Lene Elisabeth Blekken1, Anne Guttormsen Vinsnes2, Kari Hanne Gjeilo3,4, Christine Norton5, Siv Mørkved3,6, Øyvind Salvesen6, Sigrid Nakrem2. 1. Faculty of Health and Social Science, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. 2. Faculty of Health and Social Science, Norwegian University of Science and Technology, Trondheim, Norway. 3. St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. 4. Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. 5. Faculty of Nursing and Midwifery, King's College London, UK. 6. Medical Faculty, Norwegian University of Science and Technology, Trondheim, Norway.
Abstract
AIM: To explore prevalence and associations of faecal incontinence among nursing home patients, to examine the effect of clustering of observations and to study the variation in faecal incontinence rates on both the level of nursing home units and individual patients. BACKGROUND: Faecal incontinence affects 40-55% of the patients in nursing homes and is associated with increased risk of morbidity and reduced quality of life. There is a lack of studies investigating faecal incontinence with validated instruments. More studies need to include models of analyses that allow for clustering of observations. DESIGN: Cross-sectional. METHODS: Data on 261 patients from 20 nursing home units were collected during September-October 2014. The Norwegian version of the Resident Assessment Instrument for Long-Term Care Facilities was used. Mixed effect models were conducted. RESULTS: Prevalence of faecal incontinence was 42·1% or 54% depending on the frequency labelling chosen. The effect of clustering by nursing home unit was not statistically significant. Most of the variation in faecal incontinence rates was explained by differences in patient characteristics, the most important being deficiencies in activities of daily living, cognitive impairment, diarrhoea and not participating in activities. CONCLUSION: Nursing home patients should be offered individualized assessment and continence care matching their patient characteristics. The Resident Assessment Instrument for Long-Term Care Facilities is a useful instrument because of its' combination of a comprehensive range of individual items and scales allowing for comparison of immediate or long-term change in patients status. Studies evaluating interventions targeting faecal incontinence are warranted.
AIM: To explore prevalence and associations of faecal incontinence among nursing home patients, to examine the effect of clustering of observations and to study the variation in faecal incontinence rates on both the level of nursing home units and individual patients. BACKGROUND: Faecal incontinence affects 40-55% of the patients in nursing homes and is associated with increased risk of morbidity and reduced quality of life. There is a lack of studies investigating faecal incontinence with validated instruments. More studies need to include models of analyses that allow for clustering of observations. DESIGN: Cross-sectional. METHODS: Data on 261 patients from 20 nursing home units were collected during September-October 2014. The Norwegian version of the Resident Assessment Instrument for Long-Term Care Facilities was used. Mixed effect models were conducted. RESULTS: Prevalence of faecal incontinence was 42·1% or 54% depending on the frequency labelling chosen. The effect of clustering by nursing home unit was not statistically significant. Most of the variation in faecal incontinence rates was explained by differences in patient characteristics, the most important being deficiencies in activities of daily living, cognitive impairment, diarrhoea and not participating in activities. CONCLUSION: Nursing home patients should be offered individualized assessment and continence care matching their patient characteristics. The Resident Assessment Instrument for Long-Term Care Facilities is a useful instrument because of its' combination of a comprehensive range of individual items and scales allowing for comparison of immediate or long-term change in patients status. Studies evaluating interventions targeting faecal incontinence are warranted.