Incidence and Characteristics of Incontinence-Associated Dermatitis in Community-Dwelling Persons With Fecal Incontinence.
OBJECTIVE
Little is known about the incidence and characteristics of incontinence-associated dermatitis (IAD) in community-living individuals with fecal incontinence. The primary aim of this study was to describe the incidence and characteristics of self-reported IAD among community-living individuals with fecal incontinence. The study also examined whether IAD was associated with older age, sex, presence of urinary incontinence, or fecal incontinence severity.


METHODS
Secondary data analysis was performed using a prospective cohort design.


METHODS
Data were drawn from community-living adults (n = 98) with fecal incontinence (76% female, 34% aged ≥65 years, 90% white) who participated in a study about dietary fiber supplementation and were free of IAD at the start. Thirty five percent also had urinary incontinence.


METHODS
Subjects assessed their skin for IAD daily for 52 days, reporting types of IAD damage (redness, rash/fungal infection, and skin loss), location of IAD, and symptoms. They reported fecal incontinence on a diary for the first and last 14 study days.


RESULTS
The incidence of IAD was 41% (40 of the 98). The fecal incontinence severity score for subjects developing IAD was 1.2 higher than those who never had IAD (P < .001). There was no significant association of IAD with age, sex, or dual fecal and urinary incontinence. Incontinence-associated dermatitis developed within 2 weeks and healed in approximately 1 week. The most common sign and symptom were redness (60% patients) and soreness (78% patients), respectively. Most subjects (85%) had IAD in one location.


CONCLUSIONS
Assessing for IAD in community-living patients with fecal incontinence is important as IAD is common and causes discomfort. The relatively mild severity of IAD offers WOC nurses the opportunity for improving patient outcomes by preventing and managing this problem.
Donna Zimmaro Bliss, PhD, RN, FAAN, FGSA, University of Minnesota School of Nursing, Minneapolis, Minnesota. Taylor Funk, BSN, RN, University of Minnesota School of Nursing, Minneapolis, Minnesota. Megan Jacobson, BSN, RN, University of Minnesota School of Nursing, Minneapolis, Minnesota. Kay Savik, MS, University of Minnesota School of Nursing, Minneapolis, Minnesota.
Donna Zimmaro
DZ
Bliss
Taylor
T
Funk
Megan
M
Jacobson
Kay
K
Savik
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003872:Dermatitis / Q000209:etiology* / Q000451:nursing; D004043:Dietary Fiber / Q000008:administration & dosage; D005242:Fecal Incontinence / Q000150:complications* / Q000178:diet therapy / Q000451:nursing; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D057566:Self Report; D017592:Skin Care / Q000451:nursing