Abstract
Introducción
La incontinencia urinaria (IU) es un problema de salud con una elevada prevalencia, por lo que es imposible limitar su diagnóstico y tratamiento al nivel especializado.
Objetivo
Analizar los resultados tras un año de implantación de un programa en IU en el Centro de Salud (CS) de Cabra. Programa. Atención primaria realiza la detección de casos, la valoración básica y el tratamiento, así como el seguimiento en los casos no complicados; los complicados son remitidos al especialista, que completa su estudio y decide su indicación quirúrgica. Tras el alta, el seguimiento se lleva a cabo en atención primaria.
Resultados
La cobertura del programa fue del 4% (41 personas) de los incontinentes. El tiempo medio de evolución hasta la consulta fue de 7,4 años. La IU mixta constituyó el diagnóstico más frecuente (51%). En 39 casos, la severidad fue moderada/importante. A 10 sujetos la IU les impedía realizar actividades físicas, en 11 casos afectaba a sus relaciones de pareja, 25 sujetos manifestaron sentimientos negativos y 24 deseaban operarse. En 12 sujetos se eliminaron los escapes de orina al final de la rehabilitación y en siete tras un seguimiento más prolongado; en el resto se produjeron cambios positivos en la severidad, el estado afectivo, uso de elementos de protección y el deseo de someterse a cirugía. Para los sujetos tratados el resultado fue aceptable o exitoso. El programa consumió 1 h semanal del médico y 3 h de la enfermera. Conclusiones. El programa descrito es ágil, sencillo y eficiente para abordar la IU y garantizar su continuidad asistencial.
Palabras clave: Incontinencia urinariaPrograma de salud, Atención primaria
Abstract
Introduction
Urinary incontinence (UI) is an extremely widespread health problem, which makes it impossible to restrict its diagnosis and treatment to specialist clinics.
Objective
To analyse the results of a year´s UI programme at Cabra Health Centre. Programme. In straightforward cases, detection, basic assessment and treatment, and follow-up take place in primary care (PC). Complex cases are referred to specialists, who complete the examination and decide on a surgical indication. On discharge they are monitored in PC.
Results
The programme covered 4% (41 people) of incontinent patients. Mean time of evolution till consultation was 7.4 years. Mixed UI was the most common diagnosis (51%). Severity was moderate/severe in 39 cases. UI prevented 10 people from undertaking physical activities and affected 11 people´s relationships with their partner. 25 people showed negative feelings, and 24 wanted an operation. Twelve people had no involuntary passage of urine at the end of rehabilitation; and 7 had none after longer follow-up. The rest had positive changes in severity, their state of mind, use of protective items and wish for an operation. The results were acceptable or successful for the people treated. The programme took up an hour a week of doctor´s time, and three hours of nursing time.
Conclusions
The programme described is an agile, simple and efficient way of tackling UI and securing ongoing attendance.
Key words: Urinary incontinence, Health programme, Primary care
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