Incontinence (INC), which includes urinary (UI), faecal (FI) and double incontinence (DI) (1), is common among older persons and can lead to negative consequences such as incontinence-associated dermatitis (2). Moreover, incontinence negatively affects quality of life (3). However, a detailed insight into prevalence and used nursing interventions regarding incontinence in different age group among older adults is still missing. Therefore, the aim of this study was to investigate difference between persons 65-74 years, 75-84 years and 85 years or older by focusing on INC prevalence and nursing interventions focused on urinary incontinence.

This is a secondary data analysis of data collected within the “Nursing Care Quality” measurement in Austria. We used data from the years 2016 up to 2022 from all participating institutions (hospitals, geriatric institutions and nursing homes), except for the year 2020 due to the worldwide pandemic. We included data from adults 65 years or older to assess the prevalence and nursing interventions of urinary incontinence. Based on data available from the national statistical agency the power calculation enabled us to identify an ideal sample size of 385 patients/residents. Descriptive statistics and bivariate analysis were performed to identify differences between the three age groups. The responsible ethical committee approved the study and a written informed consent, was signed either from the patient or the legal representative.

The three age groups differed statistically significant in terms of care dependency or with regard to the items activity and mobility on the Braden scale. Moreover, they differed statistically significant regarding most frequent medical diagnosis and mean number of medical diagnosis as well in the UI/FI/DI prevalence rates in general. When calculation only those persons who are FI but bot DI, no statistical difference was found. The most frequent applied interventions were absorbent products, urinals and toileting aids (76%; 79%; 84%followed by adjustments to the environment or clothing (46%; 51%; 57%), which differed significantly between the age groups. The age groups also differed statistically significant with regard to pelvic floor muscle training (5%; 4%; 1%) and evaluation of the medication (22%; 26%; 27%). The analysis also showed, that the assessment of the type of urinary incontinence was only performed in 25% up to 29% all affected persons independent of the age group.

This analysis showed that the way of calculating prevalence rates influences the results. Therefore, researchers need to consider the clinical relevance, when displaying results with regard to incontinence. With regard to management, most frequent applied interventions were absorbent products, urinals and toileting aids. However, the analysis also showed differences between the age groups, when focusing pelvic floor muscle training, which is often done by physiotherapists. This is interesting, as bladder training, which is mostly trained by nursing staff was more often conducted. Both interventions are based on the physiology regarding incontinence. This can lead to the conclusion, that nursing staff might not be aware of the benefits of PFMT among older adults. Up to 29% of the type of urinary incontinence was assessed. Here there is still space for improvement in nursing practice.

Clinical relevance has to be considered in order to present meaningful incontinence prevalence rates and the knowledge about benefits of pelvic floor muscle training among older adults in nursing staff shall be improved.

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Boronat-Garrido X, Kottner J, Schmitz G, Lahmann N. Incontinence-Associated Dermatitis in Nursing Homes: Prevalence, Severity, and Risk Factors in Residents With Urinary and/or Fecal Incontinence. J Wound Ostomy Continence Nurs. 2016;43(6):630-5.
Göral Türkcü S, Kukulu K. Urinary incontinence and quality of life of women living in nursing homes in the Mediterranean region of Turkey. Psychogeriatrics. 2017;17(6):446-52.