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06.09.2016 | Original Contribution

Incontinence in nursing home residents with dementia

Influence of an educational program and nursing case conferences

verfasst von: Myrta Kohler, Jürg Schwarz, Melanie Burgstaller, Susi Saxer

Erschienen in: Zeitschrift für Gerontologie und Geriatrie

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Abstract

Background

Up to 90 % of nursing home residents with dementia suffer from urinary incontinence with adverse effects on the quality of life. Nurses are often insufficiently prepared for incontinence management and their knowledge is incomplete. Urinary incontinence management for people with dementia is complex due to the multifactorial nature of the disease and cognitive impairment.

Objective

This study explored the effects of an educational program and subsequent nursing case conferences on urinary incontinence and quality of life of nursing home residents with dementia.

Methods

The stepped-wedge trial design was used and seven nursing homes were included. In total 140 people were included in the study. The intervention consisted of an educational program and six case conferences at each ward. Urinary incontinence and quality of life were measured at baseline, after 2 and 6 months as well as at the end of the study. Univariate analysis of variance (ANOVA), repeated measures ANOVA and linear regression were used to compare the groups and the results at different times of measurement. The responsible ethics committees approved the study.

Results

After 6 months urinary incontinence decreased or was approximately equal to the initial measurement. At the end of the study urinary incontinence was slightly but not significantly higher. In the whole sample the quality of life increased in seven out of nine categories up to the end of the study.

Conclusion

Urinary incontinence management for people with dementia is complex and an educational program and case conferences during 6 months proved to be effective in reducing urinary incontinence and improve the quality of life in nursing home residents with dementia.
Literatur
1.
Zurück zum Zitat Bouman AIE, Ettema TP, Wetzels RB, van Beek APA, de Lange J, Dröes RM (2011) Evaluation of Qualidem: a dementia-specific quality of life instrument for persons with dementia in residential settings; scalability and reliability of subscales in four Dutch field surveys. Int J Geriatr Psychiatry 26:711–722CrossRefPubMed Bouman AIE, Ettema TP, Wetzels RB, van Beek APA, de Lange J, Dröes RM (2011) Evaluation of Qualidem: a dementia-specific quality of life instrument for persons with dementia in residential settings; scalability and reliability of subscales in four Dutch field surveys. Int J Geriatr Psychiatry 26:711–722CrossRefPubMed
3.
Zurück zum Zitat Buscher I, Reuther S (o.J.) FallDem, Fallbesprechung bei Menschen mit Demenz: Untersuchung der Wirkung von Fallbesprechungen zum herausfordernden Verhalten von Menschen mit Demenz. Buscher I, Reuther S (o.J.) FallDem, Fallbesprechung bei Menschen mit Demenz: Untersuchung der Wirkung von Fallbesprechungen zum herausfordernden Verhalten von Menschen mit Demenz.
4.
Zurück zum Zitat Cheater FM (2009) Overcoming the barriers to optimum continence care: the need for an expanded approach to implementation. Int J Older People Nurs 4:70–75CrossRefPubMed Cheater FM (2009) Overcoming the barriers to optimum continence care: the need for an expanded approach to implementation. Int J Older People Nurs 4:70–75CrossRefPubMed
5.
Zurück zum Zitat Dal-Bianco P (2004) Hirnleistungsstörungen/Demenzen als Ursache der Inkontinenz – neurologische Aspekte. J Urol Urogynaekol 11(1):19–21 Dal-Bianco P (2004) Hirnleistungsstörungen/Demenzen als Ursache der Inkontinenz – neurologische Aspekte. J Urol Urogynaekol 11(1):19–21
6.
Zurück zum Zitat Dichter M (2015) Inter-rater reliability of the Qol-measure QUALIDEM. BMC Nurs 14:12CrossRef Dichter M (2015) Inter-rater reliability of the Qol-measure QUALIDEM. BMC Nurs 14:12CrossRef
7.
Zurück zum Zitat DuBeau CE, Simon SE, Morris JN (2006) The effect of urinary incontinence on quality of life in older nursing home residents. J Am Geriatr Soc 54:1325–1333CrossRefPubMed DuBeau CE, Simon SE, Morris JN (2006) The effect of urinary incontinence on quality of life in older nursing home residents. J Am Geriatr Soc 54:1325–1333CrossRefPubMed
8.
Zurück zum Zitat Ettema TP, Dröes R, de Lange J, Mellenbergh GJ, Ribbe MW (2007b) QUALIDEM: development and evaluation of a dementia specific quality of life instrument. Scalability, reliability and internal structure. Int J Geriatr Psychiatry 22:549–556CrossRefPubMed Ettema TP, Dröes R, de Lange J, Mellenbergh GJ, Ribbe MW (2007b) QUALIDEM: development and evaluation of a dementia specific quality of life instrument. Scalability, reliability and internal structure. Int J Geriatr Psychiatry 22:549–556CrossRefPubMed
9.
Zurück zum Zitat Ettema TP, Dröes R, de Lange J, Mellenbergh GJ, Ribbe MW (2007a) QUALIDEM: development and evaluation of a dementia specific quality of life instrument – validation. Int J Geriatr Psychiatry 22:424–430CrossRefPubMed Ettema TP, Dröes R, de Lange J, Mellenbergh GJ, Ribbe MW (2007a) QUALIDEM: development and evaluation of a dementia specific quality of life instrument – validation. Int J Geriatr Psychiatry 22:424–430CrossRefPubMed
10.
Zurück zum Zitat Hemming K, Haines TP, Chilton PJ, Girling AJ, Lilford RJ (2015) The stepped wedge cluster randomised trial: rationale, design, analysis, and reporting. BMJ 350:h391CrossRefPubMed Hemming K, Haines TP, Chilton PJ, Girling AJ, Lilford RJ (2015) The stepped wedge cluster randomised trial: rationale, design, analysis, and reporting. BMJ 350:h391CrossRefPubMed
11.
Zurück zum Zitat Jerez-Roig J, Santos MM, Souza DLB, Amaral FL, Lima KC (2014) Prevalence of urinary incontinence and associated factors in nursing home residents. Neurourol Urodyn 35(1):102–107. doi:10.1002/nau.22675 CrossRefPubMed Jerez-Roig J, Santos MM, Souza DLB, Amaral FL, Lima KC (2014) Prevalence of urinary incontinence and associated factors in nursing home residents. Neurourol Urodyn 35(1):102–107. doi:10.​1002/​nau.​22675 CrossRefPubMed
12.
Zurück zum Zitat Jones K, Perlman CM, Hirdes JP, Scott T (2010) Screening cognitive performance with the resident assessment instrument for mental health cognitive performance scale. Can J Psychiatry 55(11):736–740CrossRefPubMed Jones K, Perlman CM, Hirdes JP, Scott T (2010) Screening cognitive performance with the resident assessment instrument for mental health cognitive performance scale. Can J Psychiatry 55(11):736–740CrossRefPubMed
13.
Zurück zum Zitat Karantanis E, Allen W, Stevermuer TL, Simons AM, O’Sullivan R, Moore KH (2005) The repeatability of the 24-hour pad test. Int Urogynecol J Pelvic Floor Dysfunct 16:63–68 (discussion 68)CrossRefPubMed Karantanis E, Allen W, Stevermuer TL, Simons AM, O’Sullivan R, Moore KH (2005) The repeatability of the 24-hour pad test. Int Urogynecol J Pelvic Floor Dysfunct 16:63–68 (discussion 68)CrossRefPubMed
15.
Zurück zum Zitat Miu DKY, Lau S, Szeto SSL (2009) Etiology and predictors of urinary incontinence and its effect on quality of life. Geriatr Gerontol Int. doi:j.1447-0594.2009.00574.x Miu DKY, Lau S, Szeto SSL (2009) Etiology and predictors of urinary incontinence and its effect on quality of life. Geriatr Gerontol Int. doi:j.1447-0594.2009.00574.x
16.
Zurück zum Zitat Morris JN, Fries BE, Mehr DR et al (1994) MDS Cognitive Performance Scale. J Gerontol 49:174–182CrossRef Morris JN, Fries BE, Mehr DR et al (1994) MDS Cognitive Performance Scale. J Gerontol 49:174–182CrossRef
17.
Zurück zum Zitat Offermans MP, Du Moulin MF, Hamers JP, Dassen T, Halfens RJ (2009) Prevalence of urinary incontinence and associated risk factors in nursing home residents: a systematic review. Neurourol Urodyn 28:288–294CrossRefPubMed Offermans MP, Du Moulin MF, Hamers JP, Dassen T, Halfens RJ (2009) Prevalence of urinary incontinence and associated risk factors in nursing home residents: a systematic review. Neurourol Urodyn 28:288–294CrossRefPubMed
18.
Zurück zum Zitat Ostaszkiewicz J, O’Connell B, Dunning T (2012) Residents’ perspectives on urinary incontinence: a review of literature. Scand J Caring Sci 26:761–772CrossRefPubMed Ostaszkiewicz J, O’Connell B, Dunning T (2012) Residents’ perspectives on urinary incontinence: a review of literature. Scand J Caring Sci 26:761–772CrossRefPubMed
19.
Zurück zum Zitat Paquay L, de Lepeleire J, Schoenmakers B, Ylieff M, Fontaine O, Buntinx F (2007) Comparison of the diagnostic accuracy of the Cognitive Performance Scale (Minimum Data Set) and the Mini-Mental State Exam for the detection of cognitive impairment in nursing home residents. Int J Geriatr Psychiatry 22:286–293CrossRefPubMed Paquay L, de Lepeleire J, Schoenmakers B, Ylieff M, Fontaine O, Buntinx F (2007) Comparison of the diagnostic accuracy of the Cognitive Performance Scale (Minimum Data Set) and the Mini-Mental State Exam for the detection of cognitive impairment in nursing home residents. Int J Geriatr Psychiatry 22:286–293CrossRefPubMed
20.
Zurück zum Zitat Park S, de Gagne JC, So A, Palmer MH (2015) Knowledge, attitudes, beliefs, and practices in registered nurses and care aids about urinary incontinence in Korean nursing homes: a cross-sectional survey. J Wound Ostomy Continence Nurs 42(2):183–189CrossRefPubMed Park S, de Gagne JC, So A, Palmer MH (2015) Knowledge, attitudes, beliefs, and practices in registered nurses and care aids about urinary incontinence in Korean nursing homes: a cross-sectional survey. J Wound Ostomy Continence Nurs 42(2):183–189CrossRefPubMed
22.
Zurück zum Zitat Rose A, Thimme A, Halfar C, Nehen HG, Rubben H (2013) Severity of urinary incontinence of nursing home residents correlates with malnutrition, dementia and loss of mobility. Urol Int 91:165–169CrossRefPubMed Rose A, Thimme A, Halfar C, Nehen HG, Rubben H (2013) Severity of urinary incontinence of nursing home residents correlates with malnutrition, dementia and loss of mobility. Urol Int 91:165–169CrossRefPubMed
23.
Zurück zum Zitat Saxer S, de Bie RA, Dassen T, Halfens RJG (2008) Nurses’ knowledge and practice about urinary incontinence in nursing home care. Nurse Educ Today 28:926–934CrossRefPubMed Saxer S, de Bie RA, Dassen T, Halfens RJG (2008) Nurses’ knowledge and practice about urinary incontinence in nursing home care. Nurse Educ Today 28:926–934CrossRefPubMed
24.
Zurück zum Zitat Saxer S, Dassen T, de Bie RA, Halfens R (2010) Nurses’ attitudes toward urinary incontinence. Cont UK 4:20–26 Saxer S, Dassen T, de Bie RA, Halfens R (2010) Nurses’ attitudes toward urinary incontinence. Cont UK 4:20–26
25.
Zurück zum Zitat Schmitz G (2013) Inkontinenz. In: Dassen T (ed) Pflegeprobleme in Deutschland. Ergebnisse von 13 Jahren Forschung in Pflegeheimen und Kliniken 2001–2013. Charité – Universitätsmedizin, Berlin Schmitz G (2013) Inkontinenz. In: Dassen T (ed) Pflegeprobleme in Deutschland. Ergebnisse von 13 Jahren Forschung in Pflegeheimen und Kliniken 2001–2013. Charité – Universitätsmedizin, Berlin
26.
Zurück zum Zitat Schrems B (2013) Fallarbeit in der Pflege. Facultas, Wien Schrems B (2013) Fallarbeit in der Pflege. Facultas, Wien
27.
Zurück zum Zitat Schüssler S, Dassen T, Lohrmann C (2014) Care dependency and nursing care problems in nursing home residents with and without dementia: a cross-sectional study. Aging Clin Exp Res. doi:10.1007/s40520-014-0298-8 PubMed Schüssler S, Dassen T, Lohrmann C (2014) Care dependency and nursing care problems in nursing home residents with and without dementia: a cross-sectional study. Aging Clin Exp Res. doi:10.​1007/​s40520-014-0298-8 PubMed
29.
Zurück zum Zitat Victor A (1990) Pad weighing test – a simple method to quantitate urinary incontinence. Ann Med 22:443–447CrossRefPubMed Victor A (1990) Pad weighing test – a simple method to quantitate urinary incontinence. Ann Med 22:443–447CrossRefPubMed
30.
Zurück zum Zitat Zeller A, Needham I, Dassen T, Kok G, Halfens R (2013) Nurses’ experiences with aggressive behaviour of nursing home residents: a cross sectional study in Swiss nursing homes. Pflege 26:321–335CrossRefPubMed Zeller A, Needham I, Dassen T, Kok G, Halfens R (2013) Nurses’ experiences with aggressive behaviour of nursing home residents: a cross sectional study in Swiss nursing homes. Pflege 26:321–335CrossRefPubMed
Metadaten
Titel
Incontinence in nursing home residents with dementia
Influence of an educational program and nursing case conferences
verfasst von
Myrta Kohler
Jürg Schwarz
Melanie Burgstaller
Susi Saxer
Publikationsdatum
06.09.2016
Verlag
Springer Medizin
Erschienen in
Zeitschrift für Gerontologie und Geriatrie
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI
https://doi.org/10.1007/s00391-016-1120-3