O'Brien J, Austin M, Sethi P, O'Boyle P
Somerset District Health Authority, Taunton.
BMJ. 1991 Nov 23;303(6813):1308-12. doi: 10.1136/bmj.303.6813.1308.
To measure the unmet need of patients with regular urinary incontinence (incontinence twice or more a month) treatable by a nurse.
Self completed postal questionnaire and randomised controlled trial of assessment and intervention by a nurse.
One urban and one rural general practice in Somerset.
7300 adults randomly selected from 10,300 aged 35 and over on the combined practice lists. 515 women and 185 men with regular incontinence were offered assessment and treatment, of whom 134 women and 49 men had no intervention for three months (historical controls). They then joined the assessment and treatment programme.
Four sessions of pelvic floor exercises and bladder retraining supervised by non-specialist nurse who had taken a three week course on assessing and treating uncomplicated incontinence.
Number of patients desiring treatment; self reported cure, improvement, or deterioration in continence after three months.
The questionnaire achieved a 79% response. Validated responses showed a prevalence of 4.4% in men and 16.4% in women aged 35-64. 315 (45%) of the 700 patients offered assessment refused it and seven had moved away or died, 64 men and 41 women were referred to their general practitioner. 197 of 292 treated women (68%) reported cure or improvement compared with seven (5%) of controls. 22 of the 86 men desiring treatment were suitable for intervention by the nurse. Seventeen were cured or improved compared with none of the men in the control group.
About half the people with regular urinary incontinence took up the offer of treatment (9.2% of women and 3.4% of men in the study population). This condition can be effectively managed by a nurse with limited training.
评估可由护士治疗的习惯性尿失禁（每月失禁两次或以上）患者未被满足的需求。
自行填写的邮寄调查问卷以及由护士进行评估和干预的随机对照试验。
萨默塞特郡的一家城市和一家农村全科诊所。
从联合诊所名单上10300名35岁及以上的成年人中随机选取7300名。515名患有习惯性失禁的女性和185名男性被提供评估和治疗，其中134名女性和49名男性三个月未接受干预（历史对照）。之后他们加入了评估和治疗项目。
由接受过为期三周的非复杂性失禁评估和治疗课程培训的非专科护士监督进行四节盆底肌锻炼和膀胱再训练课程。
希望接受治疗的患者数量；三个月后自我报告的失禁治愈、改善或恶化情况。
调查问卷的回复率为79%。有效回复显示，35 - 64岁男性的患病率为4.4%，女性为16.4%。700名被提供评估的患者中有315名（45%）拒绝了评估，7名已搬走或死亡，64名男性和41名女性被转诊至他们的全科医生处。292名接受治疗的女性中有197名（68%）报告治愈或改善，而对照组为7名（5%）。86名希望接受治疗的男性中有22名适合护士进行干预。17名治愈或改善，而对照组男性无一人治愈或改善。
约一半的习惯性尿失禁患者接受了治疗提议（研究人群中9.2%的女性和3.4%的男性）。这种情况可由受过有限培训的护士有效管理。
