Knowledge of nursing staff before and after training on incontinence-associated dermatitis / Conocimientos del personal de enfermería antes y después de la formación sobre la dermatitis asociada a la incontinencia / Conhecimento da equipe de enfermagem antes e após capacitação sobre dermatite associada à incontinência

ABSTRACT Objective: To verify the knowledge of nursing staff before and after training on incontinence-associated dermatitis. Method: A study before and after an educational intervention carried out with nursing staff from the medical and surgical clinics and intensive care unit of the university hospital in June 2023. The training took place over three meetings. Data was collected using a questionnaire administered immediately before and after the training. McNemar's test for dependent samples was used to compare before and after training. Results: 25 nurses and 14 nursing technicians took part. The items that showed statistical significance were related to the identification and correct differentiation of dermatitis associated with incontinence and pressure injury; and the correct way to sanitize the skin. Conclusion: The training of the nursing team made it possible to assess their knowledge of how to identify, prevent and treat incontinence-associated dermatitis.

RESUMEN Objetivo: Verificar los conocimientos del personal de enfermería antes y después de la formación sobre la dermatitis asociada a la incontinencia. Método: Estudio antes y después de una intervención formativa realizada con personal de enfermería de las clínicas médicas y quirúrgicas y de la unidad de cuidados intensivos de un hospital universitario en junio de 2023. La formación se impartió en tres sesiones. Los datos se recogieron mediante un cuestionario aplicado inmediatamente antes y después de la formación. Se utilizó la prueba de McNemar para muestras dependientes para comparar antes y después de la formación. Resultados: Participaron 25 enfermeras y 14 técnicos de enfermería. Los ítems que mostraron significación estadística estaban relacionados con la identificación y correcta diferenciación de la dermatitis asociada a la incontinencia y al daño por presión; y la forma correcta de higienizar la piel. Conclusión: La formación del equipo de enfermería permitió evaluar los conocimientos del equipo de enfermería sobre cómo identificar, prevenir y tratar la dermatitis asociada a la incontinencia.

RESUMO Objetivo: Verificar o conhecimento da equipe de enfermagem antes e após capacitação sobre dermatite associada à incontinência. Método: Estudo antes e depois de uma intervenção educativa realizado com profissionais da equipe de enfermagem das clínicas médicas, cirúrgicas e unidade de terapia intensiva do hospital universitário, no mês de junho de 2023. A capacitação ocorreu durante três encontros. Os dados foram coletados por meio de questionário, aplicado imediatamente antes e após a capacitação. Para a comparação do antes e após capacitação, foi realizado o teste de McNemar para amostras dependentes. Resultados: Participaram 25 enfermeiros e 14 técnicos de enfermagem. Os itens que apresentaram significância estatística foram relacionados à identificação e à diferenciação correta da dermatite associada à incontinência e lesão por pressão; e a forma correta para higienização da pele. Conclusão: A capacitação da equipe de enfermagem permitiu avaliar o conhecimento da equipe de enfermagem para identificar, prevenir e tratar a dermatite associada à incontinência.

Papel de la reparación muscular en el tratamiento de la incontinencia anal

La incontinencia anal (IA) tiene una alta prevalencia en la sociedad, aumenta con la edad, presenta elevados costes económicos y tiene un importante impacto negativo en la calidad de vida de los pacientes que la padecen. El tratamiento quirúrgico se reserva para aquellos pacientes que no responden a medidas conservadoras. Clásicamente, las técnicas de reparación muscular han jugado un papel principal en el tratamiento de la IA, sobre todo en aquellos casos en los que había un defecto del complejo esfinteriano, siendo la más extendida la esfinteroplastía solapante y reservando técnicas más complejas como la graciloplastía para casos con lesiones esfinterianas catastróficas. Otras técnicas como la reparación total del suelo pélvico se encuentran en desuso por sus pobres resultados.

Anal Incontinence (AI) is a prevalent disease, increases with aging, has high economic costs and a deep impact in the quality of life of the patients who suffer it. Surgical treatment is proposed in patients with no-response to medical therapy. Muscle repair techniques have been the main approach in AI, specially when there is a sphincteric damage. Overlapping sphincteroplasty is the most common technique and graciloplasty is used when there is a wide damage in sphinteric complex. Some other techniques such as postanal or total pelvic floor repair are not used any more because of their poor results.

Sampling reflex as a new manometric marker in the diagnosis of defecation disorders: systematic review

Introduction: Distension of the rectum wall and subsequent momentary relaxation of the internal anal sphincter (IAS) trigger a reflex called the rectoanal inhibitory reflex (RAIR). This same rectal distension causes a reflex contraction of the external anal sphincter (EAS), responsible for conscious continence called rectoanal excitatory reflex (RAER). This set of reflexes are named sampling reflex. Objectives: The sampling reflex is necessary to initiate defecation or flatulence. The objective of this study is to evaluate the sampling reflex and its practical applicability as a manometric marker of the main defecation disorders. Methodology: This review followed the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) items. The development method consisted of searching for articles in the research platforms BVS, PubMed, Cochrane Library, SciELO and ScienceDirect and for the selection of articles the Rayyan Platform was used. The articles resulting from the search strategies were added to the platform and five collaborators were invited for the blind selection. Finally, 6 articles were included in the final review. Results: An intact sampling reflex allows the individual to facilitate discrimination between flatus and stool and to choose whether to discharge or retain rectal contents. On the other hand, an impaired sampling reflex can predispose an individual to incontinence. Therefore, it was observed that patients with defecation disorders had an impaired sampling reflex, since it was found that constipated patients have incomplete opening of the IAS, lower amplitude of RAIR and increase of RAER. Most incontinent patients present a failure in the recruitment of the EAS, a decrease in the RAER and an increase in the RAIR, in duration and amplitude. (AU)

Evaluación de desenlaces percibidos por pacientes adultos con incontinencia que utilizan pañales desechables en Colombia

R E S U M E N Introducción: La incontinencia es un problema de salud frecuente que afecta la calidad de vida de las personas, limitando la autonomía y reduciendo la autoestima. Entre el 36-54% de las personas con incontinencia severa pueden presentar deterioro moderado a extremo en su cotidianidad y confianza. Objetivo: Evaluar la percepción de pacientes adultos con incontinencia urinaria y/o incontinencia fecal severa frente al uso de los pañales desechables. Metodología: Estudio observacional de cohorte, en pacientes afiliados a programas de atención domiciliaria usuarios de tres marcas comerciales de pañales. La percepción se evaluó con el instrumento ICIQ-PadPROM®. Resultados: Participaron I79 pacientes, 68% mujeres con edad promedio 7I,9 años. El dominio de diseño de pañal y efecto físico fue el que presentó mejor calificación, siendo el pañal Content Medical® el mejor calificado, con diferencias significativas principalmente frente al grupo de Rely®; en el ítem de filtraciones del dominio carga del pañal, Content Medical® presenta mejor percepción comparado contra los otros grupos (p<0.00I). Conclusiones: Los pacientes tienen adecuada percepción de las marcas de pañal; sin embargo, los que utilizaron Content Medical® refieren mayor percepción favorable.

Introduction: Incontinence is a frequent health problem that affects the quality of life of people, limiting autonomy and reducing self-esteem. Between 36-54% of people with severe incontinence may have moderate to extreme deterioration in their daily lives and confidence. Objective: To evaluate the perception of adult patients with urinary incontinence and/or severe fecal incontinence compared to the use of disposable diapers. Methodology: Observational cohort study in patients affiliated in home care programs using three commercial brands of diapers. Perception was assessed with the ICIQ-PadPROM® instrument. Results: I79 patients participated, 68% were women and an average age of 7I.9 years. The domain of diaper design and physical effect was the one that presented the best rating, with the Content Medical® diaper being the best qualified, with significant differences mainly compared to the Rely® group; in the leakage item of the diaper loading domain, Content Medical® presents better perception compared to the other groups (p<0.00I). Conclusions: Patients have adequate perception of diaper brands; however; those who used Content Medical® reported a higher favorable perception.

Introdução: A incontinência é um problema de saúde comum que afeta a qualidade de vida das pessoas, limitando a autonomia e reduzindo a auto-estima. Entre 36-54% das pessoas com incontinência severa podem ter uma deficiência moderada a extrema em sua vida diária e confiança. Objetivo: Avaliar a percepção de pacientes adultos com incontinência urinária e/ou incontinência fecal grave em relação ao uso de fraldas descartáveis. Metodologia: Estudo de coorte observacional em pacientes afiliados a programas de cuidados domiciliares utilizando três marcas comerciais de fraldas. A percepção foi avaliada com o instrumento ICIQ-PadPROM®. Resultados: I79 pacientes participaram, 68% mulheres com uma média de idade de 7I,9 anos. O domínio de design e efeito físico das fraldas foi o mais bem avaliado, sendo a fralda Content Medical® a mais bem avaliada, com diferenças significativas principalmente em relação ao grupo Rely®; no item vazamento do domínio de carga de fraldas, Content Medical® apresentou melhor percepção em comparação com os outros grupos (p<0,00I). Conclusões: Os pacientes têm uma percepção adequada das marcas de fraldas; entretanto, aqueles que usaram Content Medical® relatam uma percepção mais favorável.

Functional outcomes and satisfaction rates of sacral nerve stimulation in the treatment of one and multiples pelvic floor dysfunctions

Objective: Few studies have addressed the use of sacral nerve stimulation (SNS) in the treatment of patients with multiple pelvic floor dysfunctions (PFD). So, we evaluated the functional outcomes and level of satisfaction with SNS in selected patients with one or multiples PFD. Methods: A prospective database was used to collect information on eligible patients treated for PFD with SNS, and severity of symptoms was assessed with scores and satisfaction rates by visual analogue scale (VAS) at baseline and by the end of follow-up. Results: We recruited 70 patients, 98.6% of whom responded positively during the evaluation period (Global Response Assessment ≥ 50% for at least one type of PFD), resulting in the implantation of a permanent SNS device. Additionally, 49 of the patients (71%) had a single PFD (fecal incontinence [FI] = 38; constipation/obstructed defecation syndrome [C/ODS] = 11), while 20 (29%) had more than one PFD (double incontinence/n = 12; double incontinence + C/ODS/n = 8). All scores improved significantly between baseline (pre-SNS) and the end of follow-up (post-SNS), as did VAS in all groups (single and multiple PFD). The pre-SNS scores were higher in patients with a single PFD, including FI (Cleveland clinic Florida incontinence score [CCF-FI]) and C/ODS (Cleveland clinic constipation score [C-CCF] and the Renzi ODS score). The pre-SNS impact of VAS scores was similar in all groups (single and multiple PFD), but the VAS (post-SNS) was significantly lower (better response) for FI alone compared with multiple PFD. Conclusion: The SNS technique is an effective and safe option for patients with one or more PFD refractory to conservative measures. Response was positive for at least two PFD, based on reduced correspondent scores and satisfaction rate. (AU)

Fecal incontinence or pelvic organ prolapse among women with premature ovarian insufficiency

Objectives: To assess the status of the pelvic floor muscle (PFM) of premature ovarian insufficiency women (POI women) and the incidence of fecal incontinence (FI) and pelvic organ prolapse (POP). Methods: A secondary analysis of a cross-sectional study with 150 women with POI was performed. Pelvic floor muscle assessment was performed with the PERFECT scale. The subscales POPDI-6 and CRADI-8 of the questionnaire Pelvic Floor Distress Inventory-20 (PFDI-20) were used for pelvic floor symptoms focused on FI and POP. Moreover, FI and POP were also assessed as dichotomous variables (yes/no). Results: Women with FI and POP did not present differences in the PFM assessment across P (p = 0.61), E (p = 0.78), R (p = 0.22), and F (p = 0.79) variables when compared with women with POI; no differences were also seen between women with and without POP according the pelvic muscles: P (p = 0.91), E (p = 0.99), R (p = 0.62), and F (p = 0.10). Women with FI and POP presented higher scores in all PFDI-20 subscales and total score when compared with the control group (p < 0.05). Conclusions Pelvic floor muscle assessment within POI women with or without FI or POP did not differ. However, PF symptoms are more severe in the FI or POP groups. (AU)

The effect of transvaginal prolapse surgery on anorectal function

Objective: Pelvic floor dysfunction can manifest as a spectrum including anorectal dysfunction, vaginal prolapse, and urinary incontinence. Sacrospinous fixation is a procedure performed by gynecologists to treat vaginal prolapse. The present study aims to evaluate the impact of transvaginal prolapse surgery on anorectal function. Materials and Methods: We conducted a retrospective review of patients undergoing sacrospinous fixation surgery for vaginal prolapse between 2014 to 2020. Those with anorectal dysfunction who had also been evaluated by the colorectal service preoperatively and postoperatively were included for analysis. These patients were assessed with symptom-specific validated questionnaires. The effect of surgery on constipation and fecal incontinence symptoms was analyzed. Results: A total of 22 patients were included for analysis. All patients underwent transvaginal sacrospinous fixation, and 95.4% also had posterior colporrhaphy for vaginal prolapse. There were a statistically significant improvements in the Fecal Incontinence Severity Index (FISI), the St. Mark's Incontinence Score (Vaizey), the embarrassment and lifestyle components of the Fecal Incontinence Quality of Life Score, the Constipation Scoring System, the Obstructed Defecation Score, and components of the Patient Assessment of Constipation Quality of Life score. Conclusion: Transvaginal prolapse surgery leads to a favorable effect on anorectal function, with improvements in both obstructed defecation and fecal incontinence scores in this small series. (AU)

Are quality of life, functional capacity, and urinary incontinence associated with fecal incontinence? The Fibra-BR Study / Cuidados de saúde, capacidade funcional e incontinência urinária estão associados à incontinência fecal? Estudo Fibra-BR

OBJECTIVE: To assess the prevalence of fecal incontinence and its association with clinical, functional, and cognitive-behavioral variables, medication use, frailty, falls, and quality of life in community-dwelling older adults (aged 65 years or older). METHODS: Cross-sectional, multicenter study carried out across 16 Brazilian cities. The question "In the last 12 months, did you experience fecal incontinence or involuntary passage of stool?" was defined as the indicator variable for fecal incontinence. Bivariate analyses were carried out to assess the prevalence of fecal incontinence and sociodemographic characteristics, comorbidities, cognition, functional capacity, depression, frailty, quality of life, and falls. Logistic regression analysis was also performed, with fecal incontinence as the dependent variable. RESULTS: Overall, 6855 subjects were evaluated; 66.56% were female, 52.93% white, and the mean age was 73.51 years. The prevalence of fecal incontinence was 5.93%. It was associated with worse self-care (OR 1.78 [1.08­2.96]), dependence for basic activities of daily living (OR 1.29 [1.01­1.95]), and urinary incontinence (OR 4.22 [3.28­5.41]). Furthermore, the absence of polypharmacy was identified as a protective factor (OR 0.61 [0.44­0.85]). CONCLUSION: The overall prevalence of fecal incontinence was 5.93%. On logistic regression, one quality of life variable, dependence for basic activities of daily living, and polypharmacy were significantly associated with fecal incontinence

OBJETIVO: Avaliar a prevalência de incontinência fecal e sua associação com variáveis clínicas, funcionais, cognitivo-comportamentais, uso de fármacos, fragilidade, quedas e qualidade de vida em indivíduos com 65 anos ou mais que vivem na comunidade. METODOLOGIA: Estudo transversal e multicêntrico, realizado em 16 cidades brasileiras. A pergunta "Nos últimos 12 meses o(a) senhor(a) apresentou incontinência fecal ou perda de fezes de forma involuntária?'' foi a variável indicadora de incontinência fecal. Análises bivariadas avaliaram a prevalência de incontinência fecal e suas características sociodemográficas, comorbidades, cognição, funcionalidade, depressão, fragilidade, qualidade de vida e quedas. Também realizou-se análise de regressão logística tendo a incontinência fecal como variável dependente. RESULTADOS: No total, 6855 indivíduos foram avaliados; 66,56% eram do sexo feminino, 52,93% brancos e a média de idade de 73,51 anos. A prevalência de incontinência fecal foi de 5,93% e estava associada com pior cuidado com a própria saúde [OR 1,78 (1,08­2,96)], dependência para as atividades básicas de vida diária [OR 1,29 (1,01­1,95)] e incontinência urinária [OR 4,22 (3,28­5,41)]. Além disso, observou-se que a ausência de polifarmácia [OR 0,61 (0,44­0,85)] foi identificada como associação de proteção. CONCLUSÃO: A prevalência de incontinência fecal foi de 5,93%. Na regressão logística, uma variável de qualidade de vida, dependência para atividades básicas de vida diária e polifarmácia mostrou-se significativamente associada à incontinência fecal

Transanal irrigation to manage neurogenic bowel in the pediatric population with spina bifida: a scoping review

Abstract Objective To map available scientific evidence about the pediatric population with spina bifida submitted to transanal irrigation to manage signs and symptoms of neurogenic bowel. Source of data This research was developed according to recommendations from the Joanna Briggs Institute Reviewers' Manual and the PRISMA Extension for Scoping Reviews. Searches were carried out in the databases: CINAHL, Medline/Pubmed, Scielo, Scopus, Web of Science, Embase, LILACS, Proquest, and the CAPES catalog of theses and dissertations. Quantitative and qualitative studies on the topic were included, as long as they dealt with this population. There was no predetermined time frame. Summary of the findings The authors found 1.020 studies, selected 130 for close reading, and included 23 in the review, all of which had been published from 1989 to 2021. The authors mapped the characteristics of the studies, including their definitions of concepts and use of scales, criteria for the indication of transanal irrigation, training to carry out the procedure, devices and solutions used, number and frequency of transanal irrigations, health care actions, time spent, associated complications, complementary exams, adherence rate, follow-up, and outcomes, focusing on the benefits for bowel management. Conclusions Despite the variability of evaluation parameters and term definitions, evidence suggests that transanal irrigation is a safe and effective method to manage fecal incontinence. Studies in the field are likely to grow, using standardized scales and longitudinal follow-ups. The authors suggest further research on transanal irrigation in the pediatric population with spina bifida in the Latin American context.

Predictive model of fecal or urinary incontinence among older adults in China / 中华老年医学杂志

Objective:To construct and validate a predictive model of fecal/urinary incontinence among older adults in China.Methods:Data was obtained from the Seventh Chinese Longitudinal Healthy Longevity Survey in 2018.In the questionnaire, "Are you able to control your bowel and urine" , was regarded as the main effect indicator.Receiver operating curves(ROC)were used to find the best cut-off values of calf circumference for predicting fecal/urinary incontinence, and univariate Logistic model method was used to explore the potential factors associated with fecal/urinary incontinence among community-living older adults in China.A random sampling method was used to extract 70% of the survey data as the training set, and the remaining 30% of the survey data as the test set.A multivariate Logistic regression analysis was conducted in the training set to build a prediction model that encompassed all predictors, and a nomogram was plotted.Results:Logistic regression analysis showed that age, small calf circumference(male <28.5 cm, female <26.5 cm), inability to walk 1 km continuously, inability to lift 5 kg items, inability to do three consecutive squats, limited daily activities, and a history of urinary system disorders, nervous system disorders, and cerebrovascular disorders were all risk factors for fecal/urinary incontinence for older adults in China.Female, better socioeconomic status, and normal body mass index were protective factors for fecal/urinary incontinence.The Logistic regression model for predicting fecal/urinary incontinence among Chinese older adults was constructed using the above twelve factors.The consistency index(C-index)value of the model was 0.907, indicating that the model had good predictive ability.The area under the ROC curve(AUC)of the overall sample, training set and test set were 0.906(95% CI: 0.896-0.917), 0.907(95 % CI: 0.894-0.921)and 0.910(95% CI: 0.892-0.928), respectively, indicating that the model had high prediction ability and good discrimination. Conclusions:Age, sex, calf circumference, ability to walk 1 km continuously, ability to lift 5 kg items, ability to do three consecutive squats, daily activities, history of urinary system disorders, nervous system disorders and cerebrovascular disorders, socioeconomic status, and body mass index were independent predictors for fecal/urinary incontinence among older adults in China.The nomogram based on the above indicators has a good predictive effect on fecal/urinary incontinence for older adults.

O índice da taxa de fadiga é maior em crianças com constipação e incontinência fecal por retenção / The fatigue rate index is higher in children with functional constipation and retentive fecal incontinence

ABSTRACT Background: The Fatigue Rate Index (FRI) is a parameter in anorectal manometry (ARM) to assess sustained voluntary contraction, considering the squeeze pressure and fatigability of the external anal sphincter. It is used in adults to detect fecal incontinence even in patients who present normal squeeze pressures. The FRI in adult patients with functional constipation is similar to controls. Objective: The aim of this study was to evaluate the feasibility and values of FRI in children in relation to the values previously established in adults and comparing children with functional constipation and retentive fecal incontinence to children without retentive fecal incontinence. Methods: This retrospective study evaluated 105 ARM performed from Jan 2014 to Apr 2015. 42 patients were selected (were able to perform a voluntary contraction and had no co-morbidities other than functional constipation). 14 (33.3%) of those collaborated in sustaining contraction for 40 seconds (s), allowing the evaluation of the FRI. Patients with retentive fecal incontinence secondary to functional constipation (n=7, aged 6 to 13 years, six boys) were our interest group. Patients with functional constipation without fecal incontinence (n=7, aged 6 to 13 years, four boys) were considered a reference group. The ARM were performed with a radial eight-channel perfusion catheter (DynamedTM, São Paulo, Brazil) and the FRI was calculated (Proctomaster 6.4) in the first 20 s and overall 40 s of sustained voluntary contraction. Results: 14 of the selected 42 collaborated in sustaining contraction for 40 s, allowing the evaluation of the FRI. In the first 20 s of contraction, the fecal incontinence group showed a significantly higher mean FRI (2.48±1.39 min) compared to the reference group (1.13±0.72 min, P=0.042), which was not observed in the 40 s interval due to less uniform contraction. The anal resting pressure was higher in the fecal incontinence group (76.83 mmHg) than in the reference group (54.13 mmHg), but the statistical study did not reach significance (P=0.051). Conclusion: The FRI is feasible in children. The mean FRI obtained in this study is lower than the reported in constipated adults. The mean FRI among children with functional constipation and retentive fecal incontinence is higher than among constipated children without retentive fecal incontinence.

RESUMO Contexto O índice de Taxa de Fadiga (ITF) é um parâmetro na manometria anorretal (MAR) que é utilizado para avaliar a contração voluntária sustentada, considerando a pressão máxima de contração e a fatigabilidade do esfíncter anal externo. Este parâmetro é utilizado em adultos para diagnóstico da incontinência fecal mesmo entre paciente que apresentem pressões máximas de contração normais. O ITF em pacientes adultos com constipação é similar a controles. Objetivo: Avaliar a factibilidade e os valores do ITF em crianças com constipação e incontinência fecal por retenção em relação aos valores previamente estabelecidos para adultos, e comparar os dados das crianças com constipação intestinal funcional com e sem incontinência fecal por retenção. Métodos Este estudo retrospectivo avaliou 105 MAR realizadas de janeiro de 2014 a abril de 2015. 42 pacientes foram selecionados (foram capazes de realizar uma contração voluntária e não apresentavam outras comorbidades além da constipação). 14 destes pacientes cooperaram em manter a contração voluntária por 40 segundos, permitindo a avaliação do ITF. Pacientes com incontinência fecal por retenção secundária a constipação (n=7, 6 a 13 anos, seis meninos) constituíram nosso grupo de interesse. Pacientes com constipação funcional sem incontinência fecal por retenção. (n=7, 6 a 13 anos, quatro meninos) constituíram o grupo de referência. As MAR foram realizadas com cateter de perfusão de oito canais radiais (DynamedTM, São Paulo, Brazil) e o ITF foi calculado (Proctomaster 6.4) nos primeiros 20 segundos e também nos 40 segundos totais da contração voluntária sustentada. Resultados: Dos 42 pacientes selecionados, 14 (33%) colaboraram mantendo o platô de contração uniforme durante 40 segundos, permitindo a avaliação do ITF nos primeiros 20 segundos de contração, o grupo com incontinência fecal apresentou uma média de ITF significativamente mais alta (2,48±1,39 min) em comparação ao grupo de referência (1,13±0,72 min, P=0,042), o que não foi observado no intervalo de 40 segundos devido a contração menos uniforme. A pressão anal de repouso foi mais elevada no grupo com incontinência fecal (76,83 mmHg) do que no grupo de referência (54,13 mmHg), porém o estudo estatístico não atingiu significância (P=0,051). Conclusão: O ITF é factível em crianças. A média do ITF obtida neste estudo é mais baixa do que o reportado em adultos constipados (2,8 min). A média do ITF entre crianças constipadas com incontinência fecal por retenção fui superior ao do que observado em crianças constipadas sem incontinência fecal retentiva.

Estudo da fisiologia anorretal pré e pós terapia neoadjuvante para câncer de reto por manometria anorretal e escore de Jorge-Wexner / Study of anorectal physiology pre and pos neoadjuvant therapy for rectal cancer by anorectal manometry and jorge-wexner score

ABSTRACT Background: The treatment of distal rectal cancer may be accompanied by evacuation disorders of multifactorial etiology. Neoadjuvant chemoradiotherapy (NCRT) is part of the standard treatment for patients with locally advanced extraperitoneal rectal cancer. The assessment of anorectal function after long-term NCRT in patients with cancer of the extraperitoneal rectum has been poorly evaluated. Objective: The aim of the present study was to evaluate the effects of NCRT on anorectal function and continence in patients with extraperitoneal rectal cancer. Methods: Rectal adenocarcinoma patients undergoing neoadjuvant therapy were submitted to functional evaluation by anorectal manometry and the degree of fecal incontinence using the Jorge-Wexner score, before and eight weeks after NCRT. The manometric parameters evaluated were mean resting anal pressure (ARp), maximum voluntary contraction anal pressure (MaxSp) and average voluntary contraction anal pressure (ASp). All patients underwent the same NCRT protocol based on the application of fluoropyrimidine (5-FU) at a dosage of 350 mg/m2 associated with folic acid at a dosage of 20 mg/m2, intravenously, in the first and last week of treatment, concomitantly with conformational radiotherapy with a total dose of 50.4Gy, divided into 28 daily fractions of 1.8Gy. For statistical analysis of the quantitative variables with normal distribution, the mean, standard deviation, median and interquartile range were calculated. For comparison of two related samples (before and eight weeks after NCRT), Wilcoxon's non-parametric test was used. Results: Forty-eight patients with rectal cancer were included in the study, with a mean age of 62.8 (39-81) years, 36 (75%) of whom were male. The use of NCRT was associated with a decrease in the values of ARp (55.0 mmHg vs 39.1 mmHg, P<0.05) and ASp (161.9 mmHg vs 141.9 mmHg, P<0.05) without changing MaxSp values (185,5 mmHg vs 173 mmHg, P=0.05). There was no worsening of the incontinence score eight weeks after the use of NCRT (3.0 vs 3.3; P>0.05). Conclusion: NCRT was associated with a reduction in the values of ARp and the ASp. There was no change in MaxSp, as well as in the degree of fecal continence by the Jorge-Wexner score.

RESUMO Contexto: O tratamento do câncer retal distal pode ser acompanhado por distúrbios evacuatórios de etiologia multifatorial. A quimiorradioterapia neoadjuvante faz parte do tratamento padrão para pacientes com câncer retal extraperitoneal localmente avançado. A avaliação da função anorretal após neoadjuvância de longa duração em pacientes com câncer de reto extraperitoneal tem sido pouco estudada. Objetivo: O objetivo do presente estudo foi avaliar os efeitos da neoadjuvância na função anorretal e na incontinência em pacientes com câncer retal extraperitoneal. Métodos: Pacientes com adenocarcinoma de reto candidatos à terapia neoadjuvante foram submetidos a avaliação funcional por manometria anorretal e avaliação do grau de incontinência fecal pelo escore de Jorge-Wexner, pré e oito semanas após a neoadjuvância. Os parâmetros manométricos avaliados foram pressão anal média de repouso, pressão anal de contração voluntária máxima e pressão anal média de contração voluntária. Todos os pacientes foram submetidos ao mesmo protocolo de neoadjuvância baseado na aplicação de fluoropirimidina (5-FU) na dosagem de 350 mg/m2 associada ao ácido fólico na dosagem de 20 mg/m2, por via intravenosa, na primeira e última semana de tratamento, concomitantemente à radioterapia conformacional com dose total de 50,4Gy, dividida em 28 frações diárias de 1,8Gy. Para análise estatística das variáveis quantitativas com distribuição normal, foram calculados a média, desvio padrão, mediana e intervalo interquartil. Para comparação de duas amostras relacionadas (antes e oito semanas após a neoadjuvância, foi utilizado o teste não paramétrico de Wilcoxon. Resultados: Quarenta e oito pacientes com câncer retal foram incluídos no estudo, com média de idade de 62,8 (39-81) anos, sendo 36 (75%) do sexo masculino. O uso de neoadjuvância foi associado à diminuição dos valores de média de pressão de repouso (55,0 mmHg vs 39,1 mmHg, P<0,05) e média de pressão de contração voluntária (161,9 mmHg vs 141,9 mmHg, P<0,05) sem alterar os valores de pressão de contração voluntária máxima ((185,5 mmHg vs 173 mmHg, P=0.05)). Não houve piora do escore de incontinência oito semanas após o uso da quimiorradioterapia neoadjuvante (3,0 vs 3,3; P>0,05). Conclusão: A neoadjuvância associou-se à redução dos valores de média de pressão de repouso e média dos valores contração voluntária. Não houve alteração nos valores de contração voluntária máxima, bem como no grau de continência fecal pelo escore de Jorge-Wexner.

Effect of Surgical Treatment for Deep Infiltrating Endometriosis on Pelvic Floor Disorders: A Systematic Review with Meta-analysis / Efeito do tratamento cirúrgico para endometriose infiltrante profunda nas disfunções do assoalho pélvico: Uma revisão sistemática com metanálise

Abstract Objectives To evaluate the impact of surgical treatment of deep infiltrative endometriosis (DIE) on pelvic floor dysfunction (urinary incontinence [UI], pelvic organ prolapse [POP], fecal incontinence [FI)] or constipation, and sexual function [dyspareunia]). Data Source The present systematic review was performed in the PubMed database. For the selection of studies, articles should be published by January 5, 2021, without language restriction. Study Selection Six randomized controlled studies that evaluated surgical treatment for DIE and the comparison of different surgical techniques were included. Data Collection The studies were selected independently by title and abstract by two authors. Disagreements were resolved by a third author. All included studies were also evaluated according to the Cochrane risk of bias tool and the quality of the evidence was analyzed using the GRADE criteria. Subgroup analysis by different treatments and follow-up periods was also performed. Results Six studies were included in the quantitative analysis. The risk of bias between studies showed an uncertain risk of bias for most studies, with concealment of allocation being the least reported category. The quality of the evidence was considered low. High heterogeneity was found between the studies. No study has evaluated UI or POP comparatively before and after surgery. Conclusion Dyspareunia and FI have improved after the surgical procedure, but it was not possible to demonstratewhich surgical technique was related to these outcomes as there was surgical heterogeneity. This diversity was found across data, with the recommendation of future prospective studies addressing pelvic floor disorders withDIE.

Resumo Objetivos Avaliar o impacto do tratamento cirúrgico para endometriose infiltrante profunda (EIP) nas disfunções do assoalho pélvico (incontinência urinária [IU], prolapso de órgãos pélvicos [POP], incontinência fecal [IF] ou constipação e função sexual [dispareunia]). Fonte de Dados A presente revisão sistemática foi realizada na base de dados PubMed. Para a seleção dos estudos, os artigos deveriam ser publicados até 5 de janeiro de 2021, sem restrição de idioma. Seleção dos Estudos Foram incluídos seis estudos randomizados e controlados que avaliaram o tratamento cirúrgico para EIP e a comparação de diferentes técnicas cirúrgicas. Coleta de Dados Os estudos foram selecionados de forma independente por título e resumo por dois autores. As discordâncias foram avaliadas por umterceiro autor. Todos os estudos incluídos foram avaliados de acordo coma ferramenta Cochrane de risco de viés e a qualidade de evidência foi analisada usando os critérios GRADE. A análise de subgrupo por diferentes tratamentos e períodos de acompanhamento também foi realizada. Resultados Seis estudos foram incluídos na análise quantitativa. O risco de viés mostrou um risco incerto de viés para a maioria dos estudos, sendo a ocultação da alocação a categoria menos relatada. A qualidade de evidência foi considerada baixa. Alta heterogeneidade foi encontrada entre os estudos. Nenhum estudo avaliou a IU ou o POP comparativamente antes e após a cirurgia. Conclusão A dispareunia e a IF melhoraram após o procedimento cirúrgico, mas não foi possível demonstrar qual técnica cirúrgica esteve relacionada a estes desfechos, pois houve heterogeneidade cirúrgica. Esta diversidade foi encontrada nos dados, com a recomendação de estudos prospectivos futuros abordando distúrbios do assoalho pélvico com EIP.

Dermatite Associada à Incontinência: Prevalência e Fatores Associados em Unidade de Terapia Intensiva / Incontinence-associated Dermatitis: Prevalence and Associated Factors in Intensive Care Unit / Dermatitis Asociada con Incontinencia: Prevalencia y Factores Asociados en Unidades de Cuidados Intensivos

Objetivo:Analisar a prevalência pontual de dermatite associada à incontinência (DAI) e os fatores associados em pacientes adultos internados em unidades de terapia intensiva (UTIs). Método: Estudo transversal, observacional, retrospectivo, realizado com 105 pacientes em UTI de três hospitais universitários localizados no estado de São Paulo. As variáveis demográficas, clínicas e de DAI foram coletadas do banco de dados do projeto de pesquisa "Prevalência de lesão por pressão em Unidade de Terapia Intensiva", composto por informações extraídas dos prontuários e de exames físicos. Os dados foram analisados por meio de estatística descritiva e inferencial. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Instituição proponente. Resultados: Dos 105 pacientes, 58 (55,2%) eram do sexo masculino, com média de idade de 55,76 anos (desvio padrão = 16,4), 105 (91,3%) estavam com cateter urinário e 89,4% usavam fraldas. Dez pacientes apresentaram DAI, com prevalência pontual de 9,5%. O fator associado à DAI foi a admissão por trauma (p = 0,02). Conclusão: Estudos sobre DAI são fundamentais para uma assistência de enfermagem de qualidade, bem estruturada e fundamentada, sobretudo no cuidado aos pacientes críticos.

Objective:To analyze the point prevalence of incontinence-associated dermatitis (IAD) and associated factors in adult patients admitted to Intensive Care Units (ICUs). Method: A cross-sectional, observational, retrospective study carried out with 105 patients in the ICU of three university hospitals located in the state of São Paulo. The demographic and clinical variables and IAD come from the database of the research project "Prevalence of pressure injuries in the Intensive Care Unit," composed of information from medical records and physical examination. Data were analyzed using descriptive and inferential statistics. The study was approved by the Research Ethics Committee of the proposing institution. Results: Of the 105 patients, 58 (55.24%) were male, with a mean age of 55.76 years (SD = 16.39), 105 (91.3%) had a urinary catheter and 89.4% wore diapers. Ten patients had IAD, with a point prevalence of 9.52%. The factor associated with IAD was admission due to trauma (p = 0.02). Conclusion: Studies on IAD are essential for quality, well-structured and grounded nursing care, especially in the care of critically ill patients.

Objetivo:Analizar la prevalencia puntual de Dermatitis Asociada a Incontinencia (DAI) y factores asociados en pacientes adultos ingresados en Unidades de Cuidados Intensivos (UCI). Método: estudio transversal, observacional, retrospectivo, realizado con 105 pacientes en la UTI de tres hospitales universitarios ubicados en São Paulo. Las variables demográficas, clínicas y DAI provienen de la base de datos del proyecto de investigación "Prevalencia de lesiones por presión en la Unidad de Cuidados Intensivos", compuesta por información de historias clínicas y exámenes físicos. Los datos se analizaron mediante estadística descriptiva e inferencial. El estudio fue aprobado por el Comité de Ética en Investigación de la institución proponente. Resultados: de los 105 pacientes, 58 (55,24%) eran del sexo masculino, con una edad media de 55,76 años (DE = 16,39), 105 (91,3%) tenían sonda vesical y 89,4% usaban pañales. Diez pacientes tenían DAI, con una prevalencia puntual del 9,52%. El factor asociado a la DAI fue el ingreso por traumatismo (p = 0,02). Conclusión: los estudios sobre la DAI son esenciales para una atención de enfermería de calidad, bien estructurada y fundamentada, especialmente en el cuidado de pacientes críticos.

Implantação de um serviço para pessoas com distúrbios do assoalho pélvico / Implementation of a service for people with pelvic floor disorders / Implementación de un servicio para personas con trastornos del suelo pélvico

Objetivo:objetivou-se descrever os procedimentos técnicos operacionais e dados clínicos relacionados à implantação de um programa de atenção à saúde das pessoas com distúrbios do assoalho pélvico em um serviço público de atenção secundária. Método: trata-se de um relato de experiência, baseado em vivências relacionadas à assistência acadêmico-profissional na implantação de serviço voltado aos distúrbios do assoalho pélvico na região do Cariri cearense, realizado de maio a julho de 2021. Resultados: para a implantação do serviço, adotaram-se as seguintes estratégias: rastreamento da rede de atenção à saúde da pessoa com distúrbios do assoalho pélvico; estruturação organizacional do serviço; captação de pessoas com disfunções pélvicas; início dos atendimentos; e seguimento terapêutico. Conclusão: face ao exposto, evidencia-se que o programa de atenção à saúde das pessoas com distúrbios do assoalho pélvico pôde ser implantado satisfatoriamente, tendo em vista a infraestrutura, ao expressivo quantitativo de atendimentos realizados e ao seguimento terapêutico alcançado. Assim, com este relato, espera-se contribuir para o desenvolvimento de novos serviços ambulatoriais voltados a essa área de atuação do enfermeiro estomaterapeuta e da equipe multidisciplinar.

Objective:the objective was to describe the technical operational procedures and clinical data related to the implementation of a health care program for people with pelvic floor disorders in a public secondary care service. Method: this is an experience report, based on experiences related to academic and professional assistance in the implementation of a service aimed at pelvic floor disorders in the Cariri region of Ceará, carried out from May to July 2021. Results: for the implementation of the service, the following strategies were adopted: tracking the health care network for people with pelvic floor disorders; organizational structuring of the service; capturing people with pelvic dysfunctions; start of care; and therapeutic follow-up. Conclusion: in view of the above, it is evident that the health care program for people with pelvic floor disorders could be implemented satisfactorily, considering the infrastructure, the significant amount of care provided and the therapeutic follow-up achieved. Thus, with this report, it is expected to contribute to the development of new outpatient services aimed at this area of work of the stomatherapist nurse and the multidisciplinary team.

Objetivo:El objetivo es describir los procedimientos técnicos operativos y datos clínicos relacionados a la implementación de un programa de atención a la salud de las personas con trastornos del suelo pélvico en un servicio público de atención secundaria. Método: se trata de un reporte de experiencia, basado en vivencias relacionadas a la asistencia académico-profesional en la implementación de servicio destinado a los trastornos del suelo pélvico en la región del Cariri cearense, realizado de mayo a julio de 2021. Resultados: para la implementación del servicio, se adoptaron las siguientes estrategias: rastreo de la red de atención a la salud de personas con trastornos del suelo pélvico; estructuración organizacional del servicio; captación de personas con disfunciones pélvicas; inicio de la atención; y seguimiento terapéutico. Conclusión: frente a lo expuesto, queda evidente que el programa de atención a la salud de las personas con trastornos del suelo pélvico puede ser implementado satisfactoriamente, teniendo en cuenta la infraestructura, el importante número de atenciones realizadas y al seguimiento terapéutico alcanzado. Así, con este informe, se espera contribuir al desarrollo de nuevos servicios ambulatorios destinados a esta área de trabajo del enfermero estomaterapeuta y del equipo multidisciplinario.

Physiotherapeutic approaches to treat anal incontinence in women after obstetric trauma

Introduction: Anal incontinence is defined as the loss of voluntary control of fecal matter or gases with a recurrence period longer than 3 months in individuals aged ≥ 4 years; it has a female predominance. Among the treatment modalities is pelvic physiotherapy, the second line of treatment, which promotes the reeducation, coordination, and strengthening of the muscles of the pelvic floor to enable patients to return to their regular activities of daily living. Objective: To perform a systematic review on the physiotherapeutic treatments used in women between the ages of 18 and 65 years with a diagnosis of anal incontinence. Material and methods Clinical studies written in Portuguese, Spanish and English were searched on the the following databases: Science Direct, Medical Literature Analysis and Retrieval System Online (Medline) via PubMed, Physiotherapy Evidence Database (PEDro), Scientific Electronic Library Online (SciELO), and Scopus. Results: Of the 998 articles found, only 4 studies met the inclusion criteria of the present systematic review. The physiotherapeutic approaches to treat women with anal incontinence are biofeedback, Kegel exercises, electrostimulation, and training of the pelvic floor muscles. The average score on the PEDro scale was of 6.25, which indicates that the methodological quality was good. Conclusion: Although pelvic physiotherapy is effective to treat anal incontinence, it must be promoted through the performance of evidence-based scientific research. (AU)

Association between fecal incontinence and lower urinary tract symptoms and their impact on the quality of life of patients with prostate cancer

Objective: To evaluate the association of fecal incontinence (FI) and lower urinary tract symptoms (LUTS) in patients diagnosed with initial prostate cancer (PC) and after any therapeutic approach (surgery and radiotherapy). Methods: Cross-sectional study using the Cleveland Clinic Incontinence Score (CCIS), the Fecal Incontinence Quality of Life (FIQL) questionnaire, and the International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB). Results: A total of 84 patients with PC were included: 40 of them had not started treatment, 31 were submitted to radical prostatectomy (RP), and 13 were submitted to radiotherapy (RT). Those submitted to RT presented higher scores on the ICIQ-OAB (p=0.01). When comparing the whole sample reagarding the patients with and without FI, we observed that the incontinents presented a higher frequency of urinary incontinence (UI) (p<0.001). Moreover, when comparing patients with/without FI within their treatment groups regarding the presence of UI and FIQL scores, we identified that patients undergoing RP presented an association between UI and FI (p<0.001) and a greater impact of FI on the FIQL (p<0.001). Conclusion: Patients submitted to RT present more intense LUTS. Moreover, patients with FI present a higher association with UI, and this association is more marked in those with FI submitted to RP. (AU)

Resultados a largo plazo de la rehabilitación del piso pélvico en pacientes con incontinencia fecal / Long-term results of pelvic floor rehabilitation in patients with fecal incontinence

Resumen Introducción: La rehabilitación del piso pélvico es frecuentemente indicada a los pacientes con incontinencia fecal. Su efectividad a corto plazo ha sido demostrada. Sin embargo, sus resultados en el largo plazo son controversiales. Objetivo: Nuestro objetivo es evaluar los resultados funcionales y calidad de vida a largo plazo de los pacientes con incontinencia fecal tratados mediante rehabilitación del piso pélvico. Materiales y Método: Estudio cuasi-experimental. Se incluyeron los pacientes con incontinencia fecal tratados mediante rehabilitación del piso pélvico entre 2007-2014 en nuestro centro, sin necesidad de cirugía. Se midió el puntaje funcional de Wexner y de calidad de vida (FIQLS) antes (T1) y después del tratamiento (T2). Se realizó encuesta vía correo electrónico para obtener dichos puntajes entre 3-10 años posterior al tratamiento (T3). Resultados: De 215 pacientes, 182 cumplían criterios de inclusión. 96 (52,8%) de ellos respondieron la encuesta en T3. La mediana de seguimiento fue de 4,5 (3-10) años. La edad promedio al tiempo del estudio fue de 60,8 ±13,1 años. 88,4% fueron mujeres. La mediana del puntaje funcional fue 16 (6-20) en T1 y 7 (0-18) en T2, p = 0,000. La calidad de vida mejoró significativamente en sus 4 dimensiones entre T1 y T2. En T3, ambos puntajes presentaron mejores promedios que en T1, p = 0,000. No hubo asociación entre el tiempo de seguimiento y el resultado funcional en T3. Conclusión: Los pacientes con incontinencia fecal tratados mediante rehabilitación del piso pélvico mejoran significativamente su funcionalidad y calidad de vida. El beneficio disminuye en el tiempo, pero persiste mejor que previo al tratamiento.

Introduction: Pelvic floor rehabilitation is often indicated as first-line therapy for patients with fecal incontinence. Its short-term effectiveness has been demonstrated in these patients. However, long-term results are controversial. Aim: Our objective is to evalúate long-term functionality and quality of life in patients with fecal incontinence treated with pelvic floor rehabilitation. Materials and Method: Quasi- experimental study conducted at a single tertiary care center. We included patients with fecal incontinence treated by pelvic floor rehabilitation at our center between 2007-2014 who did not require surgery. Wexner functional score and quality of life using FIQLS were measured pre (T1) and post-treatment (T2). Poste - riorly, an-e-mail survey was conducted to retrieve scores three to 10 years after treatment (T3). Results: Of the 215 patients, 182 met the inclusion criteria. 96 (52.8%) patients responded at T3 and were therefore included. The median follow-up period was of 4.5 years (3-10). The mean age at the time of the study was 60.8 ± 13.1 years and 88.4% were women. The median Wexner score was 16 (6-20) in T1 and 7 (0-18) in T2, (p = 0.000). Quality of life improved significantly in its four dimensions when comparing T1 and T2. In T3, Wexner and the quality of life scores were significantly lower than T2. However, in T3, both scales had better means than T1, (p = 0.000). There was no association between the follow-up time and the functional result in T3. Conclusions: Patients with fecal incontinence treated by pelvic floor rehabilitation improve their functionality and quality of life significantly. This benefit decreases over time but remains above its baseline.

Nurses' best practices in the management of fecal incontinence in the hospital context: an integrative review / Prácticas de enfermería recomendadas en el manejo de la incontinencia fecal en el contexto hospitalario: una revisión integradora / Melhores práticas de enfermeiros no manejo da incontinência fecal em contexto hospitalar: revisão integrativa

ABSTRACT Objective to analyze, in the literature, the nurses' best practices towards management of Fecal Incontinence in the hospital context. Method this is an integrative literature review with a search carried out in September 2021 in the MEDLINE/PubMed and Web of Science, as well as in the Biblioteca Virtual em Saúde database, which included the Literatura Latino-Americana e do Caribe em Ciências da Saúde, Base de Dados de Enfermagem and Índice Bibliográfico Español en Ciencias de la Salud databases. The analysis considered the descriptive methods and elaboration of a textual corpus in the Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires software program. Results a total of 11 studies were included (and their analysis allowed evidencing prevalence of the English language) published between 1977 and 2021 and which presented, in a greater proportion, an observational methodological design with level of evidence 2C. The results were grouped into two categories: "Care evidence for the management of Fecal Incontinence", with greater predominance of the use of fecal drainage systems; and "Support devices and prevention of complications", presenting, in a greater proportion, the containment devices. Conclusion it was identified that the best practices adopted by nurses in the hospital context are associated with the use of drainage systems and fecal content containment devices. A limitation was evidenced in the nursing team regarding use of other beneficial practices for patients with Fecal Incontinence.

RESUMEN Objetivo analizar, en la literatura, las prácticas de Enfermería recomendadas con respecto al manejo de la Incontinencia Fecal en el contexto hospitalario. Método se trata de una revisión integradora de la literatura en la que la búsqueda se realizó en septiembre de 2021 en las bases de dados MEDLINE/PubMed y Web of Science y en el banco de datos de la Biblioteca Virtual en Salud, que incluyó a las bases de datos Literatura Latino-Americana y del Caribe en Ciencias de la Salud, Base de Datos de Enfermería e Índice Bibliográfico Español en Ciencias de la Salud. En el análisis se consideraron los métodos descriptivos y la elaboración de un corpus textual por medio del software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires. Resultados se incluyeron 11 estudios (y su análisis permitió evidenciar prevalencia del idioma inglés) publicados entre 1977 y 2021 y que, en mayor proporción, presentaron diseños metodológicos observacionales con nivel de evidencia 2C. Los resultados se agruparon en dos categorías: "Evidencias de medidas de atención para el manejo de la Incontinencia Fecal", con mayor predominancia del empleo de sistemas de drenaje fecal, y "Dispositivos de apoyo y prevención de complicaciones", con mayor proporción de dispositivos de contención. Conclusión se identificó que las prácticas recomendadas adoptadas por los enfermeros en el contexto hospitalario están asociadas al uso de sistemas de drenaje y dispositivos de contención del contenido fecal. Se puso en evidencia una limitación del personal de Enfermería en relación al uso de otras prácticas beneficiosas para los pacientes con Incontinencia Fecal.

RESUMO Objetivo analisar, na literatura, as melhores práticas de enfermeiros acerca do manejo da Incontinência Fecal em contexto hospitalar. Método trata-se de uma revisão integrativa da literatura com busca realizada em setembro de 2021 nas bases de dados MEDLINE/PubMed, Web of Science e no banco de dados da Biblioteca Virtual em Saúde, que incluiu as bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde, Base de Dados de Enfermagem e Índice Bibliográfico Español en Ciencias de la Salud. A análise considerou os métodos descritivos e a elaboração de um corpus textual mediante o software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires. Resultados foram incluídos 11 estudos (e a análise destes permitiu evidenciar a prevalência do idioma inglês) publicados entre os anos de 1977 e 2021 e que apresentaram, em maior ocorrência, delineamento metodológico observacional com nível de evidência 2C. Os resultados foram agrupados em duas categorias: "Evidências de cuidados para gerenciamento da Incontinência Fecal", tendo como maior predominância o uso dos sistemas de drenagem fecal, e "Dispositivos de apoio e prevenção de complicações", apresentando, com maior ocorrência, os dispositivos de contenção. Conclusão identificou-se que as melhores práticas adotadas pelos enfermeiros no contexto hospitalar estão associadas ao uso de sistemas de drenagem e dispositivos de contenção do conteúdo fecal. Evidenciou-se a limitação da equipe de Enfermagem quanto ao uso de outras práticas benéficas ao paciente com Incontinência Fecal.

Spanish translation, face validity, and reliability of the ICIQ-B questionnaire with colorectal cancer patients

Purpose: To describe the English-to-Spanish translation process and preliminary psychometric analysis (face validity, cultural adaptation, and test-retest reliability) of the International Consultation on Incontinence Questionnaire - Bowels Module (ICIQB) among Chilean colorectal cancer patients. Materials and Methods: The face validity was studied with 10 colorectal cancer patients, and the test-retest reliability, with 15 patients, 1 month before and 6 months after cancer surgery. Results: Two rounds of translation/back translation resulted in a Spanish version. The English expression open your bowels was translated as defecar, as it is easily understandable in Spanish. The patients reported that the instrument was easy to answer, with clear instructions, and that it was adequate to appraise their health condition. The testretest reliability was good (Spearman rho [ρ] ≥ 0.842); only item 15a, the Bristol Stool Scale, obtained a moderate correlation (ρ=0.639). The patients reported a variety of symptoms, including increased bowel movements, nocturnal bowel movements, fecal urgency, and incontinence. Conclusions: The first Spanish version of the ICIQ-B was culturally adapted for Chilean colorectal cancer patients, and showed good test-retest reliability. It might be a reference for other Spanish-speaking countries and for patients with other conditions. The ICIQ-B is a robust comprehensive questionnaire for bowel function. (AU)