Symptoms of anal incontinence and quality of life : A psychometric study of the Norwegian version of the ICIQ-B amongst hospital outpatients

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Effect of physical training on urinary incontinence: a randomized parallel group trial in nursing homes

Anne G Vinsnes1, Jorunn L Helbostad2, Signe Nyrønning3, Gene E Harkless1,4, Randi Granbo5, Arnfinn Seim61Faculty of Nursing, Sør-Trøndelag University College, 2Department of Neuroscience, Norwegian University of Science and Technology, 3Søbstad Community Hospital and Teaching Nursing Home, Trondheim, Norway; 4University of New Hampshire, College of Health and Social Services, Nursing Faculty, Durham, New Hampshire, USA; 5Department of Physiotherapy, Sør-Trøndelag University College, 6Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, NorwayBackground: Residents in nursing homes (NHs) are often frail older persons who have impaired physical activity. Urinary incontinence (UI) is a common complaint for residents in NHs. Reduced functional ability and residence in NHs are documented to be risk factors for UI.Objective: To investigate if an individualized training program designed to improve activity of daily living (ADL) and physical capacity among residents in nursing homes has any impact on UI.Materials and methods: This randomized controlled trial was a substudy of a Nordic multicenter study. Participants had to be >65 years, have stayed in the NH for more than 3 months and in need of assistance in at least one ADL. A total of 98 residents were randomly allocated to either a training group (n = 48) or a control group (n = 50) after baseline registrations. The training program lasted for 3 months and included accommodated physical activity and ADL training. Personal treatment goals were elicited for each subject. The control group received their usual care. The main outcome measure was UI as measured by a 24-hour pad-weighing test. There was no statistically significant difference between the groups on this measure at baseline (P = 0.15). Changes were calculated from baseline to 3 months after the end of the intervention.Results: Altogether, 68 participants were included in the analysis, 35 in the intervention group and 33 in the control group. The average age was 84.3 years. The 3 months' postintervention adjusted mean difference between groups according to amount of leakage was 191 g (P = 0.03). This result was statistically significant after adjusting for baseline level, age, sex, and functional status. The leakage increased in residents not receiving the experimental intervention, while UI in the training group showed improvement.Conclusion: The intervention group had significant better results compared with the control group after an individualized training program designed to improve ADL and physical capacity. Further studies are needed to evaluate the effect of a goal-oriented physical training program toward NH residents UI complaints.Keywords: effect study, nursing homes, residents, physical training program, urinary incontinenc

Healthcare personnel\u27s attitudes towards patients with urinary incontinence

The aim of the study was to understand the variability of Norwegian staffs attitudes towards patients with urinary incontinence across years and place of work, age and education levels. The Incontinence Stress Questionnaire - Staff Reaction (Norwegian version) (ISQ-SR-N) was used to measure staffs reactions and feelings towards patients with urinary incontinence. A cross-sectional survey design was used to gather self-reported data, The research sites were five nursing homes, three home care districts and medical and surgical. wards at a university hospital. Of the 745 staff invited, 535 (72%) returned the questionnaire. Staff members working in long-term care units were older than staff members working in acute care units. Most of the registered nurses worked in acute care, whilst most of the nursing assistants worked in long-term care. Stepwise regression analysis identified education, working in a medical/surgical units, and the interaction of education and working in a medical unit to be most predictive of attitudes. Nursing assistants had more positive attitudes than registered nurses. Working in medical/surgical units predicted the most negative attitudes. Only 15.2% of the variability of attitudes can be explained by the predictive variables