Prevalence and Management of Urinary Incontinence in a Brazilian Hospital: A Prospective, Descriptive Study.

Although urinary incontinence (UI) in hospitalized patients is a frequent health problem, research on the subject is limited. PURPOSE: A prospective, descriptive study was conducted to evaluate the prevalence of UI, care implemented among hospitalized adult patients, and impact of UI on quality of life (QoL) in a large private institution in Brazil. METHODS: All patients admitted during November 2018 who were at least 18 years of age, sufficiently conscious and oriented to answer questions, able to undergo skin inspection, and had the ability to urinate (ie, did not use an indwelling bladder catheter or have a nephrostomy, cystostomy, urostomy, or vesicostomy) were eligible to participate. Data were collected through interviews, physical examinations, chart review, and completion of the International Consultation on Incontinence Questionnaire-Short Form (ICQI-SF), a self-diagnostic, 6-item survey of UI frequency, amount of leakage, and overall impact of UI; answers for items 3 (6 answer options), 4 (4 answer options), and 5 (Likert scale ranging from 0 to 10) were considered individually and summed for a total score ranging from 0 to 21. Data were collected using paper forms and then double-entered and validated in a spreadsheet for statistical analysis. Continuous variables were described as mean/median and standard deviation. Categorical variables were described in absolute numbers and percentages. Pearson's chi-squared test and Fischer's exact test were used to investigate the variable statistical differences. The level of significance was 5%, and the intervals were obtained with 95% confidence. Prevalence was defined as the percentage of people with UI over the study period in all admitted patients. RESULTS: Of the 858 eligible patients, 114 were incontinent (13.3%), but 61 were unable to answer the research questions, 2 used catheterization, and 9 refused to participate; therefore 42 patients (age 80 [range 77.6-82.3] years, 30 [71.4%] women) completed the study. All patients (100%) were managed using diapers. Twenty-one (21, 50%) were married, 24 (57.1%) were white, and 25 (59.5%) were retired. Sixteen (16, 38.1%) had urine loss several times a day, and 17 (40.5%) had urine loss in large amounts; 10 (23.8%) had incontinence-associated dermatitis. The ICQI-SF item regarding interference of urine loss in daily life had a reported mean of 4.1 ± 4.0, inferring urine loss interfered with life; mean ICQI-SF score was 12.1 ± 5.86, implying UI had a moderate impact on QoL. CONCLUSION: The 13.3% prevalence of UI was similar to previous studies. The absence of a protocol for incontinence management was identified. The results suggest additional, larger sample UI prevalence studies need to be conducted.

Epidermólise Bolhosa Congênita - importância do cuidado de enfermagem / Epidermólisis Ampollosa Congénita - importancia de los cuidados de enfermería / Congenital Epidermolysis Bullosa - importance of nursing care

Introdução: A Epidermólise Bolhosa Congênita é doença rara. Dos seus quatro tipos: simples, juncional, distrófica e Síndrome de Kindler,todos têm como fator característico a presença de bolhas ou erosões na pele ou mucosas que ocasionam dor física e sofrimento emocional,causando impacto na vida da pessoa e da família. Objetivo: Destacar a importância do cuidado de enfermagem com ênfase na assistênciae qualidade de vida à criança com Epidermólise Bolhosa Hereditária. Material e Método: Revisão de literatura, cuja busca de dados foifeita por meio de publicações da Sociedade Brasileira de Dermatologia e na Biblioteca Virtual em Saúde (BVS – BIREME). Resultados: Deacordo com o delineamento da pesquisa, observou-se uma escassez de estudos que retratem cuidados de enfermagem frente à patologia.Seis artigos apenas relacionavam-se ao processo de cuidar e ações/intervenções de enfermagem, sendo cinco de revisão integrativa e umrelato de experiência. A discussão pautou-se em duas categorias: condição clínica e manifestações da Epidermólise Bolhosa Congênita;Cuidados de enfermagem no manejo da criança com Epidermólise Bolhosa. Conclusão: Há poucos estudos publicados sobre a doença ea assistência de enfermagem. É preciso que os enfermeiros desenvolvam estudos acerca dessa patologia e que implementem cuidadosde enfermagem fundamentados em evidências científicas, específicas para cada tipo de Epidermólise Bolhosa Congênita, tendo em vistamelhorar a assistência e a qualidade de vida do paciente, como também a de sua família.

Introduction: Congenital Epidermolysis Bullosa is a rare disease. All of the four types of it: simple, junctional, dystrophic and Kindler'sSyndrome, show as their characteristic factor the presence of bubbles or erosions in the skin or mucous membranes that cause physicalpain and emotional suffering, impacting the person and family life. Objective: To highlight the importance of nursing care with emphasison care and quality of life for children with Hereditary Epidermolysis Bullosa. Material and Method: It was a literature review, whose datasearch was carried out through publications of the Brazilian Society of Dermatology and through Virtual Health Library (BVS - BIREME).Results: According to the research design, we noticed a shortage of studies that portray nursing care in relation to the pathology. Onlysix articles were related to the care process and to nursing actions / interventions, being five of them an integrative review and just onean experience report. The discussion was focused on two categories: clinical condition and manifestations of Congenital EpidermolysisBullosa; Nursing care in the management of the child with Epidermolysis Bullosa. Conclusion: There are few published studies about thedisease and nursing care. It is necessary that nurses develop studies about this pathology and that they implement nursing care basedon scientific evidences, specific for each type of Congenital Bullous Epidermolysis, in order to improve the care and the quality of life ofthe patient, as well as the one of his family.

Introducción: Epidermólisis ampollosa congénita es una enfermedad rara. De los cuatro tipos: simple, penctional, distróficas y Síndromede Kindler, todos tienen como factor característico la presencia de ampollas o erosiones en la piel o membranas mucosas que causan dolorfísico y el sufrimiento emocional, causando impacto en la persona y la vida familiar. Objetivo: Destacar la importancia de los cuidadosde enfermería con énfasis en la atención y la calidad de vida de los niños con epidermólisis ampollosa heredable. Métodos: Revisiónde la literatura, cuyos datos de búsqueda se hizo a través de publicaciones de la Sociedad Brasileña de Dermatología y de la BibliotecaVirtual en Salud (BVS - BIREME). Resultados: De acuerdo con el diseño del estudio, hubo una falta de estudios que retratan la patologíay cuidados de enfermería. Seis artículos se refieren únicamente al proceso de atención y acciones/intervenciones de enfermería, cincode revisión integradora y un relato de experiencia. La discusión se basó en dos categorías: la condición clínica y las manifestaciones deepidermólisis ampollosa congênita; cuidados de enfermería en el tratamiento de niños con epidermólisis ampollosa. Conclusión: Haypocos estudios publicados sobre el cuidado de la enfermedad y de enfermería. Es necesario que el personal de enfermería desarrolleestudios sobre la enfermedad y aplicar los cuidados de enfermería basada en la evidencia científica, específicos para cada tipo deEpidermolisis ampollosa congênita, para mejorar la atención y calidad de vida de los pacientes, sino también de su familia.