Medical University of Graz, Institute of Nursing Science, Universitätsplatz 4/3, 8010 Graz, Austria.
Maastricht University, Department of Health Services Research, CAPHRI, Care and Public Health Research Institute, Duboisdomein 30, 6229 GT Maastricht, the Netherlands.
Arch Gerontol Geriatr. 2019 Mar-Apr;81:245-251. doi: 10.1016/j.archger.2019.01.003. Epub 2019 Jan 19.
Guideline-compliant conservative management of urinary incontinence (UI) is the first step of the initial management for UI and is recommended for long-term care in older persons. Recent studies have focused on the effects of guideline-compliant UI management. However, most of these studies were tested in another setting than nursing homes and were not focused on conservative management.
To measure the effectiveness of 29 evidence-based nursing recommendations regarding the conservative management of UI in Austrian nursing homes.
The study is a cluster randomized intervention trial with institution as the unit of randomization. Twelve nursing homes in two Austrian provinces (Styria, Carinthia) were randomly allocated to the intervention group (IG) and control group (CG). Data were collected from participating residents over a three-month period. The intervention consisted of the implementation of recommendations for the conservative management of UI among female nursing home residents. The primary outcome variable was the daily UI experienced by the participating residents.
Residents in the (IG n = 216) had a lower risk (OR = 0.14, p = 0.02) of experiencing daily UI and were less likely to receive absorbent products (OR = 0.01, p = 0.01) than residents in the CG (n = 165). Residents in the IG (OR = 5.16, p = 0.00) were five times more likely to receive recommended interventions (e.g., bladder training) than residents in the CG.
Introducing guideline-compliant management into nursing practice can increase the likelihood of evidence-based interventions for the conservative management of UI. The intervention in this study targeted on nurses/nurse managers and can be recommended for the nursing home setting.
符合指南的保守性尿失禁（UI）管理是 UI 初始管理的第一步，也是老年人长期护理的推荐方法。最近的研究集中在符合指南的 UI 管理效果上。然而，这些研究大多在疗养院以外的环境中进行，且并非专注于保守性管理。
测量奥地利疗养院中 29 项基于证据的护理建议对 UI 保守性管理的有效性。
这是一项以机构为随机单位的聚类随机干预试验。奥地利两个省份（施蒂利亚州、卡林西亚州）的 12 家疗养院被随机分配到干预组（IG）和对照组（CG）。在三个月的时间内，从参与的居民中收集数据。干预措施包括对女性疗养院居民 UI 保守性管理建议的实施。主要结局变量是参与居民每天经历的 UI 情况。
IG（n=216）的居民经历每天 UI 的风险较低（OR=0.14，p=0.02），且不太可能接受吸收性产品（OR=0.01，p=0.01），而 CG（n=165）的居民则更有可能接受推荐的干预措施（例如，膀胱训练）（OR=5.16，p=0.00）。
将符合指南的管理方法引入护理实践中，可以增加对 UI 保守性管理的循证干预的可能性。本研究中的干预措施针对护士/护士长，可推荐用于疗养院环境。
