title: Exploring faecal incontinence in nursing home patients: a cross-sectional study of prevalence and associations derived from the Residents Assessment Instrument for Long-Term Care Facilities.
abstract: OBJECTIVE
  To explore prevalence and associations of faecal incontinence among nursing home patients, to examine the effect of clustering of observations and to study the variation in faecal incontinence rates on both the level of nursing home units and individual patients.
  
  
  BACKGROUND
  Faecal incontinence affects 40-55% of the patients in nursing homes and is associated with increased risk of morbidity and reduced quality of life. There is a lack of studies investigating faecal incontinence with validated instruments. More studies need to include models of analyses that allow for clustering of observations.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Data on 261 patients from 20 nursing home units were collected during September-October 2014. The Norwegian version of the Resident Assessment Instrument for Long-Term Care Facilities was used. Mixed effect models were conducted.
  
  
  RESULTS
  Prevalence of faecal incontinence was 42·1% or 54% depending on the frequency labelling chosen. The effect of clustering by nursing home unit was not statistically significant. Most of the variation in faecal incontinence rates was explained by differences in patient characteristics, the most important being deficiencies in activities of daily living, cognitive impairment, diarrhoea and not participating in activities.
  
  
  CONCLUSIONS
  Nursing home patients should be offered individualized assessment and continence care matching their patient characteristics. The Resident Assessment Instrument for Long-Term Care Facilities is a useful instrument because of its' combination of a comprehensive range of individual items and scales allowing for comparison of immediate or long-term change in patients status. Studies evaluating interventions targeting faecal incontinence are warranted.
authors.affiliation: Faculty of Health and Social Science, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Lene Elisabeth
authors.initials: LE
authors.lastname: Blekken
authors.affiliation: Faculty of Health and Social Science, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Anne Guttormsen
authors.initials: AG
authors.lastname: Vinsnes
authors.affiliation: St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.|Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Kari Hanne
authors.initials: KH
authors.lastname: Gjeilo
authors.affiliation: Faculty of Nursing and Midwifery, King's College London, UK.
authors.forename: Christine
authors.initials: C
authors.lastname: Norton
authors.affiliation: St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.|Medical Faculty, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Siv
authors.initials: S
authors.lastname: Mørkved
authors.affiliation: Medical Faculty, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Øyvind
authors.initials: Ø
authors.lastname: Salvesen
authors.affiliation: Faculty of Health and Social Science, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Sigrid
authors.initials: S
authors.lastname: Nakrem
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005242:Fecal Incontinence / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D009664:Norway; D009735:Nursing Homes; D015995:Prevalence; D011788:Quality of Life
keywords: associations; cross-sectional; faecal incontinence; interRAI LTCF; mixed effects models; nursing; nursing home; prevalence; protective factors; risk factors