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PubMedDate not supplied

A warning detector for urinary incontinence for home health care.

A telemetry system for monitoring urinary incontinence has been developed using two principles, temperature and impedance changes of a diaper. The system is composed of a pair of sensors, a transmitter, and a receiver. Temperature changes are monitored using thermistors, one in the center of the diaper and the other attached to the abdomen, and the temperature differences between them after urinary incontinence is detected. For the impedance method, two electroconductive cloths as electrodes placed in the diaper are used as sensors. Urine acts as a conductor to produce a current between the sensors. Clinical evaluation showed that both methods operate well; 13 of 17 incontinence episodes were detected using the temperature method and 32 of 35 with the impedance method. The misdetections were caused by faulty sensor arrangement for temperature measurement and by detection of exudates by the conductive sensors. These monitors may be used for the care of elderly people who use diapers for home health care, to save care time and help maintain hygiene.

Aged↗
PubMed1994

[Management of voiding dysfunction in elderly patients: effectiveness of rehabilitation and familial care].

We examined whether the improvement of impaired mobility correlates with the success rate in achievement of catheter-free or diaper-free status of 260 hospitalized elderly patients whose activities in daily life (ADL) were impaired and urinary tract dysfunctions including urinary incontinence were managed by indwelling catheters or diapers. The contribution of physical rehabilitation and/or care given by family to the improvement of impaired mobility was also investigated. All 154 patients whose ADL improved during the course of the treatment acquired the catheter-free or diaper-free status. Of 106 patients whose ADL did not improve, 85 patients became free of catheters or diapers. All of the remaining 19 patients who continued to be dependent upon catheter or diapers had been bed-ridden during the course of the treatment. Among 201 patients who were bed-ridden before the treatment, the success rate in the improvement of impaired ADL in 84 patients who underwent physical rehabilitation and received care given by family, was 83%. The ADL improved in 71% of the 70 who received rehabilitation and 53% of 17 bed-ridden patients who received familial care. By contrast, only 2 out of 30 patients who received neither of them were free from the bed-ridden condition. The remaining 28 patients continued to be bed-ridden, and the 19 cases who were not free of indwelling catheters or diapers were a part of this population of patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗
PubMed1993

Incontinence and the older woman.

A vital message to convey to health care providers and to women who struggle with urinary incontinence is that female urinary problems may be significantly improved, reversed, or prevented by judicious application of current technologies. Control of female incontinence is particularly important in light of the aging trend and the need to prevent excess disability; therefore, any way in which women can be assisted in maintaining physical functioning, including voluntary control of urination, is important to avoid the dire physical and psychosocial consequences that accompany incontinence.

Adrenergic alpha-Agonists↗
PubMed1993

[Clinical study of the timed voiding schedule for urinary incontinence in demented elders].

Fourty-one demented elderly patients who had been diapered because of urinary incontinence in Hanwa-Senboku Hospital were treated with the one-week timed voiding schedule. Finally 14 patients (34%) became dry, and free from diapers for more than 1 week after the treatment. With regard to their cystometrogram findings, 10 (67%) of 15 patients having normoactive detrusor function, 3 (14%) of 21 patients having overactive detrusor function and 1 (20%) of 5 patients having underactive detrusor function became free from diapers after the treatment. Therefore a patient with normoactive detrusor function is thought to be a good candidate for the timed voiding schedule. Regardless of their detrusor function, those who showed good responsiveness to the treatment had better activities in daily life (better than D in the Katz index) and small amount of residual urine (less than 80 ml), indicating that not only the detrusor function but also both activities in daily life and the amount of residual urine are the important factors to reestablish voiding behavior in demented elderly patients. The timed voiding schedule is thought to be a useful method to treat incontinence in demented elderly patients, and should be tried first of all, although intermittent catheterization and/or other alternatives would be necessary for those with a large amount of residual urine with poor activities in daily life.

Activities of Daily Living↗
PubMed1998

[Urinary incontinence in the elderly, 2: Therapy--from toilet and pelvic floor training to drug therapy and incontinence aids].

The therapeutic strategy rests on a simple basic diagnostic investigation. As a rule, the greatest importance attaches to toilet training and individual counseling. In this context, the work of a specialist nurse capable of providing both the patient and his/her relatives with competent instruction is of considerable importance. A greater diagnostic effort is needed only for selected prior to the initiation of therapy. Even in the elderly patient urinary incontinence is curable or can at least be improved; it is not an inevitability of old age.

Aged↗
PubMed1989

Norfenefrine in the treatment of female urinary stress incontinence assessed by one-hour pad weighing test.

Thirty-three women with urinary stress incontinence were treated with the alpha-adrenoceptor-stimulating agent, norfenefrine (Nevadral Retard). Treatment was administered during 3-24 weeks at a daily dosage of 90 mg. Judged by a 1-hour pad weighing test, a significant effect could be demonstrated. With the exception of 1 case of allergic reaction and 1 case of recurrent vomiting, a simultaneously performed tolerability test revealed only minor side effects.

2-Hydroxyphenethylamine↗
PubMed2006

Comparison of 20-minute pad test versus 1-hour pad test in women with stress urinary incontinence.

OBJECTIVES: To compare the sensitivity of the 20-minute pad test with that of the 1-hour pad test in women with stress urinary incontinence. METHODS: From January to March 2005, 100 women with stress urinary incontinence who underwent a urodynamic study were enrolled. Each patient underwent a 1-hour pad test before the urodynamic study. The infusion of 250 mL water into the bladder in the 20-minute pad test was performed after the urodynamic study. The results of the two tests in each patient were analyzed and compared using Pearson's chi-square or the Wilcoxon signed-rank test. RESULTS: The mean age of the 100 women was 53.3 +/- 12.1 years, with a mean parity of 2.9 +/- 1.5. In the 100 patients, the 20-minute pad test had better sensitivity than the 1-hour pad test (46% versus 34%, P <0.001). In the quantitative study, the two pad tests had fair agreement, and the pad weight results for the 1-hour pad test had significantly larger amounts than those for the 20-minute pad test (P = 0.002). CONCLUSIONS: The 20-minute pad test had better sensitivity than the 1-hour pad test in women with stress urinary incontinence.

Adult↗
PubMed1994

How to choose: nurses' judgements of the effectiveness of a range of currently marketed continence aids.

Continence is a costly health problem, both in terms of financial burden in continence aids, but also in terms of quality-of-life issues for the person who has continence problems. Manufacturers are often perturbed as to why products specially designed to help continence problems are not popular, or do not appear to be applied as intended. This paper reports on a study involving a quantitative evaluation of a range of continence aids presently being marketed, as applied in a large elderly care centre. The evaluation used nursing judgements on a series of comfort and effectiveness criteria: amount of leakage around the pad, comfort to the client when the pad was either wet or dry, skin integrity and snugness of fit, as well as whether the pad concealed well beneath clothing. Five body pads were evaluated--two disposable and three washable--and three bed under-sheets. Effectiveness of pads was found to vary substantially according to sex of client and voiding type, that is whether the client had heavy or moderate incontinent episodes.

Aged↗
PubMed1996

Evaluation of the home pad test in the investigation of female urinary incontinence.

OBJECTIVE: To evaluate the use of the home pad test in the management of patients with urinary dysfunction with reference to feasibility, normal data, reproducibility, compliance and accuracy when compared to video urodynamics. DESIGN: A prospective study to determine 1. the accuracy of weighing pads by healthcare workers compared to weighing by patients with a spring balance; 2. the effects of evaporation; 3. the pad weight increase in continent women; 4. the compliance over 194 tests in terms of acceptability and feasibility; 5. the reproducibility in 112 women for the 24 h and 48 h tests, 6. the comparison with video urodynamic studies in 149 patients. SETTING: A London teaching hospital. MAIN OUTCOME MEASURES: Coefficient of variation and mean deviation analysis were employed to determine the accuracy of measurement. Percentage changes in standardised wet pad weights over a period of 8 weeks were used to determine the rate of weight loss due to evaporation. The percentage of patients completing the test satisfactorily was documented. The increase in the weights of all pads worn during the test period was measured in continent volunteers and incontinent patients. Video urodynamic diagnoses were used as the Gold Standard for comparison. RESULTS: Twelve perineal pads were weighed by 15 healthcare workers with a resulting coefficient of variation equal to 1.55% (standard error = 0.09%). The mean deviation between patient-measured pad weights and staff-measured weights was 49% (SD = 132%). Pads wetted with saline showed no difference in weight after 1 week and less than 5% change in weight after 8 weeks, with the upper 95% confidence limit of less than 10% loss. The mean pad weight increase over 48 h in continent women was 7.13 g (SD = 4.32 g) giving a 95% upper confidence level of less than 15 g. Compliance was reasonably high with 161 (83%) carrying out the test perfectly. Test-retest analysis of the 24 h and 48 h tests showed a strong relationship with correlation coefficients of 0.90 and 0.94 respectively. The reproducibility was also good, with differences as a percentage of the mean between the first and second test being 6.9% and 1.6% for the 24 h and 48 h tests respectively. There was good concordance when the urodynamic study data was compared with pad weight data in terms of incontinence compared with no incontinence (kappa = 0.65), but a high false positive rate was detected for the pads. When eight of these patients with a false positive pad test had repeat video urodynamic studies, six were found to have detrusor instability on the second study. CONCLUSIONS: The home pad test combined with frequency volume chart documentation is an easy test to perform. It is quite robust and reasonably reproducible. This test should be added to complement the routine urodynamic tests and may have a role in detecting occult detrusor instability.

Female↗
PubMed1996

[Use of a micturition-monitoring device in elderly inpatients].

More than 100,000 people suffer from functional urinary incontinence in Japan. To improve the quality of life of these people, we tested a device for monitoring micturition by means of a thin-layer membrane sensor in a diaper. The device was tested in elderly inpatients, and associated changes in the wordload of the nursing staff were also recorded. The device was beneficial because the precise micturition time was easily obtained and thus the daily pattern of micturition became obvious. With the use of this device, the time during which the patients wore wet diapers was shorter than with the conventional system of scheduled changes. However, the increase in the frequency of diaper changed doubled the workload of the nursing staff. In conclusion, improving the quality of life with regard to urinary incontinence entails an increase in the workload of the nursing staff; efficient distribution of that work may require some staff members to devote all their time to changing diapers.

Aged↗