Systematic review of the management of incontinence and promotion of continence in older people in care homes: descriptive studies with urinary incontinence as primary focus

Brenda Roe, Lisa Flanagan, Barbara Jack, James Barrett, Alan Chung, Christine Shaw, Kate Williams, Brenda Roe, Lisa Flanagan, Barbara Jack, James Barrett, Alan Chung, Christine Shaw, Kate Williams

Abstract

Aim: This is a review of descriptive studies with incontinence as the primary focus in older people in care homes.

Background: Incontinence is prevalent among residents of care home populations.

Data sources: MEDLINE and CINAHL were searched from 1996 to 2007 using the highly sensitive search strings of the Cochrane Incontinence Review Group for urinary and faecal incontinence including all research designs. Search strings were modified to enhance selectiveness for care homes and older people and exclude studies involving surgical or pharmacological interventions. Searching of reference sections from identified studies was also used to supplement electronic searches. The Cochrane Library was searched for relevant systematic reviews to locate relevant studies from those included or excluded from reviews. The search was limited to English-language publications.

Methods: A systematic review of studies on the management of incontinence, promotion of continence or maintenance of continence in care homes was conducted in 2007-2009. This is a report of descriptive studies. Results. Ten studies were identified that reported on prevalence and incidence of incontinence (urinary with or without faecal), policies, assessment, documentation, management or economic evaluation of its management. Use of incontinence pads and toileting programmes comprised the most common management approaches used. No studies were identified that attempted to maintain continence of residents in care homes.

Conclusions: Studies on maintaining continence and identifying components of toileting programmes that are successful in managing or preventing incontinence and promoting continence in residents of care home populations along with their economic evaluation are warranted.

© 2010 The Authors. Journal of Advanced Nursing © 2010 Blackwell Publishing Ltd.

Figures

Figure 1
Figure 1
PRISMA 2009 flow diagram of the screening process.

References

    1. Abrams P, Cardozo L, Khoury S, Wein A. Fourth WHO-ICS International Consultation on Incontinence. Plymouth: Health Publications Ltd; 2009.
    1. Button D, Roe B, Webb C, Frith T, Colin Thome D, Gardner L. Consensus guidelines for the promotion and management of continence by primary health care teams: development, implementation and evaluation. Journal of Advanced Nursing. 1998;27:91–99.
    1. Colling J, Ouslander J, Hadley BJ, Eisch J, Campbell E. The effect of Patterned Urge Response Toileting (PURT) on urinary incontinence among nursing home residents. Journal of the American Geriatrics Society. 1992;40(2):135–141.
    1. DH. Good Practice in Continence Service. London: Department of Health; 2000. Retrieved from on 28 March 2008.
    1. DH. National Service Framework for Older People. London: Department of Health; 2001. p. 23.
    1. Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. Journal of Epidemiology and Community Health. 1998;52:377–384.
DuBeau 1999
    1. DuBeau CE, Simon SE, Morris JN. The impact of urinary incontinence and changing continence status on QOL in nursing home residents. Neurourology and Urodynamics. 1999;18(4):389–390.
    1. DuBeau CE, Simon SE, Morris JN. The effect of urinary incontinence on quality of life in older nursing home residents. Journal of the American Geriatrics Society. 2006;54(9):1325–1333.
    1. Eustice S, Roe B, Paterson J. Prompted voiding for the management of urinary incontinence in adults. Cochrane Database of Systematic Reviews. 2000;(2) DOI: .
    1. Fantl JA, Newman DK, Colling J, DeLancey JOL, Keeys C, Loughery R, McDowell BJ, Norton P, Ouslander J, Schnelle HJ, Staskin D, Tries J, Urich V, Vitousek SH, Weiss BD, Whitmore K. Urinary Incontinence in Adults: Acute and Chronic Management: Clinical Practice Guideline. Rockville: Agency for Health Care Quality and Research; 1996. No. 2 Update.
    1. Fonda D, DuBeau CE, Harari D, Ouslander JG, Palmer M, Roe B. Incontinence in the frail elderly. In: Abrams P, Cardozo L, Khoury S, Wein A, editors. Third International Consultation on Incontinence, 26–29 June 2004 Monaco. Plymouth: Health Publication Ltd, Plymbridge Distribution Ltd; 2005. pp. 1165–1239. Chapter 18.
    1. Grant AM, Cody DJ, Glazener CMA, Hay-Smith J, Herbison P, Lapitan MC, Moore KN, Norton C, Wallace SA, Wilson PD, editors. Incontinence Group. About The Cochrane Collaboration (Cochrane Review Groups (CRGs) 2000. 2006. Issue 4. Retrieved from on 2 May 2006.
Jumadilova 2005
    1. Jumadilova Z, Zyczynski T, Paul B, Narayanan M. Urinary incontinence in nursing home: resident characteristics and prevalence of treatment. American Journal of Managed Care. 2005;11:S112–S120.
    1. Kmet LM, Lee RC, Cook LS. Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields. Edmonton, AB: The Alberta Heritage Foundation for Medical Research; 2004. HTA Initiative #13. Retrieved from on 11 October 2010.
    1. McGrother CM, Donaldson M, Wagg M, Matharu G, Willliams KS, Watson JM. Healthcare Needs Assessment: The Epidemiologically Based Needs Assessment Reviews. Abingdon: Radcliffe Medical Press Ltd; 2003.
    1. Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PloS Medicine. 2009;6(7) Retrieved from on 24 September 2009.
    1. NICE. Urinary Incontinence: The Management of Urinary Incontinence in Women. NICE Clinical Guideline, 40. London: National Institute for Health and Clinical Excellence; 2006.
    1. NICE. Faecal Incontinence. NICE Guideline CG49. London: National Institute for Health and Clinical Excellence; 2007.
    1. Ostaszkiewicz J, Johnson L, Roe B. Timed Voiding for Urinary Incontinence in Adults. Cochrane Database of Systematic Reviews. Chichester: John Wiley and Sons Ltd; 2004a. Issue 1.
    1. Ostaszkiewicz J, Johnson L, Roe B. Habit Training for Urinary Incontinence in Adults (Cochrane Review) Chichester: John Wiley and Sons Ltd; 2004b. The Cochrane Library, Issue 2. Update Software.
    1. Ostaszkiewicz J, Roe B, Johnson L. Effects of timed voiding for the management of urinary incontinence in adults: systematic review. Journal of Advanced Nursing. 2005;52(4):420–431.
Ouslander 1982
    1. Ouslander JG, Kane RL, Abrass IB. Urinary incontinence in elderly nursing home patients. Journal of the American Medical Association. 1982;248(10):1194–1198.
Ouslander 1984
    1. Ouslander JG, Kane RL. The costs of urinary incontinence in nursing homes. Medical Care. 1984;22(1):69–79.
    1. Ouslander JG, Schnelle JF, Uman G, Fingold S, Nigam J, Tuico E, Bates-Jenson B. Predictors of successful prompted voiding among incontinent nursing home residents. Journal of the American Medical Association. 1995;273(17):366–1370.
Palmer 1991
    1. Palmer MH, German PS, Ouslander JG. Risk factors for urinary incontinence one year after nursing home admission. Research in Nursing & Health. 1991;14(1):405–412.
    1. Paterson BL, Thorne SE, Canam C, Jillings C. Meta-Study of Qualitative Health Research. A Practical Guide to Meta-Analysis and Meta-Synthesis. London: Sage Publications; 2001.
Peet 1996
    1. Peet SM, Castleden CM, McGrother CW, Dufin HM. The management of urinary incontinence in residential and nursing homes for older people. Age and Ageing. 1996;25(2):139–143.
    1. Rawlins MD. On the Evidence for Decisions about the Use of Therapeutic Interventions. The Harevian Oration. London: Royal College of Physicians; 2008. p. 2. pp. 19–20.
    1. Robinson JP. Managing urinary incontinence in the nursing home: residents’ perspectives. Journal of Advanced Nursing. 2000;31(1):68–77.
    1. Roe B, Milne J, Ostaszkiewicz J, Wallace S. Systematic reviews of bladder training and voiding programmes in adults: a synopsis of findings on theory and methods using metastudy techniques. Journal of Advanced Nursing. 2007a;57(1):3–14.
    1. Roe B, Ostaszkiewicz J, Milne J, Wallace S. Systematic reviews of bladder training and voiding programmes in adults: a synopsis of findings from data analysis and outcomes using metastudy techniques. Journal of Advanced Nursing. 2007b;57(1):15–31.
    1. Schnelle JF, Alessi CA, Simmons SF, Al-Samarrai NR, Beck JC, Ouslander JG. Translating clinical research into practice: a randomised controlled trial of exercise and incontinence care with nursing home residents. Journal of the American Geriatrics Society. 2002;50:1476–1483.
    1. Schnelle JF, Traughber B, Sowell VA, Newman DR, Petrilli CO, Ory M. Prompted voiding treatment of urinary incontinence in nursing home patients: a behavior management approach for nursing home staff. Journal of the American Geriatrics Society. 1989;37(11):1051–1057.
Schnelle 1988
    1. Schnelle JF, Sowell VA, Traughber B, Hu TW. A behavioural analysis of the labour cost of managing continence and incontinence in nursing home patients. Journal of Organisational Behaviour Management. 1988;9(2):137–153.
Sgadari 1997
    1. Sgadari A, Topinkova E, Bjornson J, Bernabei R. Urinary incontinence in nursing home residents: a cross national comparison. Age and Ageing. 1997;26(Suppl. 2):49–54.
    1. Shaw C, McNamara R, Abrams K, Cannings-John R, Hood K, Longo M, Myles S, O'Mahony S, Roe B, Williams K. Systematic review of respite care in the frail elderly. Health Technology Assessment. 2009;13:20. Retrieved from on 11 October 2010.
Wagg 2005
    1. Wagg A, Mian S, Lowe D, Potter J, Pearson M. National audit of continence care for older people: results of a pilot study. Journal of Evaluation in Clinical Practice. 2005;11(6):525–532.
    1. Wagg A, Potter J, Peel P, Irwin P, Lowe D, Pearson M. National audit of continence care for older people: management of urinary incontinence. Age and Ageing. 2007;37:39–44.
    1. Potter J, Peel P, Mian S, Lowe D, Irwin P, Pearson M, Wagg A. National audit of continence care for older people: management of faecal incontinence. Age and Ageing. 2007;36:268–273.
    1. Wallace SA, Roe B, Williams K, Palmer M. Bladder training for urinary incontinence in adults. Cochrane Database of Systematic Reviews. 2004;(1) DOI: .
Watson 2003
    1. Watson NM, Brink CA, Zimmer JG, Mayer RT. Use of the agency for health care policy and research urinary incontinence guideline in nursing homes. Journal of the American Geriatrics Society. 2003;51:1779–1786.

Source: PubMed

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