Sampselle Carolyn M, Newman Diane K, Miller Janis M, Kirk Keri, DiCamillo Mary Ann, Wagner Todd H, Raghunathan Trivellor E, Diokno Ananias C
School of Nursing, University of Michigan, Ann Arbor, Michigan.
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
J Urol. 2017 Jun;197(6):1480-1486. doi: 10.1016/j.juro.2016.12.099. Epub 2016 Dec 31.
We compared 2-year urinary incontinence and urgency scores of older women who attended a 2-hour bladder health class vs those who viewed a 20-minute abbreviated class video for the purpose of urinary incontinence prevention.
A randomized, 2-arm, parallel design study was done to test the superiority of the 20-minute video over the 2-hour class. Outcomes at baseline, and 3, 12 and 24 months were the scores on questions 1 to 3 of ICIQ-SF (International Consultation on Incontinence Short Form) as the primary outcome and on IUSS (Indevus Urgency Severity Scale). Intent to treat analysis was done to compare the change from baseline in each intervention group across time and also with each other. Multiple imputation was used for missing data.
A total of 647 women participated in the study. Mean age was 63 years and approximately 28% of the participants were African American, primarily from an urban setting. The 2 arms were balanced on body mass index at baseline, age, race/ethnicity, education, employment status, income and marital status. No differences in primary or secondary outcomes were demonstrated between the 2 groups from baseline to the 3, 12 or 24-month visits.
The absence of significant differences in the outcome measures of ICIQ-SF and IUSS between the 2-hour class and the 20-minute video groups demonstrates that the 2 interventions were comparable. As urinary incontinence and urgency tend to rise annually in older women, instruction in bladder health self-care provided through either the 2-hour class or the 20-minute video format is a useful intervention to prevent urinary incontinence in older women.
我们比较了参加为时2小时膀胱健康课程的老年女性与观看20分钟简化课程视频的老年女性在2年期间的尿失禁和尿急评分，目的是预防尿失禁。
进行了一项随机、双臂、平行设计研究，以测试20分钟视频相对于2小时课程的优越性。基线、3个月、12个月和24个月时的结果是国际尿失禁咨询委员会简表（ICIQ-SF）第1至3题的评分作为主要结果，以及Indevus尿急严重程度量表（IUSS）的评分。采用意向性分析来比较各干预组随时间以及相互之间相对于基线的变化。对缺失数据使用多重填补法。
共有647名女性参与了该研究。平均年龄为63岁，约28%的参与者为非裔美国人，主要来自城市地区。两组在基线时的体重指数、年龄、种族/民族、教育程度、就业状况、收入和婚姻状况方面均衡。从基线到3个月、12个月或24个月随访，两组在主要或次要结果方面均未显示出差异。
2小时课程组和20分钟视频组在ICIQ-SF和IUSS结果测量上没有显著差异，这表明这两种干预措施具有可比性。由于老年女性的尿失禁和尿急情况往往逐年上升，通过2小时课程或20分钟视频形式提供的膀胱健康自我护理指导是预防老年女性尿失禁的一种有用干预措施。
