Yu Lanlan, Hao Fengming, Li Jie, Hu Yingjie, Xiong Fei, Chen Ling, Cai Wenzhi
Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, China.
School of Nursing, Southern Medical University, Guangzhou, China.
Front Public Health. 2025 Jun 9;13:1453244. doi: 10.3389/fpubh.2025.1453244. eCollection 2025.
This study explores the real-world use and challenges of fecal incontinence (FI) collection products-both absorbent items (pads, diapers) and dedicated fecal-collection devices with adhesive fixators-among long-term, bed-bound hospital patients, while also considering broader public-health implications. It seeks to identify barriers to optimal product use and to offer recommendations for improving incontinence management outcomes.
Effective FI management is essential to patient wellbeing and to preventing healthcare-associated infections (HAIs). Although multiple FI collection products are available, their use in long-term hospital settings remains suboptimal, largely because of caregiver training gaps and limited resources.
This mixed-methods study used an explanatory sequential design. Quantitative data were gathered through online and paper-based surveys administered to caregivers in three hospitals ( = 318). These data were supplemented by qualitative interviews ( = 24) that provided deeper insight into the challenges identified. We performed descriptive and inferential statistical analyses, including logistic regression, and carried out a thematic analysis of interview transcripts to clarify the factors influencing product choice and the related public-health implications.
Product choice was shaped by distinct factors across caregiver groups. For family caregivers, household income (OR = 2.380) and living arrangement (OR = 0.344) were major determinants. Among nursing assistants, prior training (OR = 8.817) strongly affected selection. For nurses, incontinence-associated dermatitis training (OR = 3.344) and work environment (OR = 3.304) were critical. Qualitative interviews highlighted mismatches between available products and actual needs, emphasizing the importance of reforming procurement channels, raising awareness, and tailoring caregiver education.
Disparities in FI product use stem mainly from economic constraints, training gaps, and limited awareness. Enhancing caregiver training, streamlining product distribution, and broadening insurance support could strengthen FI management and reduce HAIs. Although the findings offer useful guidance for policy and practice, their generalizability is limited by the single geographic setting and reliance on self-reported data. Future studies should examine diverse institutional contexts to validate and extend these results.
本研究探讨了长期卧床的住院患者对大便失禁（FI）收集产品（包括吸收性用品（护垫、尿布）和带有粘性固定器的专用粪便收集装置）的实际使用情况及面临的挑战，同时也考虑了更广泛的公共卫生影响。研究旨在确定最佳产品使用的障碍，并为改善失禁管理结果提供建议。
有效的FI管理对患者的健康以及预防医疗相关感染（HAIs）至关重要。尽管有多种FI收集产品可供使用，但它们在长期住院环境中的使用仍不理想，这主要是由于护理人员培训差距和资源有限。
本混合方法研究采用了解释性序列设计。通过对三家医院的护理人员进行在线和纸质调查收集定量数据（n = 318）。这些数据通过定性访谈（n = 24）得到补充，定性访谈能更深入地了解所发现的挑战。我们进行了描述性和推断性统计分析，包括逻辑回归，并对访谈记录进行了主题分析，以阐明影响产品选择的因素及相关的公共卫生影响。
不同护理人员群体的产品选择受不同因素影响。对于家庭护理人员，家庭收入（OR = 2.380）和生活安排（OR = 0.344）是主要决定因素。在护理助理中，先前的培训（OR = 8.817）对选择有强烈影响。对于护士，失禁相关性皮炎培训（OR = 3.344）和工作环境（OR = 3.304）至关重要。定性访谈突出了现有产品与实际需求之间的不匹配，强调了改革采购渠道、提高认识和定制护理人员教育的重要性。
FI产品使用的差异主要源于经济限制、培训差距和认识不足。加强护理人员培训、简化产品分发并扩大保险支持可以加强FI管理并减少HAIs。尽管研究结果为政策和实践提供了有用的指导，但其普遍性受到单一地理环境和对自我报告数据的依赖的限制。未来的研究应考察不同的机构背景以验证和扩展这些结果。
