Background: Continence services in the UK have developed at different rates within differing care models, resulting in scattered and inconsistent services. Consequently, questions remain about the most cost-effective method of delivering these services.
Aim: To evaluate the impact of a new service led by a continence nurse practitioner compared with existing primary/secondary care provision for people with urinary incontinence and storage symptoms.
Design Of Study: Randomised controlled trial with a 3- and 6-month follow-up in men and women (n = 3746) aged 40 years and over living in private households (intervention [n = 2958]; control [n = 788]).
Setting: Leicestershire and Rutland, UK.
Method: The continence nurse practitioner intervention comprised a continence service provided by specially trained nurses delivering evidence-based interventions using predetermined care pathways. They delivered an 8-week primary intervention package that included advice on diet and fluids; bladder training; pelvic floor awareness and lifestyle advice. The standard care arm comprised access to existing primary care including GP and continence advisory services in the area. Outcome measures were recorded at 3 and 6 months post-randomisation.
Results: The percentage of individuals who improved (with at least one symptom alleviated) at 3 months was 59% in the intervention group compared with 48% in the standard care group (difference of 11%, 95% CI = 7 to 16; P<0.001) The percentage of people reporting no symptoms or 'cured' was 25% in the intervention group and 15% in the standard care group (difference of 10%, 95% CI = 6 to 13, P = 0.001). At 6 months the difference was maintained. There was a significant difference in impact scores between the two groups at 3 and 6 months.
Conclusions: The continence nurse practitioner-led intervention reduced the symptoms of incontinence, frequency, urgency and nocturia at 3 and 6 months; impact was reduced; and satisfaction with the new service was high.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1464065 | PMC |
Publication Analysis
Top Keywords
Similar Publications
The Management of Iatrogenic Ureterovaginal Fistula in a Resource-Limited Setting: A 12-Year Experience at Four Fistula Surgery Centers in Uganda.
Cureus
December 2024
Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, UGA.
Background Ureterovaginal fistulae usually follow iatrogenic injury to the ureter during pelvic surgery. This manifests as urine incontinence and results in serious psychosocial effects on women. Ureterovaginal fistulae unlike vesicovaginal fistulae present challenges in diagnosis and management especially in resource-constrained settings.
View Article and Find Full Text PDFDoes Self-Compassion Expressive Writing Benefit People With an Ostomy? A Randomized Controlled Trial.
J Wound Ostomy Continence Nurs
January 2025
Lauren Harris, PG, DipHealthPsych, Health Psychologist, Cancer Services, Te Whatu Ora - Waitemata, New Zealand.
Purpose: The purpose of this study was to investigate whether a self-compassion expressive writing activity could improve psychological well-being in people with an ostomy, as assessed by changes in body image distress, ostomy-specific quality of life (QOL), self-compassion, and dispositional disgust.
Design: Randomized controlled trial design was used.
Subjects And Setting: The sample comprised 175 English-speaking patients over 18 years of age with a fecal or urinary ostomy; all participants resided in Australia and New Zealand.
Antenatal pelvic floor muscle exercise intervention led by midwives in England to reduce postnatal urinary incontinence: APPEAL feasibility and pilot randomised controlled cluster trial.
BMJ Open
January 2025
University of Exeter Medical school, University of Exeter, Exeter, UK.
Objectives: To assess the feasibility of an intervention of midwifery support for antenatal pelvic floor muscle exercises (PFME) to prevent postnatal urinary incontinence (UI).
Design: Feasibility and pilot cluster randomised controlled trial. Clusters were community midwifery teams.
An Outside-the-Box Approach for Treating a Rare Case of Urethrovaginal Fistula.
Cureus
November 2024
Urology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University) Pune, Pune, IND.
Urethrovaginal fistulas are rare complications often arising from urethrovaginal injuries commonly due to obstetrical trauma, urethral surgeries, pelvic fractures, or neoplastic treatments. Here, we present a unique case involving a 23-year-old female patient with a large urethrovaginal fistula and complete anterior vaginal wall sloughing following prolonged obstructed labor. Nine months post-cesarean, she reported urine leakage via the vagina upon catheter removal, which intensified in an erect posture.
View Article and Find Full Text PDFIntroduction: Urinary incontinence is associated with social isolation, deconditioning, depression, falls and early mortality. It impairs quality of life, even in residents of nursing homes, and, in the community, increases the risk of institutionalisation. Care focused on the preservation of dignity during intimate care is important in the care of older adults.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!