Læknablaðið : fylgirit - 01.05.2002, Síða 32

ABSTRACTS / 3 3RD SNC & 2ND SCNN
effect of spinal cord injury on a person’s ability to control the
elimination of stool and urine.
Material and method: 117 spinal cord injured individuals were
admitted to Reykjavík Hospital in the years 1973-96. Questionnaire
regarding method, technique, equipment on bowel and bladder
management and satisfaction was mailed to 57 spinal cord injured
individuals who had been injured in the years 1973-96. Multiple-
choice questions were developed by the investigator for data
collection. Included in this study were 44 males and 13 females.
Data was collected in mars- april 1997.
Results: 38 individuals replied, that is 66,7% of them who were
included in the study. 14 could not been reached by telephone and
5 where not willing to participate.
Demographic variable: The individuals were divided by:
A) Gender: Included in the study were 28 males and 10 females.
B) Three age groups. The mean age was 43,6 years, S.D. 13,2 years
and the range was 24-74 years.
C) Three groups a coring to length from the injury: mean 13,4 years,
S.D. 7,2 years and the range were 1-24 years since injury.
D) Three groups according to American Spinal Injury Association
impairment scale. 21 or 55,3% had A injury, 9 or 23,7% had B or
C injury and 8 or 21,1% had D injury.
Satisfaction was measured on scale, 1 = very dissatisfied to 7 = very
satisfied.
Bladder: The method of bladder emptying: Intermittent clean
catheterisation (16), reflex stimulation (12, 3 of them used also
clean intermittent catheterisation), normal micturition (6), in-
dwelling catheters (3), condom catheter (1). Urinary tract infec-
tions that needed medication were reported as less than 4 times last
year by 74,2% and over 5 times last year by 25,8%. Does bladder
management interfere with any of what is listed below? Social life,
school and work were reported by 17, home life by 4, body image by
9, sex life by 7 and 10 reported something else. Regarding choice of
bladder management, hand movement was reported by 12, prob-
lem with transport by 7 and balance by 6.
Bowel: Those who have normal bowel function are eight. They did
not answer any more questions. Method of bowel management was
reported by those who answered all questions as: Manual removal
of faeces (11). Manual stimulation (10). Transanal Irrigation (2).
External massage (16). Valsalva (bearing down)(10). Stoma (1).
Bowel medication (16). None use anal tampons. Only four need
pad/diapers after bowel management. Bowel management fre-
quency is mostly every other or every third day.
Conclusion: The conclusion is that those who use intermittent
catheterisation and those who use reflex stimulation and/or abdo-
minal pressure are satisfied with bladder management. Hand
movement has a big impact on the choice of bladder management.
Findings indicate that having a neurogenic bowel has a big impact
on life for those who have ASIA A and B or C classification, espe-
cially regarding social live, work and school. The fear for unplanned
bowel movements and the amount of time involved in bowel
management has the most significant effect on their lives after
injury. Hand movement has a big impact on the choice of bowel
management. Most individuals, special the younger, are satisfied
with teaching methods and their choice of methods. That indicates
that what we teach them in the rehabilitation unit is relevant to
home environment.
This study corresponds to similar studies, which indicate that
having neuroginic bowel and bladder affects life activities and
lifestyle for spinal cord injured individuals.
A limitation of the study is that the sample is small and the
questionnaire was in writing, a personal interview would probably
have given a better result. However it shows that our patients have
the same problems as others have reported and there is a lack of
problem solving fore the group who has the most problems.
NURSING PLATFORM SESSION I
44 - The Role of the Nurse Specialist in a Memory Clinic:
Outreach home visits to referred patients
Jakobsen O, Hasselbalcj S, Hejl AM, Waldemar G
Rigshospitalet, Memory Disorders Research, Copenhagen, Denmark
The literature demonstrates that nurse-specialists with advanced
knowledge and skills in dementia care can provide a higher quality
of care and quality of life for the patient and the caregivers.
Objective: The aim of the study was to demonstrate the value of
early contact between the nurse specialist and new referred patients
in a memory clinic.
Methods: All patients, above 60 years, referred to the clinic were
offered a home-visit prior to their first visit in the clinic. The home-
visit included an interview about their expectations and attitude
towards diagnostic evaluation, and towards the assistance of the
nurse. The patients were evaluated by use of MMSE, GDS and DAD.
Results: 157 patients were included. 70% had a visit and were
subsequently evaluated in the clinic (49 men and 61 female, mean
age was 75.6 years. Mean MMSE 23.7. Mean GDS 5.5. Mean DAD
38.0.30% declined to have a visit. Only 28% had already contact to
the community care service and 12% had no help and were only
able to manage themselves by help from a caregiver. 55% needed
more help and support in their own home.
Conclusion: The home visit played an important role in the further
evaluation program. The home-visit nurse report was very useful in
relation to the clinic program and early contact. The patient and
caregivers had increased confidence to the staff at the first visit. In
many patients suggestions from the nurse report concerning the
need for additional social measures were established and imple-
mented by the first visit in the clinic.
45 - Voice therapy for patients with Parkinson's disease
Arnardóttir E
Speech-Language Pathologist, Reykjalundur Rehabilitation Center, Mosfellsbær,
Iceland
Objective: One of the most common speech problems in Parkin-
son's disease (PD) is low volume. A group of patients with PD
received voice therapy as a part of a group rehabilitation program.
The objective of this study was to determine if this form of speech
therapy was effective in increasing volume.
Material and nicthods: Thirty-four individuals with PD, mean age
65 years (49-84) received speech therapy as a part of a five-week
multidisciplinary group therapy program, in November 1999 -
September 2001. Therapy focused on intensive voice training. Vocal
32 Læknablaðið/Fylgirit 43 2002/88