Studying Incontinence in an Urban Nursing Home

Burgio, Louis D.; Jones, Lori T; Engel, Bernard T.

doi:10.3928/0098-9134-19880401-10

Cited by 20 publications

(13 citation statements)

References 9 publications

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“…Thus, we assume that prompted voiding occurred at a very low rate under normal nursing home routine. This assumption is supported by a survey of these GAs conducted a few months prior to the initiation of this study (Burgio, Jones, & Engel, 1988), in which the GAs reported that they prompted their elderly patients infrequently. After the staff training and management procedure was implemented, staff members reported that they completed an average of 82.8% of their assigned prompted voidings.…”

Section: Discussionmentioning

confidence: 53%

“…The GAs on the nursing units were informed that continence assessments were being conducted and were asked not to alter their continence care activities in any way during this phase. A survey of normal continence care activities in this nursing home just prior to the initiation of this study showed that staff assisted in toileting or prompted patients to toilet only occasionally (Burgio, Jones, & Engel, 1988 Staff management. During the 1-hr course, the GAs and nurses were also instructed in the use of the management system.…”

Section: Design and Experimental Procedures: Phasementioning

confidence: 99%

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A Staff Management System for Maintaining Improvements in Continence With Elderly Nursing Home Residents

Burgio

Engel

Hawkins

et al. 1990

J of App Behav Analysis

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We developed a staff management system for maintaining treatment gains achieved on a specialized continence unit located in a geriatric nursing home. Geriatric assistants learned to use a prompted voiding procedure to maintain improved dryness for 4 elderly residents. The staff management system induded self-monitoring and recording of prompted voiding activities and supervisory monitoring and feedback based on group performance of these activities. Results show that the system was effective in maintaining prompted voiding activities with corresponding maintenance of improved patient continence. However, a gradual decline in staff performance was noted 4 to 5 months after the initiation of the system. During a subsequent phase of the study, provision of individual feedback restored staff performance to previous levels. Results are discussed in relation to the practicality of prompted voiding interventions in nursing home environments and the applicability of staff management systems in this setting.DESCRIPTORS: institutional staffmanagement, incontinence, behavioral gerontology, prompted voiding Behavioral interventions have been used successfully to treat various problems of institutionalized elderly individuals (Williamson & Ascione, 1983). However, much of the research focusing on the care ofsuch persons has involved specially trained research personnel as behavior change agents. Because these individuals are often not responsible for routinely carrying out treatment procedures in nursing homes, the applied significance of this research is in doubt.

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Section: Discussionmentioning

confidence: 53%

Section: Design and Experimental Procedures: Phasementioning

confidence: 99%

A Staff Management System for Maintaining Improvements in Continence With Elderly Nursing Home Residents

Burgio

Engel

Hawkins

et al. 1990

J of App Behav Analysis

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“…Prevalence of fecal incontinence in community-dwelling people over 60 years is 5.1-6.2% and age has an important influence on the rate of fecal incontinence [2]. In nursing homes, however, previous studies suggest a prevalence between 10.3% [3] and 63.6% [4], but is more often reported to be somewhere between 40 and 55% [5-10]. This difference in prevalence in community-dwelling people over 60 years compared to older nursing home residents is major.…”

Section: Introductionmentioning

confidence: 99%

“…Nursing home residents and nursing home institutions worldwide have gone through a great change during the past decades, with increasingly frail residents with multiple comorbidities. However, many fecal incontinence studies are from the 80s and 90s [4-7,9,10,14-16], but there are some studies from the past decade [3,8,17,18]. Previous studies have demonstrated the complexity of fecal incontinence among frail older residents.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and correlates of fecal incontinence among nursing home residents: a population-based cross-sectional study

et al. 2013

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BackgroundFecal incontinence is highly prevalent among nursing home residents. Previous nursing home studies have identified co-morbidity associated with fecal incontinence, but as this population is increasingly old and frail, we wanted to see if the rate of fecal incontinence had increased and to investigate correlates of fecal incontinence further.MethodsCross-sectional study of the entire nursing home population in one Norwegian municipality. Registered nurses filled in a questionnaire for all residents in the municipality (980 residents aged ≥65). Statistical methods used are descriptive statistics, binary logistic regression and multivariable logistic regression.ResultsThe response rate of the study was 90.3%. The prevalence of fecal incontinence was 42.3%. In multivariable analysis of FI, residents with diarrhea (OR 7.33, CI 4.39-12.24), urinary incontinence (OR 2.77, CI 1.73-4.42) and dementia (OR 2.17, CI 1.28-3.68) had higher odds of having fecal incontinence compared to those without the condition. Residents residing in a nursing home between 4–5 years had higher odds of having fecal incontinence compared to residents who had stayed under a year (OR 2.65, CI 1.20-5.85). Residents with deficiency in feeding (2.17, CI 1.26-3.71), dressing (OR 4.03, CI 1.39-11.65), toilet use (OR 7.37, CI 2.65-20.44) and mobility (OR 2.54, CI 1.07-6.00) had higher odds of having fecal incontinence compared to residents without deficiencies in activities of daily living (ADL). Needing help for transfer between bed and chair was a protective factor for fecal incontinence compared to residents who transferred independently (OR 0.49, CI 0.26-0.91).ConclusionsFecal incontinence is a prevalent condition in the nursing home population and is associated with ADL decline, frailty, diarrhea and quality of care. This knowledge is important for staff in nursing home in order to provide the best treatment and care for residents with fecal incontinence.

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“…In einer 1988 durchgeführten Studie in den Vereinigten Staaten wurde herausgearbeitet und geschätzt, dass mehr als 400 Mio. Dollar pro Jahr für Sanitärartikel ausgegeben werden [10]. Die Ursachen der Analinkontinenz sind mannigfaltig.…”

Section: Schlüsselwörterunclassified

Rolle der Bildgebung bei Analinkontinenz

Buhr

Kroesen

2003

Chirurg

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Endoanal sonography is a well established method for the morphological diagnosis of anal sphincter damage. The best images are obtained using a 7-10 MHz rotating rigid endoprobe. The internal anal sphincter and the external anal sphincter, as well as the other pelvic floor structures, can be clearly visualised with this technique. Endosonography has shown physiological differences in sphincter anatomy and brought new insights into the pathogenesis of anorectal disorders. Apart of anal fistulas, faecal incontinence represents the main indication for the use of this method. In addition, rectal evacuation disorders are an indication for which endosonography allows a first step towards a diagnosis. Anal ultrasound is a technique friendly to both the physician and the patient, and belongs in every coloproctological unit for the assessment of faecal incontinence. Accuracy, specificity and sensitivity for the detection of anal sphincter defects range between 83 and 100% in almost all studies. Additional methods are vaginal endosonography, three dimensional endosonography and perineal sonography.

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Studying Incontinence in an Urban Nursing Home

Cited by 20 publications

References 9 publications

A Staff Management System for Maintaining Improvements in Continence With Elderly Nursing Home Residents

A Staff Management System for Maintaining Improvements in Continence With Elderly Nursing Home Residents

Prevalence and correlates of fecal incontinence among nursing home residents: a population-based cross-sectional study

Rolle der Bildgebung bei Analinkontinenz

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