Jakou péči poskytujeme pacientům s inkontinencí v rezidenčních zařízeních a v domácí péči?
I. Názory a postoje zdravotnických profesionálů

Česká verzia

Authors: E. Topinková ^1,2; D. Jurásková ^3,4; Z. Kučera ⁵; N. Müllerová ⁶
Authors place of work: Geriatrická klinika 1. LF a VFN, Praha ¹; Subkatedra geriatrie Institutu postgraduálního vzdělávání ve zdravotnictví, Praha ²; Všeobecná fakultní nemocnice, Praha ³; Česká asociace sester ⁴; IncoForum, Česká společnost podpory zdraví, Praha ⁵; Odbor vzdělávání a vědy MZ ČR ⁶
Published in the journal: Čes Ger Rev 2009; 7(1): 14-21

Summary

Background.
Urinary and fecal incontinence are considered as symptoms worsening significantly patient’s quality of life and accounting for high costs particularly for nursing care for incontinent in long‑term care facilities. Repeated complaints of substandard quality of care and nursing practices provided to incontinent persons in these settings have been reported. In institutions, prevalence of incontinence reaches 50– 70% of residents and, about a half of home care clients suffer from incontinence, too. In the article we present results of the project “Incontinence in the context of nursing care”. Methods. Survey in 34 nursing middle management specialists was performed in 9 nursing homes, 5 social care facilities, 10 homes for seniors and 10 home care agencies focusing on the current system and quality of nursing care. Results. Specific nursing standards for incontinent patients are non‑existent in 80% of social care and senior’s facilities, 50% of home care agencies and 22% of nursing homes. 41% of respondents belief that because of incontinence higher amount of nursing time is provided, in 52.2% usual nursing care is satisfactory. Continence training programs for incontinent persons (44%) and protective absorbing garments (21%) are considered as the most appropriate nursing interventions. However, no agreement exists for the frequency of the continence training. 32% of respondents falsely believe that a training once a day and less is sufficient. Expert estimates for the optimal numbers of incontinence aids vary depending on incontinence severity. As the main barriers financial limits for incontinence garments (56%), lack of personnel (53%) and high number of incontinent persons in facility (32%) are reported. Conclusions. Significant variability in nursing practices and quality of care was found among individual providers and types of setting. Understanding of barriers differs according to different types of providers. The causes of this situation are multiple, both objective (lack of personnel, financial limits for incontinence aids) and subjective (lack of specific standards, insufficient knowledge, and low motivation). Educational activities on incontinence should be promoted together with a national guideline for nursing care in patients with urinary incontinence.

Keywords:
incontinence – diagnostic, medical and nursing interventions – quality of care – elderly people

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