A high percentage of Urinary incontinence(UI) is found among old people with dementia living in institutions. People with UI suffer from increasing financial cost, social isolation, and having reduced quality of life. The aim of this study was to explore the relationship among the influencing factors of UI, including agitated behaviors, depression, cognitive function and activities of daily living (ADL), and construct a structural equation model.
Methods: In total, 226 participants were recruited, through convenience sampling at 15 long-term care facilities in southern Taiwan. UI frequency, agitated behaviors, depression symptoms, cognitive function, and ADL were evaluated using urinary records, the Cohen-Mansfield Agitation Inventory, Cornell Scale for Depression, Mini-Mental State Exam (MMSE), and Barthel Index, respectively. The collected data were analyzed through structural equation modeling.
Results:
ADL were directly related to UI (β = -.54, p < .001), whereas age, cognitive function, depression, and agitated behaviors were not significantly related to UI. Age did not directly affect any variables in this model, whereas ADL directly and significantly affected cognitive function(β = .42, p < .001), and depression. (β = -.21, p =.001) Paths from ADL to cognitive function and from depression to agitated behaviors were created in this model. Cognitive function and depression were mediator between ADL and agitated behaviors( β = -.17, BC 95% CIs [-0.104,-0.050], p = .001).
Conclusion: The findings extend those of previous studies on how the causative factors influence UI. The results suggest that ADL influence not only UI but also other factors, thereby providing care advice for nursing home residents caring for patients with dementia. Further studies could explore the causative model of UI in different levels of cognitive function.Results could be serve as a valuable model for nursing homes in providing effective care to patients with dementia. Suggesting improving ADL function can decreasing UI and directly improve cognitive function, depression, and indirectly decreasing agitated behaviors.