Urinary Incontinence
Conditions
Keywords
aged, Therapeutics, hospitalization, nursing care, rehabilitation, prompted voiding
Brief summary
This study evaluates effectiveness to apply prompted voiding in urinary incontinence and dependence patients admitted at functional recovery ward in a mid-stay hospital. This behavioural therapy is recommended in Best Practice Guidelines, and it has good results in elderly living in the community or in nursing home but yet it has not shown his benefits in hospitalized elderly patients for a long time.
Detailed description
The increased level of chronic diseases, greater chances of survival and older people hospitalized, place the Urinary Incontinence (UI) problem in a priority position both in hospital and community care. Guadarrama (Public Madrid Health Service) is a medium-stay Hospital. It makes treatment to recover from acute disease and UI has 80% prevalence at admitted patients. Main objective:To assess the efficacy of Prompted Voiding (PV) therapy for reverse of UI status in elderly patients hospitalized in a Functional Recovery Ward. (FRW) Methods: Experimental research pre/post-Intervention, with 5 repeated measures data: baseline (preintervention); at discharge, at one, three and six months after discharge (post-intervention). Sample size is 212 admitted patients in the FRW with UI. Prompted voiding intervention will be applied by nursing team following the procedure hospital approved and it will be individualized to each patient. Main Outcome: urinary continence (YES/NO), others outcomes: amount and frequency of urine loss, type of incontinence pads; follow-up: urinary continence at one, three, and six months after discharge. Applicability: Incorporating Prompted Voiding Therapy in UI patients care, encouraging global care, relevant implications for reduce the morbidity, improvement the quality of life, decrease health costs.
Interventions
BEHAVIORALPrompted voiding
Monitoring: This involves asking the incontinent individual, at regular intervals, if he or she needs to use the toilet. The care provider may look for behaviours that the client needs to be toileted (e.g., restlessness, agitation, disrobing), and take the client to the toilet at regular intervals specific to their schedule, rather than routinely every two hours. Prompting: This process includes prompting the person to use the toilet at regular intervals, and encourages the maintenance of bladder control between prompted voiding sessions. Praising: This important step is the positive reinforcement of dryness and appropriate toileting, and is the response from the care provider to the individual's success with maintaining bladder control.
Sponsors
Guadarrama Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* onset of Urinary Incontinence less than 1 year (information extracted from the Patient's Medical History, or provided by the patient or family caregiver) * sign the informed consent.
Exclusion criteria
* patient with indwelling urinary catheters at admission * irreversible urinary incontinence by disease itself * moderate-severe cognitive impairment (Pfeiffer's questionnaire \> 4) * patients with indication of water restriction. * patients who do not collaborate in Prompted Voiding therapy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change of Urinary Incontinence status after prompted voiding program (PVP) | at admission, at discharge (about 30 to 60 days), 1 , 3 and 6 month post discharge | To value the efficacy of prompted voiding therapy to recovery urinary continence in elderly hospitalized at functional recovery ward. Data wil be collected from nursing assessment at admission, at discharge and telephone call. |
| Improve urinary incontinence episodes/symptoms after prompted voiding program. | at admission, each 15 days along admission, at discharge (about 30 to 60 days). | To value the efficacy of prompted voiding therapy to improve urinary incontinence episodes/symptoms (episodes frequency, volume loss, type pad used) in elderly hospitalized at functional recovery ward. It Will be measure with assistance nurse record. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change of Urinary Incontinence status after PVP in admitted patients with Mixed Urinary Incontinence | at admission, at discharge.(about 30 to 60 days) | Assessment will be with IU4 questionnaire and NANDA diagnosis. Data will be collected from nursing assessment at admission and nursing assesment at discharge records. |
| Change of Urinary Incontinence status after PVP in admitted patients with Functional Urinary Incontinence | at admission, at discharge.(about 30 to 60 days) | Assessment will be with IU4 questionnaire and NANDA diagnosis. Data will be collected from nursing assessment at admission and nursing assesment at discharge records. |
| Change from Urinary Incontinence status after PVP in admitted patients with Reflects Urinary Incontinence | at admission, at discharge.(about 30 to 60 days) | Assessment will be with IU4 questionnaire and NANDA diagnosis. Data will be collected from nursing assessment at admission and nursing assesment at discharge records. |
| Change of Urinary Incontinence status after PVP in admitted patients with Total Urinary Incontinence | at admission, at discharge.(about 30 to 60 days) | Assessment will be with IU4 questionnaire and NANDA diagnosis. Data will be collected from nursing assessment at admission and nursing assesment at discharge records. |
| Urinary Incontinence (UI) status reached related with aged. | at admission, at discharge (about 30 to 60 days) | To Identify promoting/difficulty continence factors. Data will be collected from clinical history records. |
| Urinary Incontinence (UI) status reached related with cognitive ability. | at admission, at discharge (about 30 to 60 days) | To Identify promoting/difficulty continence factors. Data will be collected from clinical history records. Cognitive impairments will be measure with Pfeiffer test. |
| Urinary Incontinence (UI) status reached related with Functional ability. | at admission, at discharge (about 30 to 60 days) | To Identify promoting/difficulty continence factors. Data will be collected from clinical history records. Functional ability will be measure with Barthel Scale. |
| Urinary Incontinence (UI) status reached related with risk diseases presence. | at admission, at discharge (about 30 to 60 days) | To Identify promoting/difficulty continence factors. Data will be collected from clinical history records. Risk diseases: Diabetes Mellitus, Parkinson Disease, Heart Failure, Obesity, Urinary Tract infection, Nervous System Diseases, Stroke, Abdomen and pelvis surgery. |
| Change of Urinary Incontinence status after PVP in admitted patients with Stress Urinary Incontinence | at admission, at discharge.(about 30 to 60 days) | Assessment will be with IU4 questionnaire and NANDA diagnosis. Data will be collected from nursing assessment at admission and nursing assesment at discharge records. |
| Urinary Incontinence (UI) status reached related with overweigth. | at admission, at discharge (about 30 to 60 days) | To Identify promoting/difficulty continence factors. Data will be collected from clinical history records. Body Mass Index greater than or equal to 25 |
| Urinary Incontinence (UI) status reached related with caregiver presence. | at admission, at discharge (about 30 to 60 days) | To Identify promoting/difficulty continence factors. Data will be collected from clinical history records. |
| Urinary Incontinence (UI) status reached related to diagnosis of admission | at admission, at discharge (about 30 to 60 days) | To Identify promoting/difficulty continence factors. Data will be collected from clinical history records. 3 groups will be assigned: Femoral Fractures, stroke, functional disability. |
| Urinary Incontinence (UI) status reached related to risk of Skin Ulcer | at admission, at discharge (about 30 to 60 days) | Data will be collected from clinical history records. It will be valuated with Norton Scale. |
| Urinary Incontinence (UI) status reached related to fall risk. | at admission, at discharge (about 30 to 60 days) | Data will be collected from clinical history records. It will be valuated with Sytratify Scale. |
| Urinary Incontinence (UI) status reached related to days of hospitalization. | at admission, at discharge (about 30 to 60 days) | To Identify promoting/difficulty continence factors. Data will be collected from clinical history records. |
| Urinary Incontinence (UI) status reached related with time of UI. | at admission, at discharge (about 30 to 60 days) | To Identify promoting/difficulty continence factors. Data will be collected from clinical history records. |
| Urinary Incontinence (UI) status reached related with risk drugs. | at admission, at discharge (about 30 to 60 days) | To Identify promoting/difficulty continence factors. Data will be collected from clinical history records and drug prescriptions. Risk drugs: Diuretics; sedatives; hypnotics; anticholinergics; amitriptyline; opioid analgesics, cholinesterase inhibitors. |
| Change of Urinary Incontinence status after PVP in admitted patients with Emergency Urinary Incontinence | at admission, at discharge.(about 30 to 60 days) | Assessment will be with IU4 questionnaire and NANDA diagnosis. Data will be collected from nursing assessment at admission and nursing assesment at discharge records. |
Countries
Spain
Outcome results
None listed