Implementation of a Multidisciplinary Non-Pharmacological Program to Improve Urinary Incontinence in an Intermediate Care Hospital.

چکیده اصلی

INTRODUCTION: Urinary incontinence (UI) is a prevalent geriatric syndrome that significantly affects the physical, psychological, and social well-being of older adults. Non-pharmacological interventions are recommended as the first-line approach, especially in frail older adults. DESIGN: This was a prospective pre-post observational study. METHODS: The study included sixty-one patients with rehabilitable UI who were admitted to an intermediate care hospital. The nurse-led multidisciplinary program integrated education, hygiene-dietary measures, pelvic floor physiotherapy, behavioral strategies, and transcutaneous electrical nerve stimulation (TENS). The primary outcomes were UI severity (International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF)), voiding awareness, diurnal and nocturnal voids, disposable absorbent product use, functional status (Barthel Index), cognitive status (Pfeiffer test), and quality of life (EQ-5D). Data were collected at baseline and discharge. RESULTS: Data from 61 participants were analyzed. Significant improvements were observed in the ICIQ-SF scores (16.72 ± 3.39 vs. 9.10 ± 5.86; p < 0.001), daytime voiding awareness (83.6% vs. 100%; p = 0.002), nocturnal voiding awareness (66.7% vs. 88.5%; p = 0.002), nocturnal voids (3.46 ± 2.22 vs. 2.35 ± 1.68; p < 0.001), Barthel Index (49.83 ± 23.84 vs. 70.33 ± 19.59; p < 0.001), and EQ-5D scores (0.39 ± 0.28 vs. 0.56 ± 0.26; p < 0.001). The use of disposable absorbent products decreased from 98.36% to 62.30% (p = 0.065). The patient's cognitive status remained stable. The mean satisfaction with the program was 8.53/10. CONCLUSIONS: A nurse-led, multidisciplinary, non-pharmacological intervention effectively reduced UI severity, increased voiding awareness, enhanced functional autonomy, and improved the quality of life in older adults. These findings support the implementation of individualized, evidence-based programs in intermediate care settings. CLINICAL RELEVANCE: Non-pharmacological interventions led by advanced practice nurses provide effective, patient-centered management of urinary incontinence, improving autonomy and quality of life while potentially reducing healthcare costs.

ترجمه فارسی چکیده

بی‌اختیاری ادرار (UI) یک سندرم پیری شایع است که بر سلامت جسمانی، روانی و اجتماعی سالمندان تأثیر می‌گذارد. در این مطالعه مشاهده‌ای پیش‌رو، ۶۱ بیمار دارای UI قابل بازتوانی در بیمارستان مراقبت‌های متوسط مورد بررسی قرار گرفتند. برنامه چندرشته‌ای رهبری شده توسط پرستار شامل آموزش، اقدامات بهداشتی-غذایی، فیزیوتراپی کف لگن، استراتژی‌های رفتاری و تحریک عصبی الکتریکی پوستی (TENS) بود. نتایج نشان داد که نمرات ICIQ-SF، آگاهی به ادرار، تعداد دفعات ادرار، شاخص بارثل و کیفیت زندگی به طور معنی‌داری بهبود یافتند. استفاده از کالاهای جذب‌کننده نیز کاهش یافت.

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