The objectives of this paper were to assess the quality of life of community-living women with urinary incontinence according to age, symptom group, amount of leakage, and duration, by use of the Sickness Impact Profile (SIP). Thirty-six women aged between 40 and 60 years and 40 women aged 70 years or more were randomly selected from the clients attending an incontinence clinic and interviewed using the SIP questionnaire. Urge and stress incontinence subgroups were defined by means of a symptom questionnaire. Total, psychosocial, and physical dysfunctions were moderate (8%, 7%, and 8% respectively) in general, but major differences were found when age and symptom groups were analysed. Urge symptoms were associated with more impairment than symptoms of stress incontinence. The elderly women with symptoms of stress incontinence were relatively little affected, while their younger counterparts were severely affected, especially in the categories of emotional behavior and recreation and pastimes. We conclude that urinary incontinence in women adversely affects quality of life to a significant degree; the extent depends on the nature of incontinence and the age of the person.

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Ambiguities concerning the nursing home as a home and place to live, a social environment in which the residents experience most of their social life and the institution where professional health service is provided were uncovered. High-quality care was when ambiguities were managed well and a home could be created within the institution. Implication for practice. Achieving quality care in nursing homes requires reconciling the ambiguities of the nursing home as a home. This implies helping residents to create a private home distinct from the professional home, allowing residents' personal habits to guide institutional routines and supporting meaningful activities. Using these resident developed quality indicators is an important step in improving nursing home services.

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BackgroundResidents in nursing homes (NHs) are often frail older persons who have impaired physical activity. Urinary incontinence (UI) is a common complaint for residents in NHs. Reduced functional ability and residence in NHs are documented to be risk factors for UI.ObjectiveTo investigate if an individualized training program designed to improve activity of daily living (ADL) and physical capacity among residents in nursing homes has any impact on UI.Materials and methodsThis randomized controlled trial was a substudy of a Nordic multicenter study. Participants had to be >65 years, have stayed in the NH for more than 3 months and in need of assistance in at least one ADL. A total of 98 residents were randomly allocated to either a training group (n = 48) or a control group (n = 50) after baseline registrations. The training program lasted for 3 months and included accommodated physical activity and ADL training. Personal treatment goals were elicited for each subject. The control group received their usual care. The main outcome measure was UI as measured by a 24-hour pad-weighing test. There was no statistically significant difference between the groups on this measure at baseline (P = 0.15). Changes were calculated from baseline to 3 months after the end of the intervention.ResultsAltogether, 68 participants were included in the analysis, 35 in the intervention group and 33 in the control group. The average age was 84.3 years. The 3 months’ postintervention adjusted mean difference between groups according to amount of leakage was 191 g (P = 0.03). This result was statistically significant after adjusting for baseline level, age, sex, and functional status. The leakage increased in residents not receiving the experimental intervention, while UI in the training group showed improvement.ConclusionThe intervention group had significant better results compared with the control group after an individualized training program designed to improve ADL and physical capacity. Further studies are needed to evaluate the effect of a goal-oriented physical training program toward NH residents UI complaints.

Pelvic floor muscle exercise showed some effect on quality of life and sex-life variables.

BackgroundFecal incontinence is highly prevalent among nursing home residents. Previous nursing home studies have identified co-morbidity associated with fecal incontinence, but as this population is increasingly old and frail, we wanted to see if the rate of fecal incontinence had increased and to investigate correlates of fecal incontinence further.MethodsCross-sectional study of the entire nursing home population in one Norwegian municipality. Registered nurses filled in a questionnaire for all residents in the municipality (980 residents aged ≥65). Statistical methods used are descriptive statistics, binary logistic regression and multivariable logistic regression.ResultsThe response rate of the study was 90.3%. The prevalence of fecal incontinence was 42.3%. In multivariable analysis of FI, residents with diarrhea (OR 7.33, CI 4.39-12.24), urinary incontinence (OR 2.77, CI 1.73-4.42) and dementia (OR 2.17, CI 1.28-3.68) had higher odds of having fecal incontinence compared to those without the condition. Residents residing in a nursing home between 4–5 years had higher odds of having fecal incontinence compared to residents who had stayed under a year (OR 2.65, CI 1.20-5.85). Residents with deficiency in feeding (2.17, CI 1.26-3.71), dressing (OR 4.03, CI 1.39-11.65), toilet use (OR 7.37, CI 2.65-20.44) and mobility (OR 2.54, CI 1.07-6.00) had higher odds of having fecal incontinence compared to residents without deficiencies in activities of daily living (ADL). Needing help for transfer between bed and chair was a protective factor for fecal incontinence compared to residents who transferred independently (OR 0.49, CI 0.26-0.91).ConclusionsFecal incontinence is a prevalent condition in the nursing home population and is associated with ADL decline, frailty, diarrhea and quality of care. This knowledge is important for staff in nursing home in order to provide the best treatment and care for residents with fecal incontinence.

The aim of this study was to develop and evaluate the effects of a multidisciplinary pain management programme on coping, health-related quality of life and pain intensity. Seventy-six outpatients suffering from chronic pain completed this eight-week programme with the primary aims to increase coping, as measured by the Ways of Coping Checklist, and health-related quality of life, as measured by the Short Form-36 Health Survey. Therapeutic dialogues and education, combined with physical activity, were given in order to increase understanding of and attention to non-medical factors that might affect pain perception. The programme was active, time-limited and structured on the basis of multidisciplinary pain management programmes based on a cognitive-behavioural approach. The findings suggest that this programme has the potential to improve coping skills and health-related quality of life. Additionally, pain intensity, as measured by the Visual Analogue Scale, was reduced. Age and disability were revealed as the prominent predictors of change after treatment. The differences in this sample indicated that the drop-outs tended to be older and reported more health problems, although these findings were non-significant. Clinical and research implications are discussed.