Jackson Hayley, Mann Georgina, Martini Angelita, Troeung Lakkhina, Beros Katie, Prinsloo Annelize
Brightwater Care Group, Brightwater Research Centre, Perth, Australia.
Disabil Rehabil. 2023 Apr;45(7):1208-1219. doi: 10.1080/09638288.2022.2055169. Epub 2022 Apr 20.
After acquired brain injury (ABI) dependence on intervention for continence management is common. This preliminary investigation aimed to (i) quantify toileting care hours and costs in a community-based ABI rehabilitation and disability setting, and (ii) measure change in care needs, costs, and functional independence after intervention with assistive technologies (ATs).
Pragmatic pre-post intervention pilot study of 14 adults with ABI and toileting disability accessing community-based neurorehabilitation or disability support in Western Australia. Toileting and functional independence were assessed monthly from baseline () to 3-month follow-up (). Basic and nursing care hours (Northwick Park Dependency Score), cost of care estimates (Northwick Park Care Needs Assessment), functional independence (Functional Independence and Assessment Measure), and cost of consumables were examined pre- and post-intervention with ATs. Multilevel mixed-effects models with bootstrap estimation were conducted.
Cost of consumables significantly declined (AU$69/week), and functional independence significantly improved following intervention (+23.5 points). There was a non-significant reduction in care needs for toileting (4 h/week) and in the cost of toileting care (AU$633/week).
Toileting disability substantially impacts care hours and costs. This study provides preliminary evidence that comprehensive continence management is beneficial in reducing costs and supporting people with an ABI to increase their independence.IMPLICATIONS FOR REHABILITATIONA comprehensive continence assessment and management plan reduces the number of care hours, cost of care, and cost of continence products in a neurorehabilitation and disability support sample for people with acquired brain injury (ABI).Assistive technologies for continence management are beneficial in supporting people with ABI to increase independence, and reduce costs.Providing comprehensive continence assessment and management plan reduces reliance on staff for continence care, and improves functional independence.
获得性脑损伤（ABI）后，依赖干预进行排尿管理很常见。这项初步调查旨在：（i）量化社区ABI康复和残疾环境中的如厕护理时间和成本；（ii）测量辅助技术（AT）干预后护理需求、成本和功能独立性的变化。
对14名患有ABI且有如厕残疾的成年人进行实用的干预前后试点研究，这些成年人在西澳大利亚接受社区神经康复或残疾支持。从基线（ ）到3个月随访（ ）每月评估如厕情况和功能独立性。在干预前后使用AT检查基本护理和护理时间（诺斯威克公园依赖评分）、护理成本估计（诺斯威克公园护理需求评估）、功能独立性（功能独立性和评估量表）以及消耗品成本。进行带有自助估计的多层次混合效应模型分析。
干预后消耗品成本显著下降（每周69澳元），功能独立性显著改善（提高23.5分）。如厕护理需求（每周4小时）和如厕护理成本（每周633澳元）有不显著的降低。
如厕残疾对护理时间和成本有重大影响。本研究提供了初步证据，表明全面的排尿管理有助于降低成本，并支持ABI患者提高独立性。
对康复的启示
全面的排尿评估和管理计划可减少获得性脑损伤（ABI）患者在神经康复和残疾支持样本中的护理时间、护理成本和排尿产品成本。
用于排尿管理的辅助技术有助于支持ABI患者提高独立性并降低成本。
提供全面的排尿评估和管理计划可减少对工作人员进行排尿护理的依赖，并提高功能独立性。
