From the Department of Obstetrics and Gynecology (HWB, WG, NBS), and Department of Family Medicine and Community Health (PDS), University of Wisconsin-Madison School of Medicine and Public Health (UWSMPH), Madison, WI; University of North Carolina Center for Functional GI & Motility Disorders, Chapel Hill, NC (WEW); University of Texas at Austin, Dell Medical School, Austin, TX (RGR).
J Am Board Fam Med. 2018 Sep-Oct;31(5):774-782. doi: 10.3122/jabfm.2018.05.180045.
More than half of older adults experience urinary (UI) or fecal incontinence (FI), but the majority have never discussed symptoms with health care providers. Little is known about primary care providers' (PCPs') screening for UI and FI.
We conducted a cross-sectional electronic survey of PCPs within a Midwest academic institution to ascertain and compare PCPs' beliefs, attitudes, and behaviors regarding screening and treatment for UI and FI; determine factors associated with screening for FI; and identify potential barriers to and facilitators of FI screening and treatment.
Among 154 PCPs, the screening rate for UI (75%) was more than double that for FI (35%; < .001). PCPs believed that both UI and FI screening were important but felt better informed to treat UI ( < .001). Screening for FI was associated with UI screening (OR, 11.27; 95% CI, 4.9-26.0; < .001); feeling informed to treat FI (OR, 10.21; 95% CI, 1.2-90.0; = .01); screening verbally (OR, 3.9; 95% CI, 1.9-8.0; < .001); perceiving screening as important (OR, 3.7; 95% CI, 1.8-7.4; < .001); using the term, "accidental bowel leakage" (OR, 2.9; 95% CI, 1.2-6.7; = .02) or "bowel control issues" (OR, 2.2; 95% CI, 1.1-4.5; = .03); and being a resident (OR, 0.37; 95% CI, 0.16-0.82; = .02). PCPs reported high interest in patient and provider educational materials about UI and FI.
Most PCPs screen for UI but not FI. High reported interest in educational materials, coupled with high reported rates of perceived importance of screening for UI and FI, suggests that PCPs welcome informative interventions to streamline diagnosis and treatment.
超过一半的老年人会出现尿失禁（UI）或粪便失禁（FI），但大多数人从未向医疗保健提供者讨论过这些症状。对于初级保健提供者（PCP）筛查 UI 和 FI 的情况知之甚少。
我们对中西部一所学术机构的 PCP 进行了一项横断面电子调查，以确定并比较 PCP 对 UI 和 FI 的筛查和治疗的信念、态度和行为；确定与 FI 筛查相关的因素；并确定 FI 筛查和治疗的潜在障碍和促进因素。
在 154 名 PCP 中，UI 的筛查率（75%）是 FI 筛查率（35%）的两倍多（<0.001）。PCP 认为 UI 和 FI 的筛查都很重要，但感觉更有能力治疗 UI（<0.001）。FI 的筛查与 UI 的筛查相关（OR，11.27；95% CI，4.9-26.0；<0.001）；感觉有能力治疗 FI（OR，10.21；95% CI，1.2-90.0；=0.01）；口头筛查（OR，3.9；95% CI，1.9-8.0；<0.001）；认为筛查很重要（OR，3.7；95% CI，1.8-7.4；<0.001）；使用术语“意外肠漏”（OR，2.9；95% CI，1.2-6.7；=0.02）或“肠控问题”（OR，2.2；95% CI，1.1-4.5；=0.03）；以及是住院医师（OR，0.37；95% CI，0.16-0.82；=0.02）。PCP 报告对 UI 和 FI 的患者和提供者教育材料非常感兴趣。
大多数 PCP 筛查 UI，但不筛查 FI。高报告的对教育材料的兴趣，加上高报告的对 UI 和 FI 筛查重要性的认识率，表明 PCP 欢迎信息干预来简化诊断和治疗。
