BEHAVIOR TREATMENT OF INCONTINENCE IN HOMEBOUND ELDERLY

居家老年人失禁的行为治疗

• 批准号: 3392588
• 负责人: BEATRICE JOAN MCDOWELL
• 金额: $ 38.22万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 1992
• 资助国家: 美国
• 起止时间: 1992-05-15 至 1997-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3392588
• 关键词: aging; autogenic training; behavior modification; caregivers; home health care; human old age (65+); human subject; nurse practitioners; nursing intervention; patient care management; urinary incontinence

Urinary incontinence is a common health problem among older adults. Previous research has shown that behavioral treatments are effective methods of reducing incontinence in mentally alert, ambulatory outpatients and in nursing home residents. However, their effectiveness has not been established in older patients who are homebound. The primary purpose of the proposed project is to study the effects of individualized programs of prompted voiding and biofeedback-assisted behavioral training implemented by nurse practitioners in the home care setting. The second purpose is to identify characteristics of individuals who are most responsive to such intervention in order to aid us later in developing selection criteria. This project will be a prospective, controlled trial of behavioral treatment with incontinent men and women, 60 years of age or older who receive home health care. Approximately 424 patients will be evaluated for participation with the expectation that 106 will complete the protocol (53 in each of two groups). Subjects will be classified according to three key characteristics and randomized to eight weekly sessions of behavioral treatment or to a control condition consisting of no intervention for eight weeks followed by entry into the delayed treatment protocol (also eight weekly sessions). Patients who are identified as having significant cognitive impairment (MMSE < 24) will be treated with a program of prompted voiding implemented by the caregiver. Patients without significant cognitive impairment (MMSE greater than or equal to 24) will be treated with a program of scheduled voiding and biofeedback-assisted pelvic floor muscle training, and assisted as needed by a caregiver. Bladder diaries completed by subjects or caregivers prior to randomization and following the eight-week protocols will be used to calculate reduction of incontinence.

尿失禁是老年人常见的健康问题。 先前的研究表明行为治疗是有效的 减少精神警觉的门诊病人失禁的方法 以及疗养院居民。 然而，它们的有效性尚未得到证实 在居家的老年患者中建立。 主要目的 拟议的项目是研究个性化方案的影响 实施促进排尿和生物反馈辅助行为训练 由家庭护理环境中的执业护士进行。 第二个目的是 确定对此类问题最敏感的个人的特征 干预，以帮助我们以后制定选择标准。 该项目将是一项前瞻性、对照行为试验 对 60 岁或以上失禁男性和女性进行治疗 接受家庭医疗保健。 大约 424 名患者将接受评估 参与，预计 106 人将完成协议（53 分为两组）。 科目将根据三个关键因素进行分类 特征并随机分配到每周八次的行为课程 治疗或控制条件，其中八人不干预 几周后进入延迟治疗方案（也八 每周一次）。 被确定患有严重认知障碍的患者 (MMSE < 24) 将通过实施提示排尿计划进行治疗 由护理人员。 无显着认知障碍的患者（MMSE 大于或等于 24）将按照预定的程序进行处理 排尿和生物反馈辅助盆底肌肉训练，并辅助 根据护理人员的需要。 受试者或护理人员在随机分组前完成的膀胱日记 并遵循八周方案将用于计算减少量 失禁。