Our expectations (hypotheses) are: Primary outcome 1. Regular bidet use will improve quality of life around elimination in adults with impaired functional status. Functional status will be measured by activities of daily living (ADL). 2. Regular bidet use by adults with impaired functional status will improve the quality of life around toileting for their caregivers. Secondary 3. Regular bidet use will reduce the incidence, frequency and severity of constipation (as measured by self-report) in adults with impaired functional status. 4. Regular bidet use will reduce the incidence of urinary tract infection (UTI) in adult women with impaired functional status.
The study will assess the use of a bidet (a device that is attached to the toilet which allows a person to wash their genitalia after elimination) in improving toilet related quality of life for functionally impaired individuals as measured by ADLs and caregivers of functionally impaired adults. We also want to see if bidet use is effective in lowering the incidence of urinary tract infections in this high risk population. Functional impairment around toileting has been shown to negatively impact quality of life (QOL) for both patients and their caregivers. We hope to learn if the use of bidet will improve QOL in this population. Urinary tract infections increase the risk of morbidity and mortality in women with impaired functional status. Specifically the risk of hospitalization, sepsis, kidney failure and other complications. There are not currently effective forms of non-pharmaceutical prevention. Bidets are safe, inexpensive and hygienic. Individuals with functional impairment often have difficulty maintaining their hygiene due to frailty and functional limitations. It is our hope that addressing these issues will lead to a reduced incidence of UTI. Constipation is a common problem in elderly adults and in adults with impaired functional status. It is our hope that the bidet will reduce the frequency and severity of constipation (as measured by self report).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
28
Participants used a bidet, a device installed on the toilet that provides fresh water to help clean the bottom and genitalia after having a bowel movement or urinating.
Patients in the control arm will toilet as usual.
Stanford University School of Medicine
Stanford, California, United States
Improved quality of life as measured QoL questionnaire
We are measuring the quality of life using a validated QoL questionnaire which has been slightly modified to include questions around toileting.
Time frame: 24 months
Caregiver burden for caregivers of adults with functional limitations as measured by a validated caregiver burden questionnaire.
We will measure caregiver burden using a validated instrument.
Time frame: 24 months
Incidence of UTI as measured by enquiry and chart review (female patients only).
Every month we will screen female patients in both arms of the study to ask them if they have had any symptoms of UTI or sought medical attention for UTI. We will also review their chart for diagnosis of UTI or prescription of a medication for UTI. Either self-report of a diagnosis or prescription for a medication of a UTI or a report of UTI in the chart will be considered an incidence of UTI.
Time frame: 24 months
Incidence of constipation as measured by self report
We will ask patients on a monthly basis if they have had constipation.
Time frame: 24 months
Severity (measured by self report) of constipation
For those patients who report having had constipation, will ask them to rate the severity of their constipation on a monthly basis.
Time frame: 24 months
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