Management of night-time urinary incontinence in residential settings for older people: an investigation into the effects of different pad changing regimes on skin health
Management of night-time urinary incontinence in residential settings for older people: an investigation into the effects of different pad changing regimes on skin health
Summary
Absorbent pads are the main method of managing urinary incontinence in residential settings for older people.
Improvements in technology have resulted in highly absorbent products which may be worn all night, but the effects of prolonged pad wearing on aged skin are unknown.
The aim of this study was to examine the effects of two different pad changing regimes on skin health.
A cross-over design was used.
Subjects from residential settings were randomly allocated to one of two pad changing regimes: a frequent pad changing regime or a less frequent pad changing regime. Each regime lasted 4 weeks and was followed by the alternative regime.
Skin measurements were taken twice during each regime using (i) the Diastron Erythema meter, (ii) a visual grading scale, (iii) the Servomed evaporimeter, and (iv) a pH meter. The primary outcome variable was the Diastron Erythema meter index.
Eighty-one subjects completed the study.
No significant differences were found in the severity of erythema, or skin pH, between regimes. Measurements of trans-epidermal water loss were significantly higher in the less frequent pad changing regime indicating that skin was ‘wetter’ (P = 0.01; 95% CI: 2.89–21.39).
Five subjects developed grade 2 pressure ulcers (abrasions) during the less frequent pad changing regime, but none in the frequent pad changing regime; this result was not significant (P = 0.1; 95% CI: 0–1.09).
No evidence was found that a less frequent pad changing regime has an effect on skin erythema or pH.
• There is evidence that skin is wetter which may make it more vulnerable to friction and abrasion.
• The statistically non-significant finding of greater incidence of grade 2 pressure ulcers is a cause for concern and merits further investigation because of the clinical significance of loss of skin integrity.
cross-over study, incontinence pads, older people, skin health, urinary incontinence
374-386
Fader, M.
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Clarke-O'Neill, S.
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Cook, D.
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Dean, G.
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Brooks, R.
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Cottenden, A.
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Malone-Lee, J.
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2003
Fader, M.
c318f942-2ddb-462a-9183-8b678faf7277
Clarke-O'Neill, S.
c6d9634e-1535-47a2-aeba-5e8a7a32b548
Cook, D.
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Dean, G.
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Brooks, R.
c147b4e8-cc8c-484b-a444-67c3bb418488
Cottenden, A.
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Malone-Lee, J.
999c7f30-45af-4078-8e5e-5f003b4c31fc
Fader, M., Clarke-O'Neill, S., Cook, D., Dean, G., Brooks, R., Cottenden, A. and Malone-Lee, J.
(2003)
Management of night-time urinary incontinence in residential settings for older people: an investigation into the effects of different pad changing regimes on skin health.
Journal of Clinical Nursing, 12 (3), .
Abstract
Summary
Absorbent pads are the main method of managing urinary incontinence in residential settings for older people.
Improvements in technology have resulted in highly absorbent products which may be worn all night, but the effects of prolonged pad wearing on aged skin are unknown.
The aim of this study was to examine the effects of two different pad changing regimes on skin health.
A cross-over design was used.
Subjects from residential settings were randomly allocated to one of two pad changing regimes: a frequent pad changing regime or a less frequent pad changing regime. Each regime lasted 4 weeks and was followed by the alternative regime.
Skin measurements were taken twice during each regime using (i) the Diastron Erythema meter, (ii) a visual grading scale, (iii) the Servomed evaporimeter, and (iv) a pH meter. The primary outcome variable was the Diastron Erythema meter index.
Eighty-one subjects completed the study.
No significant differences were found in the severity of erythema, or skin pH, between regimes. Measurements of trans-epidermal water loss were significantly higher in the less frequent pad changing regime indicating that skin was ‘wetter’ (P = 0.01; 95% CI: 2.89–21.39).
Five subjects developed grade 2 pressure ulcers (abrasions) during the less frequent pad changing regime, but none in the frequent pad changing regime; this result was not significant (P = 0.1; 95% CI: 0–1.09).
No evidence was found that a less frequent pad changing regime has an effect on skin erythema or pH.
• There is evidence that skin is wetter which may make it more vulnerable to friction and abrasion.
• The statistically non-significant finding of greater incidence of grade 2 pressure ulcers is a cause for concern and merits further investigation because of the clinical significance of loss of skin integrity.
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Published date: 2003
Keywords:
cross-over study, incontinence pads, older people, skin health, urinary incontinence
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Local EPrints ID: 17361
URI: http://eprints.soton.ac.uk/id/eprint/17361
ISSN: 0962-1067
PURE UUID: dce1f2c1-cd14-425c-a02d-b87ca7b387d4
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Date deposited: 25 Aug 2005
Last modified: 15 Mar 2024 05:58
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Contributors
Author:
S. Clarke-O'Neill
Author:
D. Cook
Author:
G. Dean
Author:
R. Brooks
Author:
A. Cottenden
Author:
J. Malone-Lee
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