Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom.
Faculty of Medicine and Health Sciences, Norwegian University of Technology, Trondheim, Norway.
J Am Med Dir Assoc. 2019 Aug;20(8):956-962.e8. doi: 10.1016/j.jamda.2019.03.033. Epub 2019 May 23.
Older people resident in care homes often rely on staff for support relating to their activities of daily living, including intimate care such as continence care. Managing fecal incontinence can be challenging for both residents and care staff. We conducted this review to describe the prevalence, incidence, and correlates of fecal incontinence among care home residents.
Systematic literature review.
Older care home residents (both nursing and residential care) aged 60 years and older.
We defined double incontinence as the presence of fecal plus urinary incontinence, isolated fecal incontinence as fecal incontinence with no urinary incontinence, and all fecal incontinence as anyone with fecal incontinence (whether isolated or double). The CINAHL and MEDLINE databases were searched up to December 31, 2017, to retrieve all studies reporting the prevalence and/or incidence and correlates of fecal incontinence.
We identified 278 citations after removing duplicates, and 23 articles met the inclusion criteria. There were 12 high-quality studies, 5 medium-quality studies, and 6 low-quality studies. The medians for prevalence (as reported by the studies) of isolated fecal incontinence, double incontinence, and all fecal incontinence were 3.5% [interquartile range (IQR) = 2.8%], 47.1% (IQR = 32.1%), and 42.8% (IQR = 21.1%), respectively. The most frequently reported correlates of fecal incontinence were cognitive impairment, limited functional capacity, urinary incontinence, reduced mobility, advanced age, and diarrhea.
CONCLUSIONS/IMPLICATIONS: Fecal incontinence is prevalent among older people living in care homes. Correlates included impaired ability to undertake activities of daily living, reduced mobility, laxative use, and altered stool consistency (eg, constipation or diarrhea) which are potentially amenable to interventions to improve fecal incontinence.
居住在养老院的老年人经常依赖工作人员提供日常生活活动方面的支持，包括私密护理，如大小便失禁护理。管理粪便失禁对居民和护理人员来说都是一项挑战。我们进行了这项综述，以描述养老院居民粪便失禁的患病率、发病率和相关因素。
系统文献综述。
年龄在 60 岁及以上的养老院老年人（包括护理和居住护理）。
我们将双重失禁定义为同时存在粪便和尿失禁，将单纯性粪便失禁定义为无尿失禁的粪便失禁，将所有粪便失禁定义为任何有粪便失禁（无论是单纯性还是双重性）的人。CINAHL 和 MEDLINE 数据库被搜索到 2017 年 12 月 31 日，以检索所有报告粪便失禁的患病率和/或发病率和相关因素的研究。
去除重复项后，我们共识别出 278 条引文，其中 23 篇文章符合纳入标准。其中有 12 项高质量研究、5 项中等质量研究和 6 项低质量研究。单纯性粪便失禁、双重失禁和所有粪便失禁的患病率（由研究报告）中位数分别为 3.5%（四分位距[IQR] = 2.8%）、47.1%（IQR = 32.1%）和 42.8%（IQR = 21.1%）。粪便失禁最常报告的相关因素包括认知障碍、有限的功能能力、尿失禁、活动能力降低、年龄较大和腹泻。
结论/意义：粪便失禁在居住在养老院的老年人中很常见。相关因素包括日常生活活动能力受损、活动能力降低、使用泻药和粪便稠度改变（如便秘或腹泻），这些因素可能适合干预以改善粪便失禁。
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