Jirovec M M, Templin T
Wayne State University, College of Nursing, 5557 Cass Avenue, Detroit, MI 48202, USA.
Res Nurs Health. 2001 Feb;24(1):1-8. doi: 10.1002/1098-240x(200102)24:1<1::aid-nur1001>3.0.co;2-r.
The purpose of this research was to evaluate the effectiveness of an individualized scheduled toileting (IST) program on incontinent, memory-impaired elders being cared for at home. Using a 2 x 2 mixed design analysis of variance (group by time), 118 patients were randomly assigned to experimental or control groups. Caregivers in the experimental group were taught the IST procedure. Urinary incontinence (UI) was measured at baseline and at 6 months. Weeklong voiding records were kept by caregivers and were used to calculate the percentage of times the incontinence occurred. UI significantly decreased in the experimental group, whereas in the control group it did not. The baseline cognitive ability, mobility, and consistency of implementing IST were entered into a discriminant function equation and significantly predicted patients who would improve with IST. Cognitive ability was the best predictor, with mobility also emerging as a meaningful predictor. Candidates for IST should be selected based on elders' cognitive ability and their ability to cooperate with toileting. Moderately cognitively impaired elders and ones able to cooperate with toileting protocols are prime candidates for IST.
本研究的目的是评估个性化定时如厕（IST）计划对在家接受照料的大小便失禁且有记忆障碍的老年人的有效性。采用2×2混合设计方差分析（组×时间），将118名患者随机分为实验组或对照组。实验组的护理人员学习了IST程序。在基线和6个月时测量尿失禁（UI）情况。护理人员记录为期一周的排尿情况，并用于计算失禁发生的次数百分比。实验组的UI显著下降，而对照组则没有。将基线认知能力、活动能力和实施IST的一致性纳入判别函数方程，显著预测了IST治疗后会改善的患者。认知能力是最佳预测指标，活动能力也成为一个有意义的预测指标。应根据老年人的认知能力及其配合如厕的能力来选择IST的适用对象。中度认知障碍且能够配合如厕方案的老年人是IST的主要适用对象。
