Sinead Clarke-O'Neill

A system for logging incontinence events using a simple disposable sensor.

Abstract Many elderly people entering residential or nursing care are already incontinent to some degree, relying on incontinence pads to deal with the consequences. A proportion of these people have been shown to exhibit a regular pattern in their incontinence, which opens up the possibility of mitigating the problem by instituting an individual toileting regime for the person. This can reduce their reliance on incontinence pads, both improving their quality of life, and reducing the cost of care. This paper covers the development and evaluation of a sensor for detecting incontinence events, suitable for use in this setting, and describes the design of an associated electronic logger. The devices form part of an assessment system intended to identify a pattern in incontinence where it exists, and to help with the design of the toilet regime for an individual. The requirement is that the system must reliably record incontinence events, and present the information describing them in a manner appropriate to the users of the devices, who are likely to be non-technical and non-specialist.

A pilot study to evaluate reusable absorbent body-worn products for adults with moderate/heavy urinary incontinence.

OBJECTIVE The purpose of this pilot study was to evaluate the performance of reusable absorbent body-worn products for adults with moderate/heavy urinary incontinence, compare their performance with a group of equivalent disposable products, and establish the need for a larger statistically robust study. SETTING AND SUBJECTS Ten men and 4 women living in the community were recruited from locations throughout the United Kingdom. METHODS A randomized multiple crossover design was used in which all subjects were given the opportunity to test each product. All the products were available on the UK market in January 2001. The following tools were used in the evaluation: a product performance questionnaire and a pad leakage diary. Overall opinion was used as the primary outcome indicator. RESULTS The reusable Paddy T was the best performing product overall, outperforming the disposable products. For low leakage and good absorbency (the most important product attributes identified by the subjects), the disposable all-in-one product performed best during the day. However, the Paddy T performed best for night use. The remaining reusable products performed poorly overall. CONCLUSIONS Reusable products for moderate/heavy incontinence remain unpopular for use in isolation. Surprisingly, a product manufactured from terry toweling, a traditional material, performed relatively well. Reusables may provide a useful alternative to disposable products in certain circumstances. The results from this study do not support a more comprehensive costly study.

Review of methods used for quantifying excess water in over-hydrated skin using evaporimetry

Background: Advances in diapers and skin barrier products are often aimed at reducing water penetration of the skin to prevent diaper dermatitis and evaporimetry has commonly been measured to quantify excess water in the skin. The aim of this study was to critically review the methods used to measure water vapour flux density (WVFD) using evaporimetry in order to identify a standardised methodology.

A multicenter comparative evaluation: disposable pads for women with light incontinence

OBJECTIVE The purpose of this study was to evaluate the current range of disposable pads for women with light incontinence available in the United Kingdom. SETTING AND SUBJECTS Sixty community-based women aged 50 years or older were recruited to the study from several locations throughout the United Kingdom. METHODS A multiple crossover design was used, which enabled all subjects to test all of the 12 products that were available on the UK market at the time of the evaluation. Two tools were used to evaluate the products: a product performance questionnaire and a pad leakage diary. This incorporated both subjective and objective outcome measures. RESULTS Statistically significant differences were found between the products in 13 of the 17 performance aspects, eg, ability to hold urine without leaking and the fit of the pad. CONCLUSIONS As a group, all of the products tested performed well in terms of their ability to hold urine without leakage. However, two products performed particularly well and scored highly on most aspects of performance and represented successful “all-round” products; these were the Tena Lady Extra and the Prevail Extra Plus.

The further development of the active urine collection device: a novel continence management system.

Abstract Continence difficulties affect the lives of a substantial minority of the population. Women are far more likely than men to be affected by urinary incontinence but the range of management options for them is limited. There has been considerable interest in developing an external urine collection system for women but without success to date. This paper describes the development and preliminary clinical testing of an active urine collection device (AUCD), which could provide a solution for sufferers. The device uses stored vacuum, protected by a high bubble point filter, to remove urine as quickly as it is produced. This allows a small battery-operated pump to provide the required vacuum, enabling the device to be portable. Two different types of non-invasive patient/device interface were developed, and tested by volunteers: urinal and small pad. The slimline urinal was popular with users although liquid noise was a problem. The pad interface was successful on occasions but further work is necessary to produce a reliable pad. This study has successfully demonstrated that a prototype AUCD liquid handling system can remove urine at clinically relevant flowrates. While further development is required, volunteer tests have shown that the AUCD could be a useful advance in continence management.

Individual budgets for people with incontinence: results from a ‘shopping’ experiment within the British National Health Service

Background and context  Most people with urinary incontinence are given limited choice when provided with absorbent products through the British National Health Service (NHS), even though the available range is large.