Lebensqualität älterer Patienten mit Harninkontinenz in der Hausarztpraxis
In the winter of 2001/2002 within the scope of this dissertation 126 urinary incontinent patients were questioned with the help of the SF-12 questionnaire.A few questions mainly in the field of urinary incontinence (UI) were added. The participants were in 96% women, in 6% men, who were at that time between 60 and 96 years old (on average 75 years). A differentiated presentation of the UI was made as well as an examination of it’s effect on the physical, mental and social wellbeing of the patients and the relationship between General Practitioner and patient. The issue of UI has been exsisting in nearly have of the cases for more than 7 years. It became transparent that UI was limitating the patients not only at a high age but already when they were still very activ, physically and socially. Nearly 75% of the patients endured unwanted loss of urin more than 3 times a day. In all of the age groups there is a majority of urge-incontinence (63-86%) in comparison to other forms of incontinence. Apart from UI the patients often suffered from other acute or chronic illnesses like hypertension, cardial insufficiency, arrhythmias, diabetes or pain. Their medical treatment had a potential worsening effect on the UI. The mainly used means of aid were pads which were often paid by the patients themselves out of lack of information. Therapeutically training of the pelvic diaphrame were performed by 33% of the examined patients, mainly the younger ones, with a good subjective effect. A drug therapy was used by 41% of the patients with mainly subjective success. All in all it was shown that the available therapies, like in comparable studies, led to a subjective amelioration of the UI-problem and the quality of life. A considerable lack of information and knowledge about UI and it’s treatment-options has to be stated for many of the older patients.This study confirmes that the qualitiy of life is reduced by UI in all age groups. Foremost this is the case in mental and social aspects as for example in patnerships. Is was shown that the issue of UI is still a taboo in society and rarely discussed with a doctor. Only 43% of the questionned patients dicussed this topic with there friends or accquaintances. With mounting age this readyness is further reduced. The impression that UI is a normal manifestation of old age is vastly distributed and reflects the need for more information in this field.The results of this study and comparable literature reflects that General Practitioners (GP) too rarely address the problem of UI. Therfore UI is under-diagnosed and patients receive too little information and treatment alike. The older the patient the lower is the bilateral mentioning of the problem. This is caused mainly by concentration on more important aspects of therapie by the GP and on the patient’s side it is mostly caused by the impression of normality of the problem as well as embarassment and ignorance. Apart from the fact that most of the questioned patients are very content with their GP concerning the problem of UI, many of them have a negative feeling about the future regarding UI. This signifies the tendentious hopelessness of the patients.It can be stated that the quality of the relationship between the GP and the patient has a major effect on the quality of life of patients with UI.A trustful and open relationship with individual information, advice and therapy enhances the quality of life of elderly urinary incontinent patients. The appropriate means in this field don’t seem too be fully explored yet.
info:eu-repo/classification/ddc/610, Medizin, Lebensqualität, SEL, Alter, Harninkontinenz, Hausarzt, quality of life, elderly, urinary incontinence
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