Fonda D
Aged and Extended Care Department, Heidelberg Repatriation Hospital, Victoria.
Aust Clin Rev. 1990;10(2):66-71.
To study prevalence and management of urinary incontinence in institutes and to recommend improved strategies of managing this problem.
A one-day census of ten geriatric assessment and rehabilitation services and nursing homes was undertaken to estimate the extent and management of urinary incontinence in Victoria. The definition of incontinence was extended to include patients with 'dependent continence', i.e. being dry of urine only as a result of being reminded or physically assisted.
A total of 1659 patients, comprising 333 short-stay and 1326 nursing home type patients, was surveyed. The mean age was 77 and 81 years respectively. Only 43% and 23% of these patients respectively were independently continent, whilst 26% and 11% respectively of all patients were dependent continent. Incontinence occurred once or more per day in 85% of these patients and had usually been present for at least one month. There was a high association between incontinence and physical and mental infirmity. Dependent continent patients were as physically handicapped as their wet counterparts. A diverse range of management strategies, including various toileting programmes, was employed to deal with the incontinence. It is concluded that urinary incontinence is more common than reported in previous studies, largely as a result of the additional group of patients with dependent continence, a condition that often can be achieved. Proposed management protocols are outlined which aim to define different population subgroups that might respond more effectively to the various interventions available. The need for follow-up appraisal of these interventions is emphasized.
研究机构中尿失禁的患病率及管理情况，并推荐改善该问题管理的策略。
对十家老年评估与康复服务机构及养老院进行了为期一天的普查，以评估维多利亚州尿失禁的程度及管理情况。尿失禁的定义扩大到包括“依赖型节制排尿”患者，即仅因他人提醒或身体协助才保持尿液干爽的患者。
共调查了1659名患者，其中包括333名短期住院患者和1326名养老院类型患者。平均年龄分别为77岁和81岁。这些患者中分别只有43%和23%能够自主控制排尿，而所有患者中分别有26%和11%属于依赖型节制排尿。85%的这些患者每天尿失禁一次或多次，且通常已持续至少一个月。尿失禁与身体和精神虚弱高度相关。依赖型节制排尿的患者与尿失禁患者的身体残疾程度相当。采用了多种管理策略，包括各种如厕计划来处理尿失禁问题。结论是尿失禁比以往研究报告的更为常见，主要是由于增加了依赖型节制排尿这一患者群体，这种情况往往是可以实现的。概述了拟议的管理方案，旨在界定可能对现有各种干预措施反应更有效的不同人群亚组。强调了对这些干预措施进行随访评估的必要性。
