McDowell B J, Engberg S J, Rodriguez E, Engberg R, Sereika S
University of Pittsburgh School of Nursing, PA 15261, USA.
J Am Geriatr Soc. 1996 Aug;44(8):963-8. doi: 10.1111/j.1532-5415.1996.tb01869.x.
To describe the characteristics of urinary incontinence and related factors in incontinent homebound older adults.
A descriptive study of 90 cognitively intact incontinent homebound older persons referred to a clinical trial to examine the effectiveness of behavioral therapies in the treatment of urinary incontinence (UI) in homebound patients.
Incontinent patients more than 60 years of age who met the Health Care Financing Administration's definition of homebound were referred to a clinical trial by home care nurses from a Medicare-approved home care agency in a large metropolitan country in Pennsylvania.
Structured continence and medical history, basic and instrumental activities of daily living, Folstein MMSE, Geriatric Depression Scale, mobility-toileting skills, bladder diaries, and physical examination.
Four hundred eighty-four persons were referred to the clinical trial, and 90 cognitively intact persons were found eligible to participate in this study (80 women and 10 men). Subjects had a mean age of 75.8 years, reported a mean of 8.4 medical problems, and most, 80%, had functional limitations in ambulation. Subjects recorded a mean of 3.8 urinary accidents/day-1.4 large and 2.4 small accidents/ day-in baseline bladder diaries. The majority, 73.3%, had more than 10 accidents per week, and most patients reported mixed urge, stress (57.1%), or pure urge (37.7%) UI. Half (54.4%) reported that UI further restricted their activities, and 52.2% reported that this problem was extremely disturbing. However, 90.5% believed that UI could be treated.
Urinary incontinence tends to be severe among cognitively intact homebound older adults in both frequency and volume of accidents. Although subjects were homebound with many health and functional disabilities, they perceived UI as a very disturbing problem that further restricted their activities. Participants in this study were optimistic about the potential benefits of treatment.
描述居家养老的尿失禁老年人的尿失禁特征及相关因素。
一项描述性研究，对90名认知功能正常的居家养老尿失禁老年人进行研究，这些老年人被纳入一项临床试验，以检验行为疗法对居家患者尿失禁（UI）的治疗效果。
年龄超过60岁、符合医疗保健财务管理局对居家养老定义的尿失禁患者，由宾夕法尼亚州一个大都市县的一家医疗保险批准的居家护理机构的居家护理护士转介至一项临床试验。
结构化的尿失禁及病史、基本和工具性日常生活活动、Folstein简易精神状态检查表、老年抑郁量表、移动至如厕技能、膀胱日记及体格检查。
484人被转介至该临床试验，90名认知功能正常者符合参与本研究的条件（80名女性和10名男性）。受试者的平均年龄为75.8岁，平均有8.4种医疗问题，大多数（80%）在行走方面存在功能受限。受试者在基线膀胱日记中记录的平均尿失禁次数为每天3.8次——其中1.4次为大量尿失禁，2.4次为少量尿失禁。大多数（73.3%）每周尿失禁次数超过10次，大多数患者报告为混合性急迫性、压力性（57.1%）或单纯急迫性（37.7%）尿失禁。一半（54.4%）的患者报告尿失禁进一步限制了他们的活动，52.2%的患者报告这个问题极其困扰他们。然而，90.5%的患者认为尿失禁可以治疗。
在认知功能正常的居家养老老年人中，尿失禁在发生频率和尿量方面往往都很严重。尽管受试者因多种健康和功能残疾而居家，但他们认为尿失禁是一个非常困扰他们的问题，进一步限制了他们的活动。本研究的参与者对治疗的潜在益处持乐观态度。
