was the dominant approach used to conceal urinary incontinence and contributed to social isolation. CONCLUSION Improving urinary incontinence management in community-dwelling older people requires the development of their capability and motivation, and increased opportunities to access and gain help from skilled health professionals. IMPACT Findings can facilitate resource development to improve health literacy for the general public pertinent to urinary incontinence and associated stigma. Moreover, findings can inform a user-friendly reporting and referral system for the problem. In addition, findings can inform education and skill training for health professionals, older people and their caregivers to effectively manage the problem.
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Affiliation(s)
- Fang Yan
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Lily D Xiao
- College of Nursing and Health Science, Adelaide, South Australia, Australia
| | - Keyi Zhou
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Zeen Li
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
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13
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Santini S, Socci M, Fabbietti P, Lamura G, Teti A. Factors Worsening and Mitigating the Consequences of the COVID-19 Outbreak on the Overall Health of Informal Caregivers of Older People with Long-Term Care Needs Living in Germany and in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031694. [PMID: 35162718 PMCID: PMC8835160 DOI: 10.3390/ijerph19031694] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 01/12/2022] [Accepted: 01/29/2022] [Indexed: 01/27/2023]
Abstract
Population ageing and the higher prevalence of multimorbidity in later life are increasing the demand for Long-Term Care (LTC) worldwide; this has been exacerbated by the COVID-19 pandemic. As in Europe and beyond, the bulk of care for frail older people is carried out by informal caregivers. This study aimed at understanding the factors affecting the overall worsening health of informal caregivers of older people with LTC needs living in Germany and Italy during the outbreak. To this purpose, 319 informal caregivers (149 in Germany and 173 in Italy) were surveyed online in 2020–2021. A logistic regression analysis was performed by country, to obtain an adjusted estimate of the risk of worsening of caregivers’ health. This risk increased by 42% for German caregivers compared to Italian ones, despite the former receiving more formal services. This may depend on different quality standards of LTC services and caregivers’ expectations, and on differing policies concerning migrant care workers (MCWs) during the outbreak, who could not enter Germany and were “trapped” at care recipients’ homes in Italy. Results call for in-home care reforms and policies guaranteeing more effective caregiver support, home care services and fairer working condition for MCWs in both countries.
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Affiliation(s)
- Sara Santini
- Centre for Socio-Economic Research on Aging, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy; (S.S.); (G.L.)
| | - Marco Socci
- Centre for Socio-Economic Research on Aging, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy; (S.S.); (G.L.)
- Correspondence: ; Tel.: +39-071-8004799
| | - Paolo Fabbietti
- Laboratory of Geriatric Pharmacoepidemiology, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy;
| | - Giovanni Lamura
- Centre for Socio-Economic Research on Aging, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy; (S.S.); (G.L.)
| | - Andrea Teti
- Institute for Gerontology, University of Vechta, 49377 Vechta, Germany;
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14
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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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15
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Grotenhuis N, Schreuder MC, van den Bos TWL, van der Worp H, Blanker MH. Association of Supply Source with Continence Product and Care Satisfaction in Patients with Urinary Incontinence. Patient Prefer Adherence 2022; 16:2115-2123. [PMID: 35996726 PMCID: PMC9391932 DOI: 10.2147/ppa.s359960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/27/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE We aimed to examine how supply source affects satisfaction with continence products and care among individuals with urinary incontinence (UI). Supply source was compared among pharmacies, national suppliers, and shops. The secondary aim was to compare participant characteristics between the three groups. PATIENTS AND METHODS A survey questionnaire was distributed via social media between April and June 2020. This included the international consultation on incontinence questionnaire (ICIQ) UI short form (ICIQ-UI-SF), the ICIQ-PadPROM, and the ICIQ-LUTSqol, together with questions about respondent characteristics and satisfaction with continence products. RESULTS Of the 1045 respondents, 706 fully completed and 339 partially completed the survey. Among these, 322 (45.6%), 199 (28.1%), and 185 (26.2%) made purchases from shops, national suppliers, and pharmacies, respectively. The mean ICIQ-UI-SF sum scores were comparable for the pharmacy (13.3 ± 3.7) and national supplier (13.8 ± 3.5) groups, but were significantly lower for the shop group (12.0 ± 3.3). Mean sum scores for satisfaction with continence products and satisfaction with continence care were also significantly lower in the shop group (7.9 ± 2.6 and 6.4 ± 2.7, respectively) compared with the pharmacy (9.1 ± 2.7 and 7.9 ± 2.6, respectively) and national supplier (9.3 ± 2.6 and 8.1 ± 3.0, respectively) groups. There were no statistically significant differences in the ICIQ-PadPROM and ICIQ-LUTSqol scores. Respondents' characteristics were similar, apart from the significantly lower number of males in the shop group. CONCLUSION Satisfaction with continence products and continence care is lower for people with UI who purchase materials from a shop than from a pharmacy or national supplier.
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Affiliation(s)
- Nina Grotenhuis
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Miranda C Schreuder
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Correspondence: Miranda C Schreuder, Department of General Practice and Elderly Care medicine, University Medical Center Groningen, University of Groningen, FA21, PO Box 196, Groningen, 9700AD, the Netherlands, Tel +31 625647144, Email
| | | | - Henk van der Worp
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Marco H Blanker
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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16
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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: 12] [Impact Index Per Article: 4.0] [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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17
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Burdens and Educational Needs of Informal Caregivers of Older Adults With Urinary Incontinence: An Internet-Based Study. Rehabil Nurs 2021; 46:172-178. [PMID: 33591086 DOI: 10.1097/rnj.0000000000000317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to describe the burden and educational needs of informal caregivers of care-dependent older adults with urinary incontinence (UI). DESIGN A cross-sectional, descriptive survey of informal caregivers recruited through Google Ads was performed. METHODS An online survey, including the Overactive Bladder-Family Impact Measure, was used to assess five areas of the experience of the informal caregiver that may be affected by caring for a person with UI and their educational needs. FINDINGS Respondents (n = 77) reported a substantial impact of their care recipients' UI on their lives, with concern, travel, and social subscales most affected. However, 42% never sought treatment on behalf of their care recipient. Educational needs included UI treatment strategies and guidance to select appropriate supplies. CONCLUSIONS Caregivers underreported their care recipient's UI and need substantially more support from healthcare providers to manage the condition. CLINICAL RELEVANCE Nurses should assess for UI among care-dependent older adults and, if present, provide information and strategies to lessen the impact on caregiver lives.
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18
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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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19
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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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20
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Abstract
Continence care should be individually delivered with dignity, decorum, distinction in all diverse contexts and circumstances. From the dependency of childhood to ultimately the end of life, continence care is essential for all, no matter what the setting is: at home, sheltered structures, community care, residential settings and nursing homes. Person-centred care is central to healthcare policies, procedures to the provision of personalised consultation, developing a collaborative partnership approach to continence assessment, promotion, and management.
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Affiliation(s)
- Anne Marie Kelly
- Clinical Nurse Specialist-Continence, Continence Promotion Services, Dublin, Ireland
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21
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Papa R, Efthymiou A, Lamura G, Piccinini F, Onorati G, Papastavrou E, Tsitsi T, Casu G, Boccaletti L, Manattini A, Seneca R, Vaz de Carvalho C, Durão R, Barbabella F, Andréasson F, Magnusson L, Hanson E. Review and Selection of Online Resources for Carers of Frail Adults or Older People in Five European Countries: Mixed-Methods Study. JMIR Mhealth Uhealth 2020; 8:e14618. [PMID: 32554378 PMCID: PMC7330736 DOI: 10.2196/14618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 12/02/2019] [Accepted: 03/30/2020] [Indexed: 02/02/2023] Open
Abstract
Background Informal carers have a crucial role in the care of older people, but they are at risk of social isolation and psychological exhaustion. Web-based services like apps and websites are increasingly used to support informal carers in addressing some of their needs and tasks, such as health monitoring of their loved ones, information and communication, and stress management. Despite the growing number of available solutions, the lack of knowledge or skills of carers about the solutions often prevent their usage. Objective This study aimed to review and select apps and websites offering functionalities useful for informal carers of frail adults or older people in 5 European countries (Cyprus, Greece, Italy, Portugal, and Sweden). Methods A systematic online search was conducted from January 2017 to mid-March 2017 using selected keywords, followed by an assessment based on a set of commonly agreed criteria and standardized tools. Selected resources were rated and classified in terms of scope. Focus groups with informal carers were conducted to validate the list and the classification of resources. The activities were conducted in parallel in the participating countries using common protocols and guidelines, a standardization process, and scheduled group discussions. Results From a total of 406 eligible resources retrieved, 138 apps and 86 websites met the inclusion criteria. Half of the selected resources (109/224, 48.7%) were disease-specific, and the remaining resources included information and utilities on a variety of themes. Only 38 resources (38/224, 17.0%) were devoted specifically to carers, addressing the management of health disturbances and diseases of the care recipient and focusing primarily on neurodegenerative diseases. Focus groups with the carers showed that almost all participants had no previous knowledge of any resource specifically targeting carers, even if interest was expressed towards carer-focused resources. The main barriers for using the resources were low digital skills of the carers and reliability of health-related apps and websites. Results of the focus groups led to a new taxonomy of the resources, comprising 4 categories: carer’s wellbeing, managing health and diseases of the care recipient, useful contacts, and technologies for eldercare. Conclusions The review process allowed the identification of online resources of good quality. However, these resources are still scarce due to a lack of reliability and usability that prevent users from properly benefiting from most of the resources. The involvement of end users provided added value to the resource classification and highlighted the gap between the potential benefits from using information and communication technologies and the real use of online resources by carers.
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Affiliation(s)
- Roberta Papa
- Centre for Socio-Economic Research on Ageing, IRCCS INRCA, Ancona, Italy
| | - Areti Efthymiou
- Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Giovanni Lamura
- Centre for Socio-Economic Research on Ageing, IRCCS INRCA, Ancona, Italy
| | - Flavia Piccinini
- Centre for Socio-Economic Research on Ageing, IRCCS INRCA, Ancona, Italy
| | - Giulia Onorati
- Centre for Socio-Economic Research on Ageing, IRCCS INRCA, Ancona, Italy
| | - Evridiki Papastavrou
- Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Theologia Tsitsi
- Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Giulia Casu
- Department of Psychology, University of Bologna, Bologna, Italy.,Anziani e Non Solo - social cooperative, Carpi, Italy
| | | | | | - Rita Seneca
- Anziani e Non Solo - social cooperative, Carpi, Italy
| | | | | | - Francesco Barbabella
- Centre for Socio-Economic Research on Ageing, IRCCS INRCA, Ancona, Italy.,Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
| | - Frida Andréasson
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
| | - Lennart Magnusson
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.,Swedish Family Care Competence Centre, Kalmar, Sweden
| | - Elizabeth Hanson
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.,Swedish Family Care Competence Centre, Kalmar, Sweden
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22
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Murphy C, Laine C, Macaulay M, Fader M. Development and randomised controlled trial of a Continence Product Patient Decision Aid for men postradical prostatectomy. J Clin Nurs 2020; 29:2251-2259. [DOI: 10.1111/jocn.15223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 02/04/2020] [Accepted: 02/07/2020] [Indexed: 01/24/2023]
Affiliation(s)
- Catherine Murphy
- School of Health Sciences University of Southampton Southampton UK
| | - Christine Laine
- School of Health Sciences University of Southampton Southampton UK
| | | | - Mandy Fader
- School of Health Sciences University of Southampton Southampton UK
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23
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Suzuki M, Okochi J, Iijima K, Murata T, Kume H. Nationwide survey of continence status among older adult residents living in long-term care facilities in Japan: The prevalence and associated risk factors of incontinence and effect of comprehensive care on continence status. Geriatr Gerontol Int 2020; 20:285-290. [PMID: 31991532 DOI: 10.1111/ggi.13872] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 12/22/2019] [Accepted: 01/04/2020] [Indexed: 12/15/2022]
Abstract
AIM This study aimed to identify the prevalence of urinary, fecal and double incontinence among Japanese residents aged ≥65 years living in long-term care facilities. Furthermore, the association between baseline characteristics and changes in toileting activity after a 3-month comprehensive care among older individuals was investigated. METHODS We examined the prevalence of incontinence and its significant predictors. The association between the Functional Independence Measure score at baseline and each type of incontinence (urinary, fecal or double incontinence) was examined using a logistic regression model. Similarly, the association between the Functional Independence Measure score at baseline and improvement in toileting activity after a 3-month comprehensive care was examined. RESULTS In total, 2517 residents (670 men and 1847 women) were recruited. The prevalence rates of urinary, fecal and double incontinence were 66.9%, 42.8% and 41.1%, respectively. In multivariate analysis, the sum of the motor subscales after removing four continence items and the sum of the cognitive subscales of the Functional Independence Measure score at baseline were significantly associated with all types of incontinence. The sum of the motor subscales after removing four continence items of the Functional Independence Measure score was associated with improved toileting activity. CONCLUSIONS This study presented the prevalence of urinary, fecal and double incontinence among residents living in long-term care facilities in Japan. The Functional Independence Measure items at baseline were associated with not only continence status, but also improved toileting activity after 3-month comprehensive care. Geriatr Gerontol Int 2020; 20: 285-290.
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Affiliation(s)
- Motofumi Suzuki
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Urology, Tokyo Teishin Hospital, Tokyo, Japan
| | - Jiro Okochi
- Tatsumanosato Long-Term Care Health Facility, Osaka, Japan
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| | - Taro Murata
- Department of Urology, Tokyo Teishin Hospital, Tokyo, Japan
| | - Haruki Kume
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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24
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Davis NJ, Clark PC, Johnson TM, Wyman JF. Feasibility of Tele-Prompt: A tablet-based prompted voiding intervention to support informal caregivers of older adults with urinary incontinence. Geriatr Nurs 2020; 41:411-420. [PMID: 31987698 DOI: 10.1016/j.gerinurse.2020.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 01/01/2020] [Accepted: 01/03/2020] [Indexed: 10/25/2022]
Abstract
Urinary incontinence (UI) is a highly prevalent condition, burdening older adults and their informal caregivers. This study explored the development and feasibility of a 6-week evidence-based, educational/skill building program delivered via tablet-personal computer aimed at developing informal caregiver UI knowledge; and enhancing informal caregiver skill set in prompted voiding and toileting strategies. Caregivers also received individualized weekly coaching sessions from a nurse expert. Feasibility and preliminary efficacy were tested in three caregiver/care-recipient dyads. Recruitment of eligible participants through community-based resources was a challenge to feasibility. Most caregivers found the technology acceptable, but adherence to prompted voiding was inconsistent. All caregivers rated the intervention highly, reported improvements in their care-recipient's urine leakage, found access to a UI expert beneficial, and would recommend it to a friend. The results suggest that the tablet-facilitated intervention was feasible and acceptable to informal caregivers and showed promise for improving both caregiver and care recipient outcomes.
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Affiliation(s)
- Nicole J Davis
- Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, P.O. Box 3995, Atlanta, GA 30302, United States; School of Nursing, Clemson University, 605 Grove Rd. Greenville, SC 29605, United States.
| | - Patricia C Clark
- Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, P.O. Box 3995, Atlanta, GA 30302, United States.
| | - Theodore M Johnson
- Schools of Medicine, Public Health and Nursing, Emory University, 1841 Clifton Rd NE, Atlanta, GA 30329, United States; Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, 1670 Clairmont Rd., Atlanta, GA 30033, United States.
| | - Jean F Wyman
- School of Nursing, University of Minnesota, 5-140 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455, United States.
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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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Toye F, Barker KL. A meta-ethnography to understand the experience of living with urinary incontinence: 'is it just part and parcel of life?'. BMC Urol 2020; 20:1. [PMID: 31941470 PMCID: PMC6964106 DOI: 10.1186/s12894-019-0555-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 11/08/2019] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Urinary incontinence (UI) is highly prevalent and affects the lives of many men and women. We aimed to conduct a qualitative evidence synthesis (QES) to explore the experience of living with UI and to develop a conceptual model that can help us to understand this experience, and the potential barriers to appropriate healthcare. METHODS We used the methods of meta-ethnography developed by Noblit and Hare and recently refined for larger studies. Meta-ethnography involves identifying concepts from the studies and abstracting these concepts into a line of argument. We searched for studies that explored the experience of adults with UI. We used the GRADE-CERQual framework to assess confidence in review findings. RESULTS We screened 2307 titles, 429 abstracts, 107 full texts and included 41 studies (36 unique samples) in the synthesis. We organised the concepts into 26 conceptual categories, which we further abstracted into 6 themes: (1) Am I ill or is this normal? (2) It effects who I am and how I feel; (3) I feel stigmatised, ashamed and guilty; (4) talking can be difficult but it can help; (5) keeping incontinence under control; (6) have I got to the point that I need help? Our model conceptualises living with UI as navigating antagonists: Is UI normal or am I ill? Do I need help or am I managing? Do I keep UI to myself (and manage alone) or do I tell other people (and get the support that I need)? Do I use control strategies that focus on concealing (avoid risky situations, wear pads) versus, I use strategies that focus on improving the bodily function to improve continence. Our model highlights the experience of stigma, shame and guilt which exert a pull towards concealment. CONCLUSIONS The culture of secrecy and profound sense of shame is barrier to seeking help. An environment which reduces the shame and stigma of UI may help people to switch the focus to strategies that will improve continence, rather than conceal incontinence.
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Affiliation(s)
- Francine Toye
- Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Windmill Road, Oxford, OX3 7HE UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
| | - Karen L. Barker
- Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Windmill Road, Oxford, OX3 7HE UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
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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 aim 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 first of two that provide an update on urinary incontinence and its management in older adults. The second article will contain 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. In this article, the videos can be found in Resources for Nurses.
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Affiliation(s)
- Nicole J Davis
- Nicole J. Davis is an assistant professor at the Clemson University School of Nursing in Greenville, SC; Jean F. Wyman is a professor at the University of Minnesota School of Nursing, Minneapolis; Suzanne Gubitosa is an NP in palliative and provider services at Patriot Healthcare in Easley, SC; and LaTonya Pretty is an NP in geriatric medicine at Prisma Health Upstate in Greenville, SC. Contact author: Nicole J. Davis, . The authors have disclosed no potential conflicts of interest, financial or otherwise
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Li HC, Chen KM, Hsu HF. Modelling factors of urinary incontinence in institutional older adults with dementia. J Clin Nurs 2019; 28:4504-4512. [PMID: 31429131 DOI: 10.1111/jocn.15039] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 07/04/2019] [Accepted: 08/03/2019] [Indexed: 12/15/2022]
Abstract
AIMS AND OBJECTIVES This study applied structural equation modelling to explore the relationships among agitated behaviours, depression, cognitive function and activities of daily living, as well as associations between these factors and urinary incontinence). BACKGROUND A high prevalence of urinary incontinence is found among institutional older adults with dementia. People with urinary incontinence suffer from increased financial burden and social isolation and experience reduced quality of life. DESIGN Cross-sectional correlational research. The study complied with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. METHODS In total, 226 older adults with dementia were recruited through convenience sampling at 15 long-term care facilities in southern Taiwan. The urinary incontinence frequency, agitated behaviours, depression, cognitive function and activities of daily living were evaluated using bladder records, the Cohen-Mansfield Agitation Inventory, the Cornell Scale for Depression in Dementia, the Mini-Mental State Examination and the Barthel Index, respectively. RESULTS Activities of daily living performance was found to be significantly associated with urinary incontinence; however, age, cognitive function, depression and agitated behaviours were not significantly related to urinary incontinence. Age did not have effects on any of the variables tested in this model, whereas activities of daily living performance was significantly associated with cognitive function and depression. Results further showed that cognitive function and depression were mediators between activities of daily living and agitated behaviours. CONCLUSION Enhanced activities of daily living independency directly reduced urinary incontinence, improved cognitive function, decreased degrees of depression and indirectly reduced agitated behaviours. RELEVANCE TO CLINICAL PRACTICE The findings could serve as a valuable reference for long-term care facilities in providing effective urinary incontinence care and prevention to older adults with dementia.
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Affiliation(s)
- Hui-Chi Li
- Department of Nursing, I-Shou University, Kaohsiung, Taiwan
| | - Kuei-Min Chen
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Hui-Fen Hsu
- Center for Long-Term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan
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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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Wongpun S, Guha S. Caregivers for the elderly in Thailand: development and evaluation of an online support system. INFORMATION DEVELOPMENT 2019. [DOI: 10.1177/0266666918821715] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Informal caregivers are playing a major role in helping elderly people with their activities in daily life. The purpose of this work is to develop an Online Support System for Elderly Care (OSSEC) to provide services for informal caregivers in Thailand. The system has six modules which are: patient and caregiver profile manager, elderly care recommender applying case-based reasoning, daily care plan manager, elderly care activity notifier, elderly care information resource locator and caregivers’ social interaction platform. We have established the utility of OSSEC in enhancing the knowledge and ability of informal caregivers and in reducing their stress. In particular, we measured quantitatively the usefulness of OSSEC and evaluated user satisfaction as well.
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Extended Selected Abstracts from Workshop of the Geriatric section of Hellenic Physical Medicine and Rehabilitation Society. J Frailty Sarcopenia Falls 2018; 3:203-209. [PMID: 32300709 PMCID: PMC7155352 DOI: 10.22540/jfsf-03-203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Timonet-Andreu E, Canca-Sanchez JC, Sepulveda-Sanchez J, Ortiz-Tomé C, Rivas-Ruiz F, Toribio-Toribio JC, Mora-Banderas A, Morales-Asencio JM. Overestimation of hours dedicated to family caregiving of persons with heart failure. J Adv Nurs 2018; 74:2312-2321. [PMID: 29808478 DOI: 10.1111/jan.13727] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 03/19/2018] [Indexed: 12/28/2022]
Abstract
AIMS The aim of this study is to profile the family caregivers of people living with heart failure, to determine the perceived and real time devoted to daily care and to identify the factors associated with caregivers' overestimation of time dedicated to care. BACKGROUND The time spent by family caregivers on daily care is related to overload, but there are differences between real and perceived time spent. The reason for this difference is unknown, as is its impact on the caregiver. DESIGN Multicentre, cross-sectional study. METHODS This study forms part of a longitudinal, multicentre, ambispective cohort investigation. The study population was composed of 478 patient-family caregiver dyads and the data were collected over 2 years from 2014 - 2016. RESULTS The mean time perceived to be spent on daily care was 8.79 hr versus a real value of 4.41 hr. These values were positively correlated. A significant correlation was also found between the overestimation of hours spent and the age of the caregiver, the duration of the caregiving relationship and the number of people providing support and with the patient's level of dependence and self-care. CONCLUSION The overestimation of time dedicated to care seems to be related to patients' and caregivers' characteristics, such as functional status, caregiver burden, age and cohabitation. These patterns should be considered by nurses when carrying out assessment and care planning with these patients and their caregivers.
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Affiliation(s)
| | - José Carlos Canca-Sanchez
- Nursing Unit, Costa del Sol Public Health Agency, Marbella, Spain.,School of Health Sciences, Universidad de Málaga, Málaga, Spain
| | | | - Celia Ortiz-Tomé
- Nursing Unit, Costa del Sol Public Health Agency, Marbella, Spain
| | | | | | | | - José Miguel Morales-Asencio
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Málaga, Málaga, Spain.,Research and Evidence-Based Practice, School of Health Sciences, Universidad de Málaga, Málaga, Spain
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Esparza AO, Tomás MÁC, Pina-Roche F. Experiences of women and men living with urinary incontinence: A phenomenological study. Appl Nurs Res 2017; 40:68-75. [PMID: 29579501 DOI: 10.1016/j.apnr.2017.12.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 12/12/2017] [Accepted: 12/14/2017] [Indexed: 12/21/2022]
Abstract
AIMS To explore and understand, from a gender-based perspective, the quality-of-life experiences of men and women who suffer from urinary incontinence. BACKGROUND Urinary incontinence (UI) is a major health problem with significant social, psychological, occupational, sexual and economic effects leading to a substantial decrease in quality of life. Although this condition is increasingly frequent in men, research has tended to focus on women, adopting a quantitative approach. DESIGN The data were examined using interpretive phenomenological analysis (IPA). METHODS The data were collected through a semi-structured interview conducted between January and June 2016. An inductive discourse content analysis was performed in three stages: preparation, organization and report. Participants were recruited until data saturation was achieved. FINDINGS A sample of 33 participants was recruited: 17 women and 16 men. Gender-specific features were found. Six categories emerged: (i) normalization of incontinence; (ii) verbalization of the problem; (iii) social isolation; (iv)experienced feelings and emotions; (v) impact on daily routine; (vi) self-care strategies to address the problem in the most suitable way. CONCLUSION Urinary incontinence has a negative effect on the quality of life of men and women. However, there are gender differences as to how this phenomenon is experienced, particularly with regard to its psychological and social dimensions. A comprehensive, targeted assessment of the needs of these men and women is required on the part of professional nurses.
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Affiliation(s)
| | - Miguel Ángel Cánovas Tomás
- Department of Nursing, Spain Faculty of Health Sciences, University of Murcia, Spain; Research Group of Urology, Morales Meseguer Hospital, Murcia, Spain.
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Vethanayagam N, Orrell A, Dahlberg L, McKee KJ, Orme S, Parker SG, Gilhooly M. Understanding help-seeking in older people with urinary incontinence: an interview study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2017; 25:1061-1069. [PMID: 27860034 DOI: 10.1111/hsc.12406] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/13/2016] [Indexed: 06/06/2023]
Abstract
The prevalence of urinary incontinence (UI) increases with age and can negatively affect quality of life. However, relatively few older people with UI seek treatment. The aim of this study was to explore the views of older people with UI on the process of seeking help. Older people with UI were recruited to the study from three continence services in the north of England: a geriatrician-led hospital outpatient clinic (n = 18), a community-based nurse-led service (n = 22) and a consultant gynaecologist-led service specialising in surgical treatment (n = 10). Participants took part in semi-structured interviews, which were transcribed and underwent thematic content analysis. Three main themes emerged: Being brushed aside, in which participants expressed the feeling that general practitioners did not prioritise or recognise their concerns; Putting up with it, in which participants delayed seeking help for their UI due to various reasons including embarrassment, the development of coping mechanisms, perceiving UI as a normal part of the ageing process, or being unaware that help was available; and Something has to be done, in which help-seeking was prompted by the recognition that their UI was a serious problem, whether as a result of experiencing UI in public, the remark of a relative, the belief that they had a serious illness or the detection of UI during comprehensive geriatric assessment. Greater awareness that UI is a treatable condition and not a normal part of ageing is needed in the population and among health professionals. Comprehensive geriatric assessment appeared an important trigger for referral and treatment in our participants. Screening questions by healthcare professionals could be a means to identify, assess and treat older people with UI.
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Affiliation(s)
| | - Alison Orrell
- School of Social Sciences, Bangor University, Bangor, UK
| | - Lena Dahlberg
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
- Aging Research Center, Karolinska Institutet & Stockholm University, Stockholm, Sweden
| | - Kevin J McKee
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | | | - Stuart G Parker
- Institute of Health and Society, Newcastle University, Newcastle, UK
| | - Mary Gilhooly
- Department of Clinical Sciences, Brunel University London, London, UK
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Poole K, Kerlin M, Wynne R. Prevalence and characteristics of urinary incontinence in a cohort of patients with chronic heart failure. Heart Lung 2017; 46:67-73. [PMID: 28190530 DOI: 10.1016/j.hrtlng.2017.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 01/05/2017] [Accepted: 01/06/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Evidence describing the characteristics of urinary incontinence (UI) in patients with chronic heart failure (CHF), and the impact of this combination of conditions on functional status and quality of life, is limited. OBJECTIVE The primary aim of this study was to determine the prevalence and characteristics of UI in a cohort of CHF patients. METHODS A prospective survey of 100 outpatients with CHF was undertaken. RESULTS There were 43 (65.1%) patients with UI secondary to mixed incontinence (n = 16, 37.2%), urge incontinence (n = 19, 44.2%), stress incontinence (3, 6.9%) or post micturition dribble (n = 5, 1.6%) and 23 (34.9%) cited urgency with the potential for urge incontinence as their primary continence problem. CONCLUSION UI was bothersome and managed by patients to minimize interference in daily living. Strategies for the measurement and management of UI in disease specific cohorts such as CHF requires further exploration.
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Affiliation(s)
- Kerry Poole
- The Royal Melbourne Hospital, Melbourne, Australia
| | | | - Rochelle Wynne
- The Royal Melbourne Hospital, Melbourne, Australia; Deakin University, School of Nursing & Midwifery, Geelong, Australia.
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Badawi JK. Editorial Comment. Urology 2017; 99:97-98. [DOI: 10.1016/j.urology.2016.07.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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