住院病患大便失禁之研究

The Study of Fecal Incontinence in Hospitalized Patients

10.6320/FJM.2002.6(2).03

于博芮(Po-Jui Yu)；戴玉慈(Yu-Tzu Dai)

大便失禁 ； 盛行率 ； 危險因子 ； 住院病人 ； fecal incontinence ； prevalence ； risk factors ； inpatient

台灣醫學

6卷2期（2002 / 03 / 01）

150 - 156

繁體中文

排便是一個非常個人及隱私的行為。大便失禁是指一個人無法控制排便，時常不自主排出氣體、糞液及糞塊，弄髒內褲。護理人員在醫院照顧病人常處於第一線，可藉由護理評估、發現問題及提供適切的護理措施。本研究的目的乃了解住院病患發生大便失禁的盛行率及其相關影響因子。本研究採前瞻性、相關性研究設計,共收集1226位一般內外科住院病患，評估項目包括年齡、性別、意識狀況、自覺健康狀況，身體活動度、大便性質及大便失禁情形。結果呈現住院病患大便失禁的盛行率為20.7%，大便失禁患者中55.5%為男性，64.2%為年齡≧65歲者，相對危險因子包括年齡、自覺健康狀況、體位移動能力、住院日數、大便軟硬度及腹瀉。由研究結果之初步分析可進一步提供臨床處理此類病患之初步建議，進而奠定日後研究的根基。

Fecal incontinence is defined as the involuntary loss of stool at any time of life after toilet training. Acute care nurses are in a good position to identify patients with rectal control problems, inform physicians, provide initial interventions, and make appropriate referrals. The purposes of this study are to explore the prevalence rate of fecal incontinence and to detect risk factors for fecal incontinence. A questionnaire was developed for this study. It had two parts, one included questions related to age, sex, and education. The second part of the questionnaire was a fecal incontinence assessment sheet. A total of 1226 subjects(632 men and 594 women) with mean age and standard deviation of 56.53±17.76 years were interviewed on the day of their admission to the ward. In this study, 20.7%(254/1226)of the patients self-reported fecal incontinence. Chi-square analysis revealed a statistically significant difference in age(＜65, ≧65), length of stay(＜8, ≧8), health status, level of consciousness, mobility, body transformation and diarrhea history between those with and without fecal incontinence. Logistic regression risk factors for fecal incontinence were age(OR=1.94, 95% CI=1.25, 3.03), health status (OR=3.12, 95% CI=1.54, 6.35), mobility(OR=2.65, 95% CI=1.70, 4.14) and unformed/loose or liquid consistency(OR=2.89, 95% CI=1.66, 5.02). Based on these findings, nurses are advised to assess inpatients of all ages and develop strategies to decrease fecal incontinence.