Ribas Yolanda, Coll Meritxell, Espina Avelina, Jiménez Concepció, Chicote Montserrat, Torné Marta, Modolell Ines
Department of Surgery (Coloproctology), Consorci Sanitari de Terrassa, Terrassa (Barcelona), Spain.
Primary Care Nurse, Consorci Sanitari de Terrassa, Terrassa (Barcelona), Spain.
Fam Pract. 2017 Apr 1;34(2):175-179. doi: 10.1093/fampra/cmx004.
Faecal incontinence (FI) is a distressing condition with a significant impact on quality of life. The true prevalence of FI is unknown but probably underestimated. Identifying patients affected is of key importance because a significant proportion may improve with conservative treatments, and there are a number of other treatments available.
The aim of our project was to improve detection of FI in our primary care setting.
A multidisciplinary working group was created in order to raise awareness and educate health professionals about FI. We designed a simple protocol and organized educational meetings at 7 primary care centres. The usual diagnostic computer-based tools used by nurses were modified, so that FI was systematically asked about. A proactive attitude among doctors and midwives regarding FI was recommended for high-risk patient groups.
The project was implemented in October 2014. Before the intervention, only 250 (<1%) patients with a diagnosis of FI were identified from the primary care register out of a population over 165000 people. Between October 2014 and February 2016, 17370 patients were questioned about anal continence in routine follow-ups. Of those questioned, 829 (4.8%) disclosed suffering from FI. Mean age was 78.5 ± 14 years (16-104), 565 (68.2%) were females, and 264 (31.8%) were males. The percentage of patients with FI increased with age and was higher in women.
Our results show that a proactive approach with direct questions on FI may lead to a significant increase in FI detection in primary care.
大便失禁（FI）是一种令人苦恼的病症，对生活质量有重大影响。FI的实际患病率尚不清楚，但可能被低估了。识别受影响的患者至关重要，因为很大一部分患者可能通过保守治疗得到改善，而且还有许多其他治疗方法可用。
我们项目的目的是改善在基层医疗环境中对FI的检测。
成立了一个多学科工作组，以提高对FI的认识并对卫生专业人员进行教育。我们设计了一个简单的方案，并在7个基层医疗中心组织了教育会议。护士常用的基于计算机的诊断工具进行了修改，以便系统地询问FI相关情况。建议医生和助产士对高危患者群体对FI采取积极主动的态度。
该项目于2014年10月实施。在干预之前，在超过165000人的人群中，从基层医疗登记册中仅识别出250名（<1%）诊断为FI的患者。在2014年10月至2016年2月期间，在常规随访中对17370名患者询问了肛门节制情况。在这些被询问的患者中，829名（4.8%）透露患有FI。平均年龄为78.5±14岁（16 - 104岁），565名（68.2%）为女性。患有FI的患者百分比随年龄增加，女性中更高。
我们的结果表明，对FI直接提问的积极方法可能会导致基层医疗中FI检测率显著提高。
