Factors with the management of incontinence and promotion of continence in older people in care homes

Authors

  • Lisa Flanagan BSc MBBch MRCP,

    Consultant in Geriatric Medicine, Corresponding author
    1. Wirral University Teaching Hospital NHS Foundation Trust, UK
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  • Brenda Roe PhD RN RHV,

    Professor of Health Research, Honorary Fellow
    1. Evidence-based Practice Research Centre, Faculty of Health & Social Care, Edge Hill University, Ormskirk, UK
    2. Personal Social Services Research Unit, University of Manchester, UK
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  • Barbara Jack PhD RN RNT,

    Director, Head of Research and Scholarship
    1. Personal Social Services Research Unit, University of Manchester, UK
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  • Christine Shaw PhD RN,

    Reader in Nursing Research
    1. Department of Care Sciences, University of Glamorgan, Pontypridd, UK
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  • Kate S. Williams PhD RN,

    Senior Research Fellow in Nursing
    1. Department of Health Sciences, University of Leicester, UK
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  • Alan Chung BSc RN,

    Cardiology Research Nurse
    1. Cardiology Department, Birmingham Heartlands Hospital, UK
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  • James Barrett MD FRCP

    Consultant Physician in Geriatric and Stroke Medicine, Visiting Professor
    1. Evidence-based Practice Research Centre, Faculty of Health & Social Care, Edge Hill University, Ormskirk, UK
    2. Wirral University Teaching Hospitals NHS Foundation Trust, Arrowe Park Hospital, UK
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Abstract

Aim

Review of intervention studies of associated factors with incontinence as the primary outcome in older people in care homes to identify and inform practice and future research.

Background

Incontinence is highly prevalent among care home populations. Previous reviews of descriptive and intervention studies have used urinary incontinence as the primary outcome.

Design

Systematic review and narrative summary.

Data sources

Electronic searches of English empirical studies undertaken using MEDLINE and CINAHL from January 1966–May 2010. All relevant empirical designs were selected from MEDLINE highly sensitive search strings from the Cochrane Incontinence Review Group, modified to exclude surgical and pharmacological studies

Review methods

The PRISMA statement was followed and established methods for systematic review to produce a narrative summary.

Results

Nine studies identified relating to associated factors with the management of incontinence in care homes. Factors included economic data, skin care, exercise studies, staff quality and prompted voiding adherence and the promotion of continence by the management of dehydration and incontinence.

Conclusion

Managing incontinence and promoting continence in care homes is complex, requiring time and cost-efficient management procedures to contain the problem and deliver quality, achievable care. When developing and designing systems of care in care homes, it is important to also recognize the impact of associated factors. As with any healthcare intervention programme, resources are required to implement the protocols. Economic evaluation studies are limited, with further studies warranted alongside preventative studies to maintain long-term continence in these populations.

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