School of Nursing, University of Minnesota, Minneapolis, MN 55455, USA.
Nurs Outlook. 2011 Jul-Aug;59(4):215-20, 220.e1. doi: 10.1016/j.outlook.2011.05.010.
This systematic literature review aimed to identify conservative interventions for reducing urinary incontinence (UI) in non-institutionalized frail older adults. Randomized and quasi-experimental studies published in English reporting outcomes on UI frequency, severity, or quality of life were included and rated for quality. Studies reporting improvements over 50% in UI outcomes were considered clinically significant. Seven studies with 683 participants (75% female) were eligible. Multicomponent behavioral interventions including pelvic floor muscle exercises and bladder training had the strongest evidence for reducing UI. The evidence supporting comprehensive geriatric assessment with multicomponent behavioral interventions, pattern urge response training, and toilet skills was limited. There is insufficient evidence to derive firm conclusions regarding the use of conservative interventions. Clinical trials are needed on a variety of interventions to guide practice on UI prevention and management in frail community-dwelling older adults.
本系统文献回顾旨在确定非住院虚弱老年人减少尿失禁（UI）的保守干预措施。纳入并评价了发表英文、报告 UI 频率、严重程度或生活质量结局的随机和准实验研究，并对其质量进行了评价。报告 UI 结局改善超过 50%的研究被认为具有临床意义。有 7 项研究（75%为女性），共 683 名参与者符合纳入标准。包括盆底肌肉锻炼和膀胱训练在内的多组分行为干预对减少 UI 最有证据支持。支持全面老年评估与多组分行为干预、急迫性尿失禁反应训练和如厕技能训练相结合的证据有限。关于保守干预的使用，目前还没有足够的证据得出明确的结论。需要开展各种干预措施的临床试验，以指导虚弱的社区居住老年人 UI 预防和管理的实践。
