| Abstract | Uvod: Međunarodno društvo za kontinenciju (eng. International Continence Society - ICS), definira inkontinenciju urina (IU) kao nehotično istjecanje urina kroz mokraćnu cijev. I kod muškaraca i kod žena, dob je dosljedan čimbenik rizika za razvoj IU-a, međutim, to se ne smatra normalnom posljedicom starenja. Sveukupno, IU se razvija u do 30% starijih osoba koje žive u zajednici i više od 50% štićenika domova za starije i nemoćne osobe. Oko 2-3 puta je češći u žena nego u muškaraca do 80. godine života, nakon čega su stope IU-a slične.Iako su predložene brojne definicije i teorije QoL-a, nedostaje sustavan pregled mišljenja samih starijih osoba. Neophodno je znati što starije osobe smatraju važnim u životu kako bi se ciljevi usluga skrbi uskladili s njihovim očekivanjima.
Cilj: Cilj istraživanja je istražiti vrste inkontinencije kod štićenika domova za starije i nemoćne te povezanost inkontinencije s kvalitetom njihovog života.
Hipoteze: Više od 50% ispitanika domova za starije i nemoćne ima urinarnu inkontinenciju. Kod žena u uzorku je češća stresna inkontinencija, a urgentna je podjednako zastupljena kod oba spola.Kod štićenika domova za starije i nemoćne, kod kojih je prisutna inkontinencija urina, kvaliteta života je lošija u usporedbi sa štićenicima koji nemaju inkontinenciju.
Ispitanici i metode: Istraživanje je provedeno u ustanovama za starije i nemoćne Obiteljski dom „Pongračić“ i Dom za starije inemoćne osobe „Ivana“ u vremenskom razdoblju od 01. lipnja do 01. srpnja 2022. godine pomoću Upitnika pod nazivom „Upitnik o simptomima donjeg urinarnog trakta međunarodnog konzorcija o inkontinenciji – modul kvalitete života (eng. ICIQ-LUT Sqol)“ koji se temelji na upitniku King's Health Questionnaire grupe autora King's College Hospital London.
Rezultati: Postotak žena s inkontinencijom varira od 35% (urgentna) do 52% (stresna inkontinencija). Većina ispitanika pati od miješanog tipa inkontinencije. Urgencija se može prepoznati 35% žena i 50% muškaraca, stresna inkontinencija kod 52% žena i 7% muškaraca, preljevna inkontinencija kod 4% žena i 36% muškaraca i refleksna inkontinencija kod 9% žena i 7% muškaraca. Kod žena je najzastupljenija stresna, a kod muškaraca urgentna inkontinencija. Najčešći komorbiditeti korisnika s inkontinencijom uruna su šećerna bolest (32%) i hipertenzija (35%). Indeks smanjenja kvalitete života za ukupnu populaciju se kretao od 0 do 10 (4,8±3,4) s medijan vrijednosti 5. Smetnje su nešto izraženije kod žena (5,1±4,2) u
odnosu na muškarce (4,2±3,2), ali ta razlika nije bila i statistički značajna. Za dvije najmlađe skupine indeks je jednak nuli, a najviši je za dobnu skupinu od 51 do 60 godina (5,4±3,3) i medijan vrijednost 7. Ta razlika između dobnih skupina pokazala se i statistički značajnom (p=0,0401). Indeks smanjenja kvalitete života zbog problema s mokrenjem statistički značajno (p=0,0000) je niži u osoba s nekim tipom inkontinencije (3.9±3.2) u odnosu na one bez inkontinencije (6.6±2.9).
Zaključak: Hipoteza 1 se ne prihvaća jer je učestalost iste 31,9%. Hipoteza 2 se djelomično prihvaća jer je u žena zaista najčešća stresna inkontinencija (52%), dok je urgentna inkontinencija zastupljena u nešto malo više od trećine žena (35%) i čak polovice muškaraca (50%). Potvrđena je dobra, statistički značajna povezanost prediktorskih varijabli i indeksa smanjenja kvalitete života zbog problema s mokrenjem, a od četiri prediktorske varijable jedino životna dob i pridružene bolesti imaju statistički značajan doprinos ukupnoj korelaciji, čime se potvrđuje treća hipoteza prema kojoj štićenici s inkontinencijom urina imaju lošiju kvalitetu života u odnosu na one koji nemaju. |
| Abstract (english) | Background: The International Continence Society (ICS) defines urinary incontinence (IU) as the involuntary leakage of urine through the urethra. In both men and women, age is a consistent risk factor for developing IU, however, it is not considered a normal consequence of aging. Overall, IU develops in up to 30% of community-dwelling seniors and more than 50% of nursing home residents. It is about 2-3 times more common in women than in men until the age of 80, after which the rates of IU are similar. Although numerous definitions and theories of QoL have been proposed, a systematic review of the opinions of the elderly themselves is lacking. It is necessary to know what the elderly consider important in life in order to align the goals of care services with their expectations.
Aim: The aim of the research is to investigate the types of incontinence in residents of homes for the elderly and infirm and the connection between incontinence and their quality of life.
Hypotheses: More than 50% of respondents of homes for the elderly and infirm have urinary incontinence. In women in the sample, stress incontinence is more common, and urgent incontinence is equally represented in both sexes. In residents of homes for the elderly and infirm, in whom urinary incontinence is present, the quality of life is worse compared to residents who do not have incontinence.
Methods: The research was conducted in the institutions for the elderly and infirm Family Home "Pongračić" and the Home for the Elderly Infirm "Ivana" in the time period from June 1 to July 1, 2022 using the Questionnaire entitled "Questionnaire on symptoms of the lower urinary tract of the international consortium on incontinence - quality of life module (ICIQ-LUT Sqol)" which is based on the King's Health Questionnaire group of authors King's College Hospital London.
Results: The percentage of women with incontinence varies from 35% (urgent) to 52% (stress incontinence). Most of the respondents suffer from a mixed type of incontinence. Urgency can be recognized in 35% of women and 50% of men, stress incontinence in 52% of women and 7% of men, overflow incontinence in 4% of women and 36% of men, and reflex incontinence in 9% of women and 7% of men. Stress incontinence is the most common in women, and urge incontinence in men. The most common comorbidities of users with urinary incontinence are diabetes (32%) and hypertension (35%). The quality of life reduction index for the total
population ranged from 0 to 10 (4.8±3.4) with a median value of 5. Disturbances are slightly more pronounced in women (5.1±4.2) than in men (4.2 ±3.2), but this difference was not statistically significant. For the two youngest groups, the index is equal to zero, and the highest is for the age group from 51 to 60 years old (5.4±3.3) and the median value is 7. This difference between the age groups proved to be statistically significant (p=0.0401 ). The index of reduction in quality of life due to problems with urination is statistically significantly (p=0.0000) lower in people with some type of incontinence (3.9±3.2) compared to those without incontinence (6.6±2.9).
Conclusion: Hypothesis 1 is not accepted because its frequency is 31.9%. Hypothesis 2 is partially accepted because stress incontinence is indeed the most common in women (52%), while urgent incontinence is represented in slightly more than a third of women (35%) and even half of men (50%). A good, statistically significant correlation between the predictor variables and the index of reduction in quality of life due to problems with urination was confirmed, and of the four predictor variables, only age and associated diseases have a statistically significant contribution to the overall correlation, thus confirming the third hypothesis that residents with urinary incontinence have worse quality of life compared to those who do not. |
