RESNA 27th International Annual Confence

Technology & Disability: Research, Design, Practice & Policy

June 18 to June 22, 2004
Orlando, Florida


Use and Satisfaction with Urinary Incontinence Pads by Home-Based Elderly

William C. Mann, Bhagwant S. Sindhu
and Michael D. Justiss
Rehabilitation Engineering Research Center on Aging
University of Florida, Gainesville, FL

 

ABSTRACT

Urinary incontinence frequently impacts home-based elderly. As a result, the U.S. government spends millions of dollars for its management. Absorbent pads are one of the most common assistive devices for managing urinary incontinence. This paper provides descriptive information on elders who use absorbent pads, and identifies reasons for dissatisfaction with their use.

KEYWORDS

Urinary incontinence, assistive devices, absorbent pads, and home-based elderly

BACKGROUND

Urinary incontinence impacts from 8 to 30% of home-based elderly [1] . The U.S. government spends millions of dollars every year on the management of urinary incontinence largely on absorbent pads [2] . Despite the high prevalence of incontinence and high cost of providing absorbent pads, no prior study identified factors associated with absorbent pad use and satisfaction by home-based elderly.

RESEARCH QUESTION

In this study, we described the health and functional status elderly who used absorbent. We also identified the most common reasons of non-use and dissatisfaction from using absorbent pads.

METHODOLOGY

This paper is based on the Rehabilitation Engineering Research Center Consumer Assessments Study (CAS), a ten-year (1991-2001) longitudinal study of the coping strategies of elders with disabilities. For the present report, we selected from the 1102 CAS participants those who indicated they used absorbent pads, and scored < 6 on the FIM question on sphincter control (n= 114; 10.3% of the CAS sample). The CAS collects information on demographics, health status, functional status, psychosocial and mental status, and the use and satisfaction with assistive devices, including incontinency products. We used descriptive statistics to report results.

RESULTS

The absorbent pad users ranged in age from 60 to 101 years, with a mean of 76.7 years. Eighty five percent of the sample was female, and 86% was white. Thirty nine percent of the absorbent pad users completed high school. Twenty-eight percent of the subjects were married, just over forty seven percent lived alone, and forty six percent owned their own home. Fifty-six percent of the absorbent pad users had incomes under $10,000 per year.

Participants averaged approximately 5 physician visits in a month. They also spent an average of 1 day in the hospital in the last six months. Further, they had a mean of 7 chronic diseases or conditions. Seventeen percent reported impaired vision. Participants scored a mean of 7 out of 14 for IADLS, and 4 out of 7 on FIM sphincter control. Participants had a mean MMSE score of 23; 24 is typically the cutoff point for separating samples into cognitively / non-cognitively impaired (Table 1). Eighteen percent of the users were dissatisfied with their pads. The 2 most common reasons for dissatisfaction with pads were: non-functional design and cost of absorbent pads (Table 2).

Table 1: Health, Functional, and Psychosocial Status of the Incontinence Pad Users (n = 114)

 

Mean (Standard Deviation) or Number (%)

I. HEALTH

1) Number of Physician Visits in Past 6 months

4.69 (05.34)

2) Number of Sick Days in Hospital in Past 6 months

2a) None

54 (47.40%)

2b) Less than a week

17 (14.90%)

2c) 1 week 1 month

20 (17.50%)

2d) 1 month 3 months

10 (08.80%)

2e) 4months 6 months

11 (09.60%)

2f) Not Answered/Missing

2 (01.80%)

3) Number of Days in a Hospital

1 (05.02)

4) Number of Medications

5.06 (3.16)

5) Number of Chronic Illnesses

6.83 (2.91)

6) Eyesight

 

6a) Excellent

9 (07.90%)

6b) Good

52 (45.60%)

6c) Fair

32 (28.10%)

6d) Poor

18 (15.80%)

6e) Blind

2 (01.80%)

6f) Missing

1 (00.90%)

II. FUNCTIONAL STATUS

1) IADL-OARS (0-14)

6.80 (04.35)

2) Sickness Impact Profile (0-100)

41.22 (14.52)

3) FIM Sphincter Control (1-7)

4.05 (02.13)

4) FIM Toileting (1-7)

4.97 (02.38)

5) FIM Cognitive (5-35)

27.51 (10.71)

6) FIM Motor (13-91)

59.83 (23.98)

7) FIM Total (18-126)

87.34 (32.56)

III. PSYCHOSOCIAL AND MENTAL STATUS

1) Mental Status-MMSE (0-30)

22.97 (09.49)

2) Self Esteem-Rosenberg (10-40)

31.08 (05.26)

3) Depression-CESD (0-60)

15.17 (10.80)

Table 2: Reasons for non-use or dissatisfaction with Urinary Incontinence Pads

Category

Frequency

1) Not Functional/Design Related Issues

19

1a) Not absorbent enough

8

1b) Inappropriate size

5

1c) Bunches up/Bulky

2

1d) Cannot refasten tape

2

1e) Causes irritation

1

1f) Should have removable liner

1

2) Financial Reasons

10

3) Other Reasons

9

4) Uncomfortable

5

5) Not aesthetically pleasing

3

6) Not needed any longer

3

DISCUSSION

We found that women represented over eighty percent of the absorbent pad users. This coincides with the literature that suggests incontinence impacts elderly women more often than men. Insufficient absorbency, and factors related to comfort and fit ranked high in the list of concerns expressed by the pad users. Manufacturers should consider features such as large ends that are easy to distinguish and manipulate. Also, designs that take into consideration any visual impairment may increase the chances of successful use of absorbent pads for urinary incontinence.

REFERENCES

  1. Borrie, M.J., et al., Interventions led by nurse continence advisers in the management of urinary incontinence: a randomized controlled trial. Canadian Medical Association Journal, 2002. 166 (10): p. 1267-1273.
  2. Resnick, N., Improving Treatment of Urinary Incontinence. Journal of the American Medical Association, 1998. 280 (23): p. 2034-2035.

ACKNOWLEDGEMENTS

This is a publication of the Rehabilitation Engineering Research Center on Aging, which is funded by the National Institute on Disability and Rehabilitation Research of the Department of Education under grant number H133E60006. The opinions contained in this publication are those of the authors and do not necessarily reflect those of the Department of Education.

William Mann, PhD, OTR/L
University of Florida
P.O. Box 100164
Gainesville, Fl 32610
(352) 273-6817;
wmann@hp.ufl.edu

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