The European Journal of Public Health Advance Access originally published online on September 1, 2007
The European Journal of Public Health 2008 18(3):323-328; doi:10.1093/eurpub/ckm085
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Miscellaneous |
Increased work-load associated with faecal incontinence among home care patients in 11 European countries
H. Finne-Soveri1,2, L. W. Sørbye3, P. V. Jonsson4, G. I. Carpenter5 and R. Bernabei6
1 National Research and Development Centre (STAKES).
2 Social Department of the City of Helsinki, Finland.
3 Diakonhjemmet University College, Oslo, Norway.
4 University of Iceland, Landspitali-University Hospital, Reykjavik, Iceland.
5 The University of Kent, Canterbury, Kent, UK.
6 Facoltà di Medicina, Università Cattolica del Sacro Cuore, Rome, Italy.
Correspondence: Harriet Finne-Soveri MD, PhD, Senior Researcher and Senior Medical Officer, STAKES, P.O.BOX 220, Helsinki 00531, tel: +358 50 3809885, fax: +358 9 39672485, -mail: harriet.finne-soveri{at}stakes.fi; harriet.finne{at}pp.inet.fi
Received February 4, 2007 , accepted July 5, 2007
The plurality of definition of faecal incontinence (FI) complicates the cross-national comparisons between studies conducted in the area. The aim of the study was to investigate work-load and subjective care-giver burden associated with FI, among home-care patients, in Europe. Design and methods: In this cross-sectional retrospective study, a random sample of 4010 RAI-HC assessments were collected during 2001–02 from home care patients aged 65 years and over (74% females; age 82.8 ± 7.2 years) in Czech Republic, Denmark, Finland, France, Germany, Iceland, Italy, The Netherlands, Norway, Sweden and United Kingdom. Results: Of the 4010 individuals, 411 (10.3%) suffered from FI (range 1.1–30.8% from site to site). The factors significantly associated with faecal incontinence were diarrhoea [odds ratio (OR) 10.3, 95% confidence interval (CI) 6.590–15.96], urinary incontinence (OR 3.99, 95% CI 2.991–5.309) and pressure ulcers (OR 3.15, 95% CI 2.196–4.512) together with severe impairments in physical (OR 4.25, 95% CI 2.872–6.295) and cognitive (OR 3.76, 95% CI 2.663–5.304) functions. High use of working hours of the visiting nurses (OR 2.04, 95% CI 1.221–3.414) and home health carers (OR 2.40, 95% CI 1.289–4.470) were additionally associated with faecal incontinence. Use of five or more medications was an inversely associated with FI (OR 0.62, 95% CI 0.473–0.820). Conclusions: The additional work load associated with faecal incontinence comprises considerable numbers of formal health care hours and should be taken into account when planning home health services for the older in home care patients.
Keywords: Europe, faecal incontinence, formal and informal care, home care, health politics