Profile of urinary incontinent elderly in long-term care institutions.
Profile of urinary incontinent elderly in long-term care institutions.
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长期护理机构中老年人尿失禁的概况。
DOI：
10.1111/j.1532-5415.1990.tb03542.x
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发表时间：
1990
影响因子：
6.3
通讯作者：
Dennis,PJ
中科院分区：
文献类型：
--
作者：
Yu,LC;Rohner,TJ;Kaltreider,DL;Hu,TW;Igou,JF;Dennis,PJ
这篇文章介绍了长期护理机构中失禁老年人的概况。从宾夕法尼亚州中部的七家疗养院招募了133名虚弱的老年妇女进行为期三年的临床试验，以测试行为疗法对尿失禁的有效性。所有患者都有不止一种医学诊断。80%的人有心肺疾病；最常见的诊断是心血管疾病。80%的人患有一种或多种神经系统疾病，包括“器质性脑综合征”(47%)和老年痴呆症(30%)；44%的人患有关节炎/风湿病。一半的患者表现出严重的认知障碍；只有12%的患者没有认知障碍。63%的人完全依赖；68%的人使用轮椅，61%的人被绑在椅子上；50%的人视力受损，三分之一的人听力受损，14%的人说话。41%的患者膀胱容量正常，无逼尿肌不稳定，膀胱排空满意，残余尿量低证明了这一点，这表明这一老年组的尿失禁可能不是主要的膀胱问题，而是精神和身体上的残疾可能是这些患者失禁的更重要的潜在原因。这项研究中的一个重要发现是34%的患者有逼尿肌不稳定。从理论上讲，抗胆碱能药物或丙咪嗪的药物治疗可以改善这一组患者的尿失禁。5%的人被发现有大量剩余尿量，与大容量膀胱有关，这表明溢流性尿失禁是他们每天渗漏的原因。与年轻和中年女性相比，老年疗养院患者中骨盆放松和应力渗漏的发生率要低得多。
This article presents a profile of incontinent elderly in long‐term care institutions. One hundred thirty‐three frail elderly women were recruited from seven nursing homes in central Pennsylvania for a three‐year clinical trial to test the effectiveness of a behavioral therapy on urinary incontinence. All of the patients had more than one medical diagnosis. Eighty percent had cardiorespiratory conditions; the most prevalent diagnoses were cardiovascular diseases. Eighty percent had one or more neurological diseases, including “organic brain syndrome”(47%) and senile dementia (30%); 44% had arthritis/rheumatism. Half of the patients showed severe cognitive impairment; only 12% showed no cognitive impairment. Sixty‐three percent were totally dependent; 68% used wheelchairs, 61% were chairbound; 50% had impairments in vision, one‐third in hearing, and 14% in speech. Normal bladder capacity, absence of detrusor instability, and satisfactory bladder emptying, as evidenced by low residual urines, was found in 41% of the patients, suggesting that incontinence in this elderly group may not be a primary bladder problem, but rather that mental and physical disabilities may be a more important underlying cause of incontinence in these patients. An important finding in this study is that 34% of the patients had detrusor instability. It is theoretically possible that pharmacologic therapy with anticholinergic agents or imipramine could improve incontinence in this group. Five percent were found to have large residual urine volumes in association with high‐capacity bladders suggesting overflow incontinence as the cause of their daily leakage. Pelvic relaxation and stress leakage was far less common in this elderly group of nursing home patients than in young and middle‐aged women.