title: Increased work-load associated with faecal incontinence among home care patients in 11 European countries.
abstract: 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.
  
  
  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.
authors.affiliation: National Research and Development Centre (STAKES), Helsinki, Finland. harriet.finne-soveri@stakes.fi
authors.forename: H
authors.initials: H
authors.lastname: Finne-Soveri
authors.forename: L W
authors.initials: LW
authors.lastname: Sørbye
authors.forename: P V
authors.initials: PV
authors.lastname: Jonsson
authors.forename: G I
authors.initials: GI
authors.lastname: Carpenter
authors.forename: R
authors.initials: R
authors.lastname: Bernabei
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D015897:Comorbidity; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005062:European Union; D005242:Fecal Incontinence / Q000453:epidemiology*; D005260:Female; D006299:Health Services for the Aged; D006699:Home Care Services; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000453:epidemiology* / Q000523:psychology; D012044:Regression Analysis; D012189:Retrospective Studies; D013315:Stress, Psychological / Q000453:epidemiology*; D000078329:Workforce; D016526:Workload