The impact of the absorbent products distribution system on family caregivers of older people with incontinence in Italy: perception of the support received.

BACKGROUND: Urinary incontinence is a chronic, age-related disorder, likely to increase in the future due to global population ageing. In Italy, as in most countries, older people with incontinence are often cared for by family caregivers, whose burden might be worsened by the perception of receiving an inadequate support, due to the lack of customized services. The aim of this study was to evaluate the impact of the absorbent products distribution method on family caregivers' perception of the support received. METHODS: The study compared the distribution of pads to homes and in pharmacy via a survey reaching 101 family caregivers of older people with incontinence living in two geographical areas of the Marche Region (Central Italy) with different distribution systems. The association between "Quality of perceived support" (the outcome variable) and two types of absorbent products delivery methods (i.e. pharmacy and home distribution) was analysed by means of a general linear model. RESULTS: Findings show that family caregivers receiving pads at home (HODs) perceived a higher support than those gaining them at the pharmacy (PHADs) (respectively 68.1% vs 35%). The association between perceived support level and distribution system remained even after correction for confounding factors. 70.2% of PHADs reported "Poor well-being", versus only 53.7% of HODs. The latter are more satisfied with the type of products distribution and thus less inclined to experiment different systems for the supply of products for the urinary continence (e.g. by voucher). The results are virtually reversed among PHADs and the difference is statistically significant (p <  0.001). CONCLUSIONS: When family caregivers feel supported by a more customized service delivery system, their perception of the care-related burden is mitigated. Thus, it is important to consider the needs of both family caregivers and cared for older people, and not only of the latter for designing a more suitable distribution of absorbent products. The best solution could be leaving end-users the freedom to choose how they want to get products (e.g. voucher or personal budget). This requires a reorganization of the current pads delivery systems adopted by the Marche and by other Italian Regional Health Systems.

An overview of body-worn disposable absorbent pads.

Joanna George describes the range of products that are available to people who need to use absorbent products for incontinence.

Attends Slip with S-form: a new design of an all-in-one product.

Disposable absorbent containment products (continence pads) should only be used after a thorough assessment of the client's needs with regard to preference, independence, comfort and security. This article offers a list of criteria that can be used to examine the quality of products. It then looks at a new product using this criteria.

Incontinence products and devices for the elderly.

Devices and products to contain or collect the urine are part of the management of bladder dysfunction, particularly urinary incontinence (UI) (Newman, Bliss, & Fader, in press). The aim of continence nurse experts and those who care for incontinent individuals during the past decade has been to greatly decrease the indiscriminate use of absorbent pads and garments, external collecting devices, and indwelling catheterization, through the successful treatment of urinary incontinence (UI) with behavioral interventions, drug therapies, and new surgical procedures. However, these products and devices can be beneficial for persons who are elderly, fail treatment and remain incontinent, who are too ill or disabled to participate in behavioral programs, who cannot be helped by medications, or who have a type of UI that cannot be alleviated by other interventions (Newman, 2003). The judicious use of products to contain urine loss and maintain skin integrity is a first-line defense for these patients (Fantl et al., 1996). Urinary collection devices and products that are appropriate for elderly patients, that are used by nurses in all clinical settings, and are available at local pharmacies, retail stores, medical equipment dealers or directly from manufacturers are discussed.

A pilot study to evaluate reusable absorbent body-worn products for adults with moderate/heavy urinary incontinence.

OBJECTIVE: The purpose of this pilot study was to evaluate the performance of reusable absorbent body-worn products for adults with moderate/heavy urinary incontinence, compare their performance with a group of equivalent disposable products, and establish the need for a larger statistically robust study. SETTING AND SUBJECTS: Ten men and 4 women living in the community were recruited from locations throughout the United Kingdom. METHODS: A randomized multiple crossover design was used in which all subjects were given the opportunity to test each product. All the products were available on the UK market in January 2001. The following tools were used in the evaluation: a product performance questionnaire and a pad leakage diary. Overall opinion was used as the primary outcome indicator. RESULTS: The reusable Paddy T was the best performing product overall, outperforming the disposable products. For low leakage and good absorbency (the most important product attributes identified by the subjects), the disposable all-in-one product performed best during the day. However, the Paddy T performed best for night use. The remaining reusable products performed poorly overall. CONCLUSIONS: Reusable products for moderate/heavy incontinence remain unpopular for use in isolation. Surprisingly, a product manufactured from terry toweling, a traditional material, performed relatively well. Reusables may provide a useful alternative to disposable products in certain circumstances. The results from this study do not support a more comprehensive costly study.