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Prevalence
of medically recognized continence problems in a German geriatric
rehabilitation centre
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Authors:
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M. Pfisterer, M. Müller,
U. Hestermann, M. Menzel, E. Kuno, N. Wezler, P. Oster
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Institution:
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Bethanien-Krankenhaus
-Geriatric Centre at the University of Heidelberg, Germany
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Aim of the
study:
To determine the prevalence of continence problems in a geriatric rehabilitation
setting in Germany.
Methods:
A nurse continence adviser performed weekly continence meetings (CM) with the
nurses and the physician of a geriatric rehabilitation ward. Patients with known
continence problems (Urinary incontinence at least once a week, urinary catheter,
faecal incontinence and burdensome urge-symptoms without incontinence) were
discussed and documented in a continence chart. In order to compare this subgroup
of patients with all the other patients on the ward the continence charts of
the patients with continence problems and the medical/nursing records of all
patients on the ward were reviewed and abstracted according to a protocol by
trained research personal using a structured abstraction form. Collected variables
were: sex, age, main admission-diagnosis, Barthel-Index on admission (ADLA)
and discharge (ADLD), Minimental State Examination (MMSE), continence problem
according to the CM and/or the medical record of a patient.
Results:
Within the study period of one year 268 patients were admitted on the geriatric
rehabilitation ward (Table 1). 139 (51,9 %) of the 268 patients had medically
recognized continence problems. In table 2 the prevalence of the different types
of continence problems are listed. The mean stay was 32,4 days of patients with
continence problems and 26,1 days of patients without continence problems.
Table 1
Characteristics of geriatric rehabilitation patients
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Women
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Men
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All
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Admission-diagnosis neurological
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53 (29,6%)
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50 (56,2%)
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103 (38,4%)
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musculo-skeletal
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91 (50,9%)
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26 (29,2%)
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117 (43,7%)
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Other
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35 (19,6%)
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13 (14,6%)
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48 (17,9%)
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Age (! SD)
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80,7 (! 7,1)
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76,2 (! 8,6)
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79,2 (! 7,9)
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MMSE (! SD)
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25,5 (! 9,8)
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25,1 (! 10,3)
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25,4 (! 9,9)
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ADLA (! SD)
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57,4 (! 23,5)
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55,2 (! 25,1)
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56,7 (! 24,0)
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ADLD (! SD)
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73,6 (! 22,2)
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70,7 (! 25,5)
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72,7 (! 23,3)
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Table
2 %Prevalence of continence problems
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Women (n=179)
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Men (n=89)
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All (n=268)
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CM
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Extra
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CM
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Extra
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å
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Urinary I
+ catheter
- catheter
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30,2 (54)
2,8 (5)
27,4 (49)
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5,6 (10)
1,1 (2)
4,5 (8)
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35,9 (32)
16,9 (15)
19,1 (17)
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9,0 (8)
2,3 (2)
6,7 (6)
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38,8 (104)
9,0 (24)
29,8 (80)
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UI and FI
+ catheter
- catheter
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7,3 (13)
3,9 (7)
3,4 (6)
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1,1 (2)
0,6 (1)
0,6 (1)
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5,6 (5)
2,3 (2)
3,4 (3)
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2,3 (2)
–
2,3 (2)
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8,2 (22)
3,7 (10)
4,5 (12)
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Faecal I
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0,6 (1)
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0,6 (1)
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1,1 (1)
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1,1 (3)
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Continent
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3,4 (6)®
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51,4 (92)
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3,4 (3)®
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41,6 (37)
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51,5 (138)
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Æ Data
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-
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1,1 (1)
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0,4 (1)
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CM: weekly continence
meeting, Extra: patients not
discussed during the CM but with a documented continence problem in their
medical record. ®Patients with burdensome urge symptoms and no incontinence.
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Conclusion:
A significant number of patients with a documented continence problem was not
reported/discussed during the weekly continence meetings. This could be related
to the fear of further workload, different sensibility to this topic within
the team or communication problems. Nevertheless the results show continence
problems to be very common in geriatric rehabilitation patients. This should
influence the training of medical staff and implements that there is a need
for continence advisers and continence training in rehabilitation of geriatric
patients.