Characterizing symptom clusters for older adults with urinary incontinence in home healthcare.
Danielle Scharp, Jiyoun Song, Zidu Xu and 3 others
PMID 40972057WHAT IT FOUND
Most home healthcare episodes for older adults with urinary incontinence had no tracked symptoms documented.
When symptoms appeared, anxiety, dizziness, constipation, and a complex all-symptom cluster emerged; dizziness-anxiety was tied to a history of two or more falls.
Key findings
01Most home healthcare episodes had no tracked symptoms documented (71.5%).
02The largest symptom cluster was anxiety alone (13.8%), and another cluster contained all tracked symptoms (5.8%).
03The dizziness-anxiety cluster had more episodes for patients with a history of two or more falls than the no-symptoms cluster (33% versus 25%).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Symptoms came from clinical notes, so absence may mean underreporting or under-documenting rather than no symptom. Symptoms were only present or absent, not how often or how severe. Only urinary incontinence present at admission was included; patients who developed it during an episode were not captured. The extraction software was checked on 1,000 notes, but it may still miss symptoms not written in the notes. Findings are from one home healthcare agency in New York and data from 2015 to 2017, so they may not apply to other settings, places, or current documentation practices. Race and ethnicity were combined into White and Other because some groups were small, so differences by specific groups are unclear. The analysis did not show that these clusters predict hospitalization, quality of life, or other outcomes.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that these clusters prove urinary incontinence causes the symptoms or that treating them will reduce hospitalization. The study was observational, did not test treatment or outcomes, and the no-symptom group may reflect missing documentation.