[ES-1-4] Predictive factors associated with continued disposable diaper use in hospitalized elderly patients
Introduction Disposable diapers are often used for elderly patients in hospital settings. Although many patients could remove disposable diapers early in their hospitalization, some patients continue using disposable diapers throughout their hospitalization. However, there is little information about the factors affecting continued disposable diaper use. In this study, we investigated predicting factors for continued disposable diaper use in a general hospital.
Methods This study design was a retrospective case-control study. Eligible patients who were 75 years or older and used disposable diapers at admission were enrolled. We excluded the patients who had disabilities or lived in a care home before admission. Patients’ data were collected at the two points. Upon admission, we gathered information on age, sex, diagnosis, the use of physical restraint, and the admission Functional Independence Measure (FIM). Upon discharge, information on discharge FIM, length of stay, and the destination were collected. We divided patients into two groups; the continued group (continued the use of disposable diapers until discharge) and the non-continued group (stop the use during hospitalization). The differences between groups were investigated using the Mann-Whitney U test for continuous data and the chi-square test for nominal data. Logistic regression analysis (stepwise method) was used to determine factors affecting continued disposable diaper use. Then, the cutoff value for predicting continued disposable diaper use was estimated. The study was approved by the ethics committee of the hospital. Results Of 101patients, 48 patients were included in the continued group (47.5%, median age of 85.5 years, 26 males and 22 females, 26 disuse syndrome, 9 musculoskeletal disease, 7 stroke, 2 respiratory disease,4 others), and 53 patients in the non-continued group (52.5%, median age of 84.0 years, 27 males and 26 females, 28 disuse syndrome, 11 musculoskeletal disease, 8 cardiovascular disease, 5 stroke, 1 other). Intergroup comparisons showed that the continued group was lower the FIM total, motor and cognitive scores, and had a high rate of physical restraint use than those of the non-continued group. The admission FIM cognitive was the only factor associated with continued disposable diaper use (Odds ratio = 0.877, p = 0.001). The cut off values was 23.5/35 point for predicting continued disposable diaper use (sensitivity 75.5%, specificity 75.0%, AUC = 0.789, p < 0.001). In terms of discharge outcome, the continued group had lower discharge FIM total, motor and cognitive scores and a low rate of home discharge
Discussion The admission FIM cognitive was the only factor for predicting continued portable diaper use, suggesting that interpersonal and problem-solving skills are deeply related to discontinuing using disposable diapers. This finding can provide to improve hospital care for elderly patients.
Methods This study design was a retrospective case-control study. Eligible patients who were 75 years or older and used disposable diapers at admission were enrolled. We excluded the patients who had disabilities or lived in a care home before admission. Patients’ data were collected at the two points. Upon admission, we gathered information on age, sex, diagnosis, the use of physical restraint, and the admission Functional Independence Measure (FIM). Upon discharge, information on discharge FIM, length of stay, and the destination were collected. We divided patients into two groups; the continued group (continued the use of disposable diapers until discharge) and the non-continued group (stop the use during hospitalization). The differences between groups were investigated using the Mann-Whitney U test for continuous data and the chi-square test for nominal data. Logistic regression analysis (stepwise method) was used to determine factors affecting continued disposable diaper use. Then, the cutoff value for predicting continued disposable diaper use was estimated. The study was approved by the ethics committee of the hospital. Results Of 101patients, 48 patients were included in the continued group (47.5%, median age of 85.5 years, 26 males and 22 females, 26 disuse syndrome, 9 musculoskeletal disease, 7 stroke, 2 respiratory disease,4 others), and 53 patients in the non-continued group (52.5%, median age of 84.0 years, 27 males and 26 females, 28 disuse syndrome, 11 musculoskeletal disease, 8 cardiovascular disease, 5 stroke, 1 other). Intergroup comparisons showed that the continued group was lower the FIM total, motor and cognitive scores, and had a high rate of physical restraint use than those of the non-continued group. The admission FIM cognitive was the only factor associated with continued disposable diaper use (Odds ratio = 0.877, p = 0.001). The cut off values was 23.5/35 point for predicting continued disposable diaper use (sensitivity 75.5%, specificity 75.0%, AUC = 0.789, p < 0.001). In terms of discharge outcome, the continued group had lower discharge FIM total, motor and cognitive scores and a low rate of home discharge
Discussion The admission FIM cognitive was the only factor for predicting continued portable diaper use, suggesting that interpersonal and problem-solving skills are deeply related to discontinuing using disposable diapers. This finding can provide to improve hospital care for elderly patients.