title: EFFECTIVENESS OF DIAPERS AMONG PEOPLE WITH CHRONIC INCONTINENCE IN THAILAND.
abstract: OBJECTIVE
  The aim of this study was to assess effect of adult diapers on health-related quality of life (HRQOL) and the independent level of performing activities of daily living (ADLs) in people with urinary or fecal incontinence. Psychological consequences of patients' caregivers were also measured.
  
  
  METHODS
  This quasi-experimental study was conducted at two rehabilitation centers in Thailand. People aged 15 years or greater with chronic urinary or fecal incontinence were eligible. Study participants received adult diapers for 10 weeks after recruitment. Thai EuroQol Five Dimensions (EQ-5D) and the Barthel Index were measured at baseline and weeks 2, 6, and 10 to evaluate HRQOL and the independent level of performing ADLs, respectively. The Braden Scale was used to assess the risk of having pressure ulcers. Mean differences in the Thai EQ-5D, the Barthel Index, and the Braden Scale, before and after receiving adult diapers, were estimated using a multilevel linear regression model.
  
  
  RESULTS
  There were ninety patients and forty-eight caregivers who took part in this study. HRQOL and independent level of performing ADLs had improved significantly by week 10 after receiving adult diapers with mean differences of 0.102 (95% confidence interval [CI], 0.046-0.158) and 4.40 (95% CI, 1.74-7.07), respectively. The risk of having pressure ulcers had significantly decreased by 67 percent (95% CI, 16 percent-78 percent) by week 10 after receiving adult diapers.
  
  
  CONCLUSIONS
  The results indicate a significant improvement of HRQOL and the independent level of performing ADLs among incontinent patients after receiving adult diapers. These results were used to inform the development of the health benefits package under the Universal Health Coverage Scheme in Thailand.
authors.affiliation: Health Intervention and Technology Assessment Program,Ministry of Public Health.
authors.forename: Yot
authors.initials: Y
authors.lastname: Teerawattananon
authors.affiliation: Department of Family Medicine,Faculty of Medicine,Ramathibodi Hospital,Mahidol Universitythunyarat.ano@mahidol.ac.th.
authors.forename: Thunyarat
authors.initials: T
authors.lastname: Anothaisintawee
authors.affiliation: Health Intervention and Technology Assessment Program,Ministry of Public Health.
authors.forename: Sripen
authors.initials: S
authors.lastname: Tantivess
authors.affiliation: Sirindhorn National Medical Rehabilitation Center,Department of medical Services,Ministry of Public Health.
authors.forename: Ubonwan
authors.initials: U
authors.lastname: Wattanadilokkul
authors.affiliation: Sirindhorn National Medical Rehabilitation Center,Department of medical Services,Ministry of Public Health.
authors.forename: Pranorn
authors.initials: P
authors.lastname: Krajaisri
authors.affiliation: Sirindhorn National Medical Rehabilitation Center,Department of medical Services,Ministry of Public Health.
authors.forename: Sudarat
authors.initials: S
authors.lastname: Yotphumee
authors.affiliation: Department of Physical Medicine and Rehabilitation,Phramongkutklao College of Medicine.
authors.forename: Jaraspas
authors.initials: J
authors.lastname: Wongviseskarn
authors.affiliation: Health Intervention and Technology Assessment Program,Ministry of Public Health.
authors.forename: Utsana
authors.initials: U
authors.lastname: Tonmukayakul
authors.affiliation: Health Intervention and Technology Assessment Program,Ministry of Public Health.
authors.forename: Roongnapa
authors.initials: R
authors.lastname: Khampang
mesh_terms: D000328:Adult; D000368:Aged; D017028:Caregivers; D002908:Chronic Disease; D041382:Diapers, Adult / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013785:Thailand; D014549:Urinary Incontinence
keywords: Diaper; Fecal incontinence; Quality of life; Urinary incontinence