Individual and Institutional Factors Associated With Urinary Incontinence Among Nursing Home Residents: A Multilevel Analysis.

AIMS: (1) To analyse individual and institutional-level factors associated with urinary incontinence in older adults living in nursing homes; (2) to estimate the prevalence of urinary, faecal and double incontinence in nursing home residents.

DESIGN

Cross-sectional study.

METHODS

Residents aged 65+ living in 22 nursing homes in Catalonia (Spain) were included. Descriptive, bivariate, and multilevel analyses were performed.

RESULTS

The final sample comprised 452 residents (75.9% female, mean age of 87.0 years). The prevalence of urinary, faecal and double incontinence was 77.5%, 46.1% and 45.7%, respectively. Urinary incontinence was statistically significantly associated with neurological conditions, moderate cognitive impairment, moderate dementia, severe cognitive impairment, very severe cognitive impairment and age.

CONCLUSION

Approximately three out of four nursing home residents suffered from urinary incontinence and almost half of the sample from faecal or double incontinence. Individual-level factors (cognition, neurological conditions and age) played a more important role than institutional-level factors for urinary incontinence.

IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: The findings of this study highlight the importance of individual-level interventions to prevent and manage urinary incontinence in nursing homes.

IMPACT: In Catalonian nursing homes, individual factors such as cognitive impairment and neurological conditions were more strongly associated with urinary incontinence than institutional factors. This has implications for improving care provided to older adults, particularly those with dementia and neurological conditions.

REPORTING METHOD: STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines.

PATIENT OR PUBLIC CONTRIBUTION: Nursing home residents were not involved in this study.