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使用提示性排空法管理养老院中的尿失禁:这种方法能持续吗?

Using Prompted Voiding to Manage Urinary Incontinence in Nursing Homes: Can It Be Sustained?

机构信息

Professor and Director, Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University; Cadenza Fellow, The Hong Kong Jockey Club Charities Trust, Hong Kong.

Lecturer, School of Medicine, Yangzhou University, China.

出版信息

J Am Med Dir Assoc. 2017 Jun 1;18(6):509-514. doi: 10.1016/j.jamda.2016.12.084. Epub 2017 Feb 22.

Abstract

OBJECTIVES

Studies reporting prompted voiding (PV) interventions were of short duration and were delivered by research personnel rather than nursing home staff. This study examined the effectiveness of the use of PV by nursing home staff in managing urinary incontinence among residents over a 6-month period.

DESIGN

A randomized controlled trial.

SETTING

Five nursing homes in Hong Kong.

PARTICIPANTS

Data were collected from 52 nursing home residents who had been admitted to the facility for at least 6 months prior to the initiation of the study and whose incontinence had been stable over the 6-month period.

INTERVENTION

The PV intervention was delivered by the staff for 6 months. All nursing home staff were trained to ensure that they would be able to correctly deliver the intervention before initiating the intervention. The control group received the usual care.

MEASUREMENTS

Outcomes were defined in terms of wet episodes per day, incontinence rate per day, self-initiated toileting per day, and total continent toileting per day. Data were collected at baseline, 3 months postintervention (T1), and 6 months postintervention (T2).

RESULTS

There were significant differences between the two groups in wet episodes per day, incontinence rate per day, and total continent toileting per day at 6 months post-intervention, with positive results found in the intervention group. A decrease of 9.1% was observed in the incontinence rate of the intervention group.

CONCLUSIONS

PV was shown to have positive effects, although the effects in this study were not as powerful as those found in overseas studies. The intervention delivered by staff was sustainable for a 6-month period. Nursing home operators should promote better continence care through PV, as it is a sustainable noninvasive behavioral intervention that can be mastered by staff with training.

摘要

目的

报道提示性排尿干预的研究持续时间较短,且由研究人员而非养老院工作人员实施。本研究考察了养老院工作人员在 6 个月内管理居民尿失禁时使用提示性排尿的效果。

设计

随机对照试验。

设置

香港的 5 家养老院。

参与者

本研究纳入了在研究开始前至少已入住养老院 6 个月且在 6 个月期间失禁情况稳定的 52 名养老院居民。

干预

提示性排尿干预由工作人员实施 6 个月。所有养老院工作人员均接受培训,以确保他们在开始干预前能够正确实施干预。对照组接受常规护理。

测量

以每日湿尿片数、每日失禁率、每日自主如厕次数和每日完全自主如厕次数作为结局。在基线、干预后 3 个月(T1)和干预后 6 个月(T2)收集数据。

结果

干预后 6 个月,两组在每日湿尿片数、每日失禁率和每日完全自主如厕次数方面存在显著差异,干预组的结果为阳性。干预组的失禁率下降了 9.1%。

结论

提示性排尿显示出积极的效果,尽管本研究的效果不如海外研究中的效果显著。工作人员实施的干预可持续 6 个月。养老院经营者应通过提示性排尿促进更好的控尿护理,因为这是一种可持续的非侵入性行为干预措施,经过培训,工作人员可以掌握该措施。

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