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1.
J Wound Ostomy Continence Nurs ; 51(4): 313-323, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39037164

RESUMEN

PURPOSE: This systematic review analyzed evidence related to risk factors for Incontinence Associated Dermatitis (IAD) in critically ill incontinent patients. METHOD: Systematic review and meta-analysis. SEARCH STRATEGY: Eight databases, including PubMed, Embase, CINAHL, Cochrane Library, and Web of Science, were searched for studies published in the English language. The China National Knowledge Infrastructure, WanFang Data, and Chinese Scientific Journal Database were also searched for studies evaluating risk of IAD in critically ill incontinent patients published in the Chinese language. FINDINGS: Twenty-four studies with moderate-to-high methodological quality were included. Significant risk factors for developing IAD were being older [odds ratio (OR) = 1.06, 95% confidence interval (CI): 1.02-1.10, P = .007], fever (OR = 2.57, 95% CI: 1.87-3.57, P < .00001), diagnosed with consciousness disorder (OR = 5.70, 95% CI: 2.28-14.22, P = .0002), having higher Acute Physiology and Chronic Health Evaluation (APACHE) II score (OR = 1.71, 95% CI: 1.25-2.35, P = .0009), lower Braden score (OR = 0.73, 95% CI: 0.56-0.96, P = .02), lower oxygen saturation (OR = 2.76, 95% CI: 1.52-5.00, P = .0008), double incontinence (OR = 4.10, 95% CI: 2.34-7.17, P < .00001), liquid stool (OR = 6.55, 95% CI: 4.12-10.41, P < .00001), frequent incontinence (OR = 1.21, 95% CI: 1.03-1.43, P = .02), and higher perineal assessment tool (PAT) score (OR = 3.18, 95% CI: 1.76-5.76, P = .0001). IMPLICATIONS: Findings of this systematic review and meta-analysis suggest that healthcare providers should consider risk factors such as older age, fever, consciousness disorder, higher APACHE II score, lower Braden score and double incontinence matter when developing strategies for the prevention and management of IAD in critically ill incontinent patients.


Asunto(s)
Enfermedad Crítica , Dermatitis , Incontinencia Fecal , Incontinencia Urinaria , Humanos , Dermatitis/etiología , Dermatitis/epidemiología , Incontinencia Fecal/complicaciones , Factores de Riesgo , Incontinencia Urinaria/complicaciones
3.
Wound Manag Prev ; 70(2)2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38959349

RESUMEN

PURPOSE: This study aimed to assess nursing students' knowledge levels and attitudes towards the etiology, risk factors, and preventive measures of incontinence-associated dermatitis (IAD) using an escape room game. DESIGN: A mixed-method study. SUBJECTS AND SETTING: The sample size of the study was 32 students. METHODS: Quantitative data obtained with the Knowledge, Attitude and Practice of Nurses in Managing Incontinence-Associated Dermatitis Questionnaire (KAP-IAD-Q) and qualitative data obtained through FGDs following the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist were analyzed using a thematic approach. RESULTS: The average age of the participants was 22.63 ± 0.90, 87.5% of them were female (n=28), and 50% were third (n=16) and fourth-year students (n=16). KAP-IAD-Q total posttest score (88.06+7.00) was found to be high. Data obtained from the FGDs were categorized under 3 main themes: main focus areas during participation in the IAD-themed escape room game; advantages and disadvantages of teamwork in IAD management; and the game's contribution to a better understanding and classification of IAD. CONCLUSIONS: The use of the escape room game facilitated high, fast, and efficient learning of IAD knowledge and attitudes. It revealed challenges in collaborative decision-making, accurate diagnosis, distinguishing from other wounds, and attitude development in the management of IAD.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Estudiantes de Enfermería , Incontinencia Urinaria , Humanos , Estudiantes de Enfermería/psicología , Estudiantes de Enfermería/estadística & datos numéricos , Femenino , Masculino , Encuestas y Cuestionarios , Incontinencia Urinaria/complicaciones , Incontinencia Urinaria/enfermería , Incontinencia Urinaria/psicología , Investigación Cualitativa , Dermatitis/etiología , Dermatitis/psicología , Incontinencia Fecal/complicaciones , Incontinencia Fecal/psicología , Incontinencia Fecal/enfermería , Bachillerato en Enfermería/métodos , Adulto Joven , Competencia Clínica/estadística & datos numéricos , Competencia Clínica/normas
4.
Rehabil Nurs ; 49(4): 125-133, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38959364

RESUMEN

GENERAL PURPOSE: To provide information on the association between risk factors and the development of new or worsened stage 2 to 4 pressure injuries (PIs) in patients in long-term care hospitals (LTCHs), inpatient rehabilitation facilities (IRFs), and skilled nursing facilities (SNFs). TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant will:1. Compare the unadjusted PI incidence in SNF, IRF, and LTCH populations.2. Explain the extent to which the clinical risk factors of functional limitation (bed mobility), bowel incontinence, diabetes/peripheral vascular disease/peripheral arterial disease, and low body mass index are associated with new or worsened stage 2 to 4 PIs across the SNF, IRF, and LTCH populations.3. Compare the incidence of new or worsened stage 2 to 4 PI development in SNF, IRF, and LTCH populations associated with high body mass index, urinary incontinence, dual urinary and bowel incontinence, and advanced age.


Asunto(s)
Úlcera por Presión , Humanos , Úlcera por Presión/epidemiología , Úlcera por Presión/prevención & control , Factores de Riesgo , Masculino , Femenino , Incidencia , Anciano , Instituciones de Cuidados Especializados de Enfermería/estadística & datos numéricos , Instituciones de Cuidados Especializados de Enfermería/organización & administración , Atención Subaguda/métodos , Atención Subaguda/estadística & datos numéricos , Atención Subaguda/normas , Anciano de 80 o más Años , Persona de Mediana Edad , Incontinencia Urinaria/complicaciones , Incontinencia Urinaria/epidemiología
5.
BMC Womens Health ; 24(1): 398, 2024 Jul 12.
Artículo en Inglés | MEDLINE | ID: mdl-38997642

RESUMEN

INTRODUCTION: Pelvic organ prolapse is the implosion of one or more pelvic floor structures which affect womens quality of life by compromising overall health, physical, social, structural, functional and emotional well-being. OBJECTIVE: To assess the quality of life and its associated factors among women with pelvic organ prolapse who attend gynecology clinics at Gurage zone hospitals, Southern Ethiopia 2022. METHODS: Facility-based cross-sectional study was applied in gurage zone hospital from April, 30 to Jun 30, 2022. Systematic random sampling was employed to select 416 women. Interview based structured questionnaires were applied to collect the data. The collected data were analyzed using Statistical Produte and Service Solution. Binary and multivariable logistic regressions were fitted to assess the association between dependent and independent variables. P-value < 0.05 was used to declare the final statistical significance. RESULT: The mean (SD) score of quality of life in this study was 53.57 (21.59). The most affected domains were general health perception and physical limitation (mean (SD) score 67.45 29.24) and (64.26 32.36)) respectively. Had no formal education (AOR = 1.50, 95% CI: 1.02, 3.12), stage III/IV POP (AOR = 2.02, 95% CI: 1.19, 3.60), constipation (AOR = 3.51, 95% CI: 2.12, 7.21), urge urinary incontinence (AOR = 3.89, 95% CI: 2.32, 6.95), and not did regular physical exercise (AOR = 2.18, 95% CI: 1.41, 3.37) were significantly associated with poor quality of life. CONCLUSION: More than half of the participants in this study had impaired quality of life. The factor associated with quality of life was had no formal education, stage III/IV, constipation, urge urinary incontinence, and regular physical activity. It is recommended to have access education, counseling regular physical activity, detection, and management of its comorbidity.


Asunto(s)
Prolapso de Órgano Pélvico , Calidad de Vida , Humanos , Femenino , Calidad de Vida/psicología , Etiopía/epidemiología , Prolapso de Órgano Pélvico/psicología , Prolapso de Órgano Pélvico/epidemiología , Estudios Transversales , Adulto , Persona de Mediana Edad , Encuestas y Cuestionarios , Anciano , Ginecología , Incontinencia Urinaria/psicología , Incontinencia Urinaria/epidemiología , Incontinencia Urinaria/complicaciones
7.
J Wound Ostomy Continence Nurs ; 51(4): 324-329, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39037166

RESUMEN

PURPOSE: The aim of this study was to develop a model to determine the correlation between comfort level and quality of life in women with UI. DESIGN: Cross-sectional, descriptive correlational research design with causal modeling. SUBJECTS AND SETTING: The study was conducted in the urology outpatient clinic of a university hospital in the Central Anatolia region of Turkey. The sample comprised 233 women admitted to the outpatient clinic between December 2017 and May 2018. Participants had a mean age of 52.5 (SD = 13.9) years. METHODS: Data were collected using a researcher-designed Descriptive Characteristics Form, the Incontinence Quality of Life (I-QOL) form, the Urinary Incontinence and Frequency Comfort Questionnaire (UIFCQ), and the Short Form-36 (SF-36). Multivariate correlations were analyzed using structural equation modeling; an AMOS covariance-based structural equation model was developed. RESULTS: The correlational pathway between I-QOL, UIFCQ, and SF-36 was statistically significant. As a result of the confirmed model, I-QOL scores were moderately correlated with SF-36 scores (r = .65, P = .001) and highly correlated with UIFCQ scores (r = .76, P = .001). Mean UIFCQ scores were moderately correlated with SF-36 scores (r = .66, P = .001). The structural equation modeling resulted in a model with a good fit. CONCLUSIONS: The higher the comfort level, the higher the UI-specific and health-related quality of life. Risk factors related to UI should be monitored, and necessary training and counseling should be provided to eliminate this common problem.


Asunto(s)
Análisis de Clases Latentes , Calidad de Vida , Incontinencia Urinaria , Humanos , Femenino , Calidad de Vida/psicología , Incontinencia Urinaria/psicología , Incontinencia Urinaria/complicaciones , Estudios Transversales , Turquía/epidemiología , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto , Anciano
8.
Int Wound J ; 21(7): e14962, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-39016196

RESUMEN

Incontinence-associated dermatitis (IAD) is an irritant contact dermatitis from prolonged contact with urine or faeces, which can significantly impact patient comfort and quality of life. The identification of prognostic factors for the development of IAD has the potential to enhance management, support preventive measures and guide future research. The objective of this systematic review was to summarize the empirical evidence of prognostic factors for the development of IAD. This study included prospective and retrospective observational studies or clinical trials that described prognostic factors associated with IAD. There were no restrictions on setting, time, language, participants or geographical regions. Exclusion criteria included reviews, editorials, commentaries, methodological articles, letters to the editor, cross-sectional and case-control studies, and case reports. Searches were conducted from inception to April 2024 on MEDLINE, CINAHL, EMBASE and the Cochrane Library. The studies were assessed by two independent reviewers using the QUIPS and the CHARMS-PF for data extraction. A narrative synthesis approach was employed due to study heterogeneity and using the 'vote counting based on direction' method and the sign test. The overall certainty of evidence was assessed using adapted GRADE criteria. The review included 12 studies and identified 15 potential predictors. Moderate-quality evidence suggests that increased stool frequency, limited mobility and friction/shear problems are risk factors for IAD development. Female sex, older age, vasopressor use and loose/liquid stool are risk factors supported by low-quality evidence. Increased stool frequency, limited mobility and friction/shear problems seem to be risk factors for the development of IAD. There is insufficient evidence to support the predictive validity of female sex, older age, loose/liquid stool and vasopressor use. There is substantial methodological variability across studies, making it challenging to make comparisons. Large-scale cohort studies in different settings that incorporate our review findings should be conducted in the future.


Asunto(s)
Incontinencia Fecal , Incontinencia Urinaria , Humanos , Incontinencia Urinaria/complicaciones , Incontinencia Urinaria/terapia , Incontinencia Fecal/complicaciones , Pronóstico , Femenino , Masculino , Factores de Riesgo , Anciano , Persona de Mediana Edad , Dermatitis Irritante/etiología , Anciano de 80 o más Años , Adulto , Calidad de Vida
9.
Int Wound J ; 21(6): e14936, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38899615

RESUMEN

The study aimed to evaluate the effect of an intervention on the prevalence and severity of incontinence-associated dermatitis (IAD) in six hospitals in one state in Australia. This quasi-experimental pre-and post-study, conducted in 18 wards, was part of a larger implementation science study on incontinence-associated dermatitis. Skin and incontinence assessments were conducted on patients during February and March 2020 (pre-intervention) and July and August 2021 (post-intervention). The intervention comprised continence assessment and management, an education brochure for patients, family and caregivers on IAD, the Ghent Global IAD Categorisation Tool (GLOBIAD) and a skin care regime with patient skin protection measures (three-in-one barrier cream cloths, minimisation of bed protection layers, use of appropriate continence aid). A total of 1897 patients were assessed (pre-intervention = 964, post-intervention = 933). A total of 343 (35.6%) pre-intervention patients and 351 (37.6%) post-intervention patients had incontinence. The prevalence of hospital-acquired IAD was 6.71% in the pre-intervention group and 4.27% in the post-intervention group; a reduction of 36.3% (p = 0.159) despite higher patient acuity, prevalence of double incontinence and the COVID-19 pandemic in the post-intervention group compared with the pre-intervention group. Our multisite best practice IAD prevention and treatment intervention was able to reduce the prevalence and severity of hospital-acquired IAD, suggesting enduring effectiveness of the intervention.


Asunto(s)
Dermatitis , Incontinencia Fecal , Incontinencia Urinaria , Humanos , Femenino , Masculino , Incontinencia Urinaria/complicaciones , Incontinencia Urinaria/epidemiología , Prevalencia , Anciano , Incontinencia Fecal/complicaciones , Anciano de 80 o más Años , Dermatitis/etiología , Dermatitis/prevención & control , Dermatitis/epidemiología , Australia/epidemiología , Persona de Mediana Edad , Cuidados de la Piel/métodos , Investigación Biomédica Traslacional , Paquetes de Atención al Paciente/métodos
10.
Br J Community Nurs ; 29(Sup5): S8-S14, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38728161

RESUMEN

Dementia and incontinence are both prevalent in older age; yet, neither are an inevitable or normal part of ageing. It has been recognised that there is a skills and knowledge gap in professionals assessing and managing incontinence for people living with dementia. All too often, assumptions are made that incontinence is a symptom of dementia and that nothing can be done if a person living with dementia experiences episodes of incontinence. While dementia may impact on a person's ability to remain continent, it may not be the sole cause, and there may be treatments and strategies that can reduce the incidence in those affected. Therefore, a person-centred continence assessment should be undertaken to promote continence and reduce the impact of incontinence for people living with dementia and those who care for them. This paper will highlight some of the issues that are important for health and social care professionals to explore and identify, assess and manage incontinence to improve outcomes for families affected by dementia.


Asunto(s)
Demencia , Incontinencia Fecal , Incontinencia Urinaria , Humanos , Incontinencia Urinaria/complicaciones , Demencia/complicaciones , Incontinencia Fecal/complicaciones , Incontinencia Fecal/enfermería , Anciano
11.
Br J Community Nurs ; 29(6): 294-295, 2024 Jun 02.
Artículo en Inglés | MEDLINE | ID: mdl-38814833

RESUMEN

Incontinence-associated dermatitis (IAD) is often treated a hygienic challenge, rather than a serious condition with potentially life-threatening consequences. More appropriate education on the management strategies specific to IAD is required, in order for personalised and effective care that reflects the critical nature of this condition to be provided. Francesca Ramadan provides an overview of the key elements of best practice in IAD management and treatment.


Asunto(s)
Dermatitis , Incontinencia Fecal , Incontinencia Urinaria , Humanos , Incontinencia Urinaria/complicaciones , Incontinencia Fecal/complicaciones , Incontinencia Fecal/enfermería , Dermatitis/etiología , Dermatitis/enfermería , Cuidados de la Piel/enfermería , Enfermería en Salud Comunitaria , Femenino
12.
Br J Nurs ; 33(9): S16-S28, 2024 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-38722011

RESUMEN

Incontinence-associated dermatitis (IAD) is a skin inflammation caused by contact with urine or faeces or both. It has a negative effect on the patient's quality of life and is indicative of the care provided. However, globally there is a lack of empirical data on the prevalence of IAD. AIM: To identify, for the first time, the proportion of older adults in extended care settings in Ireland affected by IAD. DESIGN: Cross-sectional, multisite, point prevalence survey, across three community extended care settings for older people in Ireland. METHODS: Two clinical nurse specialists, using the Scottish Excoriation and Moisture Related Skin Damage Tool, identified the presence of IAD through clinical observation and visual skin inspection. IAD prevalence was calculated for the total population and incontinent population sets using percentages and confidence intervals (CI). RESULTS: The prevalence of incontinence was 86.4% (n=165), a significantly higher proportion were female (P=0.003). The point prevalence of IAD across the total population and incontinent population was 11.5% (22/191; 95% CI, 7.4-19.9%) and 13.3% (22/164; 95% CI, 8.5-19.5%), respectively. Being incontinent was associated with being female, more dependent (Barthel), having possible cognitive impairment, poorer mobility (Braden and Waterlow) and a high risk of pressure ulcers (Waterlow). A logistic regression analysis found no predictor variables for IAD among the variables that met the cut-off point for this analysis. CONCLUSIONS: The study provides the first point prevalence empirical data on the occurrence of IAD in Ireland. It can inform decision-making on future planning and budgeting of new quality improvement projects and act as a benchmark for ongoing auditing of IAD.


Asunto(s)
Incontinencia Fecal , Incontinencia Urinaria , Humanos , Femenino , Estudios Transversales , Masculino , Irlanda/epidemiología , Prevalencia , Anciano , Incontinencia Urinaria/epidemiología , Incontinencia Urinaria/complicaciones , Incontinencia Fecal/epidemiología , Incontinencia Fecal/complicaciones , Anciano de 80 o más Años , Dermatitis/epidemiología , Dermatitis/etiología
13.
Br J Community Nurs ; 29(Sup5): S34-S36, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38728164

RESUMEN

Incontinence-associated dermatitis, previously and sometimes still referred to as moisture lesions or moisture damage, is a commonly seen contact dermatitis that is a reactive response of the skin to chronic contact to urine and faecal matter. Understanding the etiology is fundamental to creating a skin care plan and successfully prevention. Systemic reviews and studies have shown that the continued variability in management results from a combination of knowledge base, observation, diagnosis, and product selection. This article aims to improve clinicians' understanding of incontinence-associated dermatitis and its management.


Asunto(s)
Incontinencia Fecal , Cuidados de la Piel , Incontinencia Urinaria , Femenino , Humanos , Dermatitis/etiología , Dermatitis/enfermería , Dermatitis por Contacto/etiología , Incontinencia Fecal/complicaciones , Cuidados de la Piel/enfermería , Incontinencia Urinaria/complicaciones
14.
Can J Urol ; 31(2): 11840-11846, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38642462

RESUMEN

INTRODUCTION: There are multiple historic reports linking lower urinary tract symptoms (LUTS) in children with food allergies (FA), but contemporary studies are sparse. The objective of this study was to evaluate a potential link between FA and LUTS in the pediatric population. We hypothesized that children with FAs are more likely to have LUTS. MATERIALS AND METHODS: After local IRB approval, pediatric patients (6-17 years [y]) with FAs proven by positive skin prick and/or serum IgE testing were invited to participate. A control group of pediatric patients without FAs was also recruited. All families/legal guardians signed informed consent, and all children signed written assent. Each participant filled out the Vancouver Symptom Score (VSS), a validated questionnaire for dysfunctional elimination syndrome, and the Pediatric Incontinence Questionnaire (PinQ), a validated quality of life assessment for children with bladder dysfunction. Demographic and clinical information were obtained retrospectively. RESULTS: From 2019-2020, 26 children with FAs and 57 without agreed to participate. Mean age was 9.3 y (IQR 7.9 y-13.5 y). There were no differences in gender, age, or race between the two cohorts. There were no significant differences between the two groups in mean VSS score or mean PinQ score. Four children with FAs (15%) and 15 children without (26%) had VSS score ≥ 11 (p = 0.339), indicating dysfunctional elimination. The median PinQ score was 0 (IQR 0-2) in both cohorts. CONCLUSIONS: This study did not identify an association between FAs and LUTS in a population of pediatric patients with laboratory proven FAs.


Asunto(s)
Hipersensibilidad a los Alimentos , Síntomas del Sistema Urinario Inferior , Incontinencia Urinaria , Humanos , Niño , Estudios de Casos y Controles , Calidad de Vida , Estudios Retrospectivos , Síntomas del Sistema Urinario Inferior/diagnóstico , Incontinencia Urinaria/complicaciones , Encuestas y Cuestionarios , Hipersensibilidad a los Alimentos/complicaciones
15.
J Tissue Viability ; 33(3): 357-361, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38632012

RESUMEN

AIM: This research was conducted to determine the factors affecting the development of incontinence-associated dermatitis in intensive care patients. METHODS: The sample of the study consisted of 114 intensive care patients who developed incontinence-associated dermatitis. Patients were followed for a minimum of 8 days. The 'Patient Information Form' and the 'Incontinence-Associated Dermatitis and Severity Instrument (IADSI)' were used for data collection. The data were collected between February and May 2022. Ethics committee approval was obtained for the research. In the evaluation of the data, SPSS for Windows (Version 24.0, Statistical Package for Social Sciences) program was used. RESULTS: It was determined that there was a statistically significant difference in the mean IADSI score between day 1 (17.79 ± 6.06) and day 8 (27.35 ± 9.55). Statistically significant differences were found between mean IADSI score and gender, status of smoking and alcohol use, chronic disease status, regular medication use, type and level of nutrition, defecation characteristics and number, presence of infection, presence of urinary and fecal incontinence, mobility and sweating status, body and defecation hygiene, age and BMI (p < 0.05). CONCLUSION: The day 8 IADSI scores are considered to be evidence of the rapid progress of IAD after its development. It is important to know the risk factors associated with IAD in order to recognize the risk factors before IAD develops and to take possible precautions for these risk factors.


Asunto(s)
Dermatitis , Incontinencia Fecal , Unidades de Cuidados Intensivos , Incontinencia Urinaria , Humanos , Femenino , Masculino , Unidades de Cuidados Intensivos/organización & administración , Unidades de Cuidados Intensivos/estadística & datos numéricos , Persona de Mediana Edad , Incontinencia Fecal/complicaciones , Dermatitis/etiología , Dermatitis/epidemiología , Incontinencia Urinaria/complicaciones , Incontinencia Urinaria/epidemiología , Anciano , Adulto , Factores de Riesgo
16.
Neurourol Urodyn ; 43(4): 818-825, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38451041

RESUMEN

BACKGROUND: The presence of urinary incontinence (UI) in acute stroke patients indicates poor outcomes in men and women. However, there is a paucity and inconsistency of data on UI risk factors in this group and hence we conducted a sex-specific analysis to identify risk factors. METHODS: Data were collected prospectively (2014-2016) from the Sentinel Stroke National Audit Program for patients admitted to four UK hyperacute stroke units. Relevant risk factors for UI were determined by stepwise multivariable logistic regression, presented as odds ratios (OR) and 95% confidence intervals (CI). RESULTS: The mean (±SD) age of UI onset in men (73.9 year ± 13.1; n = 1593) was significantly earlier than for women (79.8 year ± 12.9; n = 1591: p < 0.001). Older age between 70 and 79 year in men (OR = 1.61: CI = 1.24-2.10) and women (OR = 1.55: CI = 1.12-2.15), or ≥80 year in men (OR = 2.19: CI = 1.71-2.81), and women (OR = 2.07: CI = 1.57-2.74)-reference: <70 year-both predicted UI. In addition, intracranial hemorrhage (reference: acute ischemic stroke) in men (OR = 1.64: CI = 1.22-2.20) and women (OR = 1.75: CI = 1.30-2.34); and prestroke disability (mRS scores ≥ 4) in men (OR = 1.90: CI = 1.02-3.5) and women (OR = 1.62: CI = 1.05-2.49) (reference: mRS scores < 4); and stroke severity at admission: NIHSS scores = 5-15 in men (OR = 1.50: CI = 1.20-1.88) and women (OR = 1.72: CI = 1.37-2.16), and NIHSS scores = 16-42 in men (OR = 4.68: CI = 3.20-6.85) and women (OR = 3.89: CI = 2.82-5.37) (reference: NIHSS scores = 0-4) were also significant. Factors not selected were: a history of congestive heart failure, hypertension, atrial fibrillation, diabetes and previous stroke. CONCLUSIONS: We have identified similar risk factors for UI after stroke in men and women including age >70 year, intracranial hemorrhage, prestroke disability and stroke severity.


Asunto(s)
Accidente Cerebrovascular Isquémico , Accidente Cerebrovascular , Incontinencia Urinaria , Masculino , Humanos , Femenino , Estudios de Cohortes , Accidente Cerebrovascular Isquémico/complicaciones , Factores de Riesgo , Incontinencia Urinaria/complicaciones , Hemorragias Intracraneales/complicaciones , Sistema de Registros
17.
J Wound Ostomy Continence Nurs ; 51(2): 138-145, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38527324

RESUMEN

PURPOSE: The purpose of this study was to examine the prevalence of urinary (UI), fecal (FI), and dual incontinence (DI) in older adults and their association with urinary tract infections, dermatitis, slips and falls, and behavioral disturbances based on Medicare fee-for-service (FFS) claims data. DESIGN: Retrospective analysis. SUBJECTS AND SETTINGS: Data from administrative claims from the CMS Medicare Limited Data Set (5% sample) for all months in 2018 were reviewed. The analysis was limited to FFS Medicare beneficiaries, with minimum of 3-month enrollment in Parts A and B who were at least 65 years old. This cohort included 1.2 million beneficiaries in the United States. METHODS: We used diagnosis codes to identify members with incontinence and grouped these members into 3 categories (UI only, FI only, and DI). We also divided claims based on 4 sites of care (nursing home, skilled nursing facility, home health, and self- or family care). We then determined the prevalence of (1) urinary tract infections (UTIs), (2) dermatitis, (3) slips and falls, and (4) behavioral disturbances for each type of incontinence. RESULTS: We found that 11.2% of Medicare members had a claims-based diagnosis of incontinence in 2018. On average, those diagnosed with incontinence experienced 5 times more UTIs, 2 times as many dermatitis events, more than twice as many slips and falls, and 2.8 times more behavior disturbances compared to those without an incontinence diagnosis. For those with DI, the prevalence of the 4 outcomes was significantly higher (between 22% and 185%) compared to those with UI only. CONCLUSIONS: Findings show that Medicare beneficiaries diagnosed as incontinent experience a much higher prevalence of UTIs, dermatitis, slips and falls, and behavioral disturbances compared to those without a diagnosis of incontinence. Our results suggest that incontinence may be an important indicator diagnosis for multiple other conditions and, if not well-managed, may challenge the desire for those who are incontinent to age at home.


Asunto(s)
Dermatitis , Incontinencia Urinaria , Infecciones Urinarias , Humanos , Anciano , Estados Unidos/epidemiología , Estudios Retrospectivos , Medicare , Prevalencia , Accidentes por Caídas , Incontinencia Urinaria/complicaciones , Incontinencia Urinaria/epidemiología , Infecciones Urinarias/complicaciones , Infecciones Urinarias/epidemiología , Dermatitis/epidemiología , Dermatitis/etiología
18.
Saudi Med J ; 45(3): 313-316, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38438203

RESUMEN

OBJECTIVES: To evaluate the sexual function of women with urinary incontinence (UI) and double incontinence (DI) comparing with a healthy control group by using the Female Sexual Function Index (FSFI). METHODS: This study was designed as a retrospective study consisting of UI, DI, and a control group, each containing age-matched 40 patients. Statistical comparisons were made among the UI, DI, and control groups in terms of the FSFI total score as well as each domain's score. RESULTS: The FSFI total scores were found to be 22.92, 20.53, and 20.32 for the control, UI, and DI groups, respectively, and no statistically significant difference was found among the groups. A statistically significant difference existed among the groups only in terms of satisfaction and pain. Significantly higher pain was found in the UI and DI groups compared with the control group (p=0.007 and p<0.001). Although there was significantly lower satisfaction in the DI group compared with the control group (p=0.012), no significant difference was found between the UI and control groups. CONCLUSION: The pain in the UI group and the pain and the low satisfaction in the DI group might be parameters that cause sexual dysfunction.


Asunto(s)
Trastornos Mentales , Incontinencia Urinaria , Humanos , Femenino , Estudios Retrospectivos , Estado de Salud , Dolor , Incontinencia Urinaria/complicaciones
19.
Neurourol Urodyn ; 43(4): 811-817, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38451038

RESUMEN

INTRODUCTION: Neurogenic detrusor overactivity (NDO) has a major impact on patients' quality of life and can lead to upper urinary tract complications. Intradetrusor botulinum toxin type A injections are administered as second-line treatment to these patients following the failure of anticholinergic agents. The aim of the DETOX 2 study is to propose a consensus definition of the failure of intradetrusor botulinum toxin injections for NDO in patients presenting spinal cord injury, spina bifida, or multiple sclerosis (MS) with self-catheterization. METHOD: This study followed the method adopted by the French National Authority for Health for recommendations by consensus. Based on a review of the literature and a preliminary survey, a steering committee compiled a questionnaire and selected a rating group comprising 16 experts from the Neuro-Urology Committee of the French Urology Association (cnuAFU) and Genulf. The experts were asked to complete the online questionnaire. At the end of the first round, all participants came together to discuss any disagreements and a second-round online questionnaire was completed to reach a consensus. RESULTS: Thirteen of the 16 experts approached completed both rounds of questionnaires. A strong consensus was reached for two proposals (median score = 9/10) which were therefore included in the definition from the first round: at least one repeat injection of the same botulinum toxin at the same dose must be given to rule out failure on technical grounds and a duration of efficacy <3 months must be considered a failure. At the end of round 2, a relative consensus was reached regarding the clinical criterion defining failure (median score = 7/10) and the urodynamic criterion of failure (median score = 8/10). An additional proposal was selected during this second round on the need for a voiding diary (median score = 8/10). CONCLUSION: The first consensus definition of failure of an intradetrusor injection of TB-A for NDO has been achieved with this study: persistence of detrusor overactivity with maximum detrusor pressures >40 cm H2O and/or a compliance issue and/or persistence of urinary incontinence and/or urgency and/or a number of daily self-catheterizations >8/day and/or efficacy <3 months. This study will help to standardize research on the failure of the intradetrusor botulinum toxin for NDO in clinical practice and clinical research.


Asunto(s)
Toxinas Botulínicas Tipo A , Fármacos Neuromusculares , Vejiga Urinaria Neurogénica , Vejiga Urinaria Hiperactiva , Incontinencia Urinaria , Humanos , Toxinas Botulínicas Tipo A/uso terapéutico , Fármacos Neuromusculares/uso terapéutico , Calidad de Vida , Resultado del Tratamiento , Vejiga Urinaria Neurogénica/etiología , Vejiga Urinaria Hiperactiva/tratamiento farmacológico , Incontinencia Urinaria/complicaciones , Urodinámica
20.
Sci Rep ; 14(1): 7444, 2024 03 28.
Artículo en Inglés | MEDLINE | ID: mdl-38548832

RESUMEN

Urinary incontinence is a common complication following radical prostatectomy, as the surgery disturbs critical anatomical structures. This study explored how pudendal nerve (PN) injury affects urinary continence in male rats. In an acute study, leak point pressure (LPP) and external urethral sphincter electromyography (EMG) were performed on six male rats with an intact urethra, the urethra exposed (UE), the PN exposed (NE), and after PN transection (PNT). In a chronic study, LPP and EMG were tested in 67 rats 4 days, 3 weeks, or 6 weeks after sham PN injury, PN crush (PNC), or PNT. Urethras were assessed histologically. Acute PNT caused a significant decrease in LPP and EMG amplitude and firing rate compared to other groups. PNC resulted in a significant reduction in LPP and EMG firing rate 4 days, 3 weeks, and 6 weeks later. EMG amplitude was also significantly reduced 4 days and 6 weeks after PNC. Neuromuscular junctions were less organized and less innervated after PNC or PNT at all timepoints compared to sham injured animals. Collagen infiltration was significantly increased after PNC and PNT compared to sham at all timepoints. This rat model could facilitate preclinical testing of neuroregenerative therapies for post-prostatectomy incontinence.


Asunto(s)
Traumatismos de los Nervios Periféricos , Nervio Pudendo , Incontinencia Urinaria de Esfuerzo , Incontinencia Urinaria , Masculino , Ratas , Animales , Incontinencia Urinaria de Esfuerzo/etiología , Incontinencia Urinaria de Esfuerzo/patología , Ratas Sprague-Dawley , Nervio Pudendo/patología , Modelos Animales de Enfermedad , Traumatismos de los Nervios Periféricos/complicaciones , Incontinencia Urinaria/complicaciones
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