Investigation And Intervention Of Long-term Catheter Care For Community Elderly

Objective To investigate the general situation of community elderly indwelling catheters and their caregivers, cognition and demand of long-term catheter care, as well as the prevalence of catheter related complications. To analysis risk factors of catheter related complications. To evaluate the effectiveness of the intervention about regulating catheter care behavior of caregivers designed to prevent catheter related complications. To provide the scientific evidences for developing standards of long-term catheter care appropriate for community elderly.Methods 194 community elderly indwelling catheters were included in the Investigation. The situation of catheter care, the prevalence and risk factors of catheter related complications were investigated by a self-report questionnaire.45 community elderly indwelling gastric tube and 35 community elderly indwelling urinary catheter were involved in the intervention program with a random sample. The catheter care behavior of their caregivers was regulated. The prevalence of catheter related complications were made comparison before and after six months intervention.Results All of 194 community elderly indwelling catheters were disabled.51.0% of them were severely disabled. The types of catheter included gastric tube (106 cases), urinary catheter (91 cases) and tracheostomy tube (30 cases). Caregivers mainly were nannies (54.6%), followed by family members (38.1%). Most of caregivers were women (76.8%).91.2% of caregivers didn’t receive education from university.82.5% of caregivers were not trained in catheter care. The rate of cognition of catheter care was low, and the rate of demand was high.76 community elderly had catheter related complications (39.2%). The prevalence of catheter related complications increased with the degree of disability (P< 0.05). The possibility of catheter related complications occurred in female was 2.3 times that of the male (P< 0.05). The possibility of catheter related complications occurred in whose caregivers didn’t have experience of catheter care training was 4.2 times that of elderly whose caregivers had training experience (P< 0.05). The prevalence of gastric tube related complications was 44.3%(47/106), including tube dislodgement, blockage of the tube, cough or aspiration and unplanned extubation. The prevalence of urinary catheter related complications was 49.5%(45/91), including urinary tract infection, urine precipitation, leakage of urine and blockage of the catheter. The prevalence of tracheostomy tube related complications was 13.3% (4/30), including blockage of the tube and tube dislodgement. Non-standard care was the main cause of catheter related complications. By multiple logistic regression analysis, pulling tube and feeding without extraction of gastric fluid were two main factors of gastric tube related complications (P< 0.05). The main factors of urinary catheter related complications included sterilizing urethral orifice not on time, incorrect sterilization and cleaning perineum not every day (P< 0.05). The significant factors affecting tracheostomy tube complications were not analyzed (P> 0.05). During six months after intervention, the prevalence of complication of 45 community elderly indwelling gastric tube was 13.3% compared with 37.8% before (P< 0.05), and the prevalence of complication of 35 community elderly indwelling urinary catheter was 20.0% compared with 54.3% before (P< 0.05). The rate of cognition and the rate of operating correctly catheter care were improved, reaching 90% basically.Conclusions The prevalence of catheter related complications of community elderly was high. The ability of caregivers was low. The rate of cognition of catheter care was low, and the rate of demand was high. Non-standard care was the main cause of catheter related complications. Regulating catheter care behavior of caregivers could prevent catheter related complications from occurring in community elderly.