Miss Bronte Jordan1, Ms Wendy Bower1,2
1Royal Melbourne Hospital, Parkville, Australia, 2The University of Melbourne, Melbourne, Australia
Biography:
Bronte is a Grade 2 Occupational Therapist at the Royal Melbourne Hospital who has been working in a hybrid research role for 18 months. Bronte is passionate about ensuring clinicians are working to the maximum capacity of their scope and therefore works to bridge gaps in our knowledge, including incontinence management for OTs.
Abstract:
Background:
Urinary incontinence (UI) is common in older patients and often delays discharge and contributes to increased dependence. Evidence suggests a multimodal approach to treating incontinence including pharmacological and non-pharmacological treatments. Occupational Therapy (OT) aims to optimise independence in personal care tasks like toileting. To date, there are limited OT-specific approaches to addressing UI.
Aim:
This study aimed to identify OT-specific interventions for managing UI for inpatients older than 65.
Method:
A systematic review was conducted following PRISMA guidelines, with searches of three electronic databases and a manual reference list search. Studies published after 1999, excluding systematic reviews and literature reviews, were considered. Outcomes of interest included incontinence frequency, patient-reported outcomes, and incontinence-specific interventions. Data from seven studies (five randomized controlled trials and two cohort studies) involving 635 participants from 99 nursing homes were analysed descriptively.
Results:
Of the 7 studies included, 2 described interventions delivered directly by OT, whereas the remaining interventions were delivered by nursing home staff. The mean age of participants ranged from 75 to 88. Four studies showed a reduction in overall UI, and two found decreased urine loss. One study found no difference in daytime frequency or nocturia, while another decreased leakage three months post-intervention.
Discussion/Conclusion:
There is limited evidence of OT-specific interventions for people experiencing UI. However, the features of reported interventions align with OT practice scope and show promising patient outcomes. This review will inform future research required to develop intervention models that can be delivered by OT and translate into clinical practice.