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Biomedical subjects

Carolyn M Sampselle

Publications and source records attributed to Carolyn M Sampselle.

14 recordsLinked to original sources
PubMed2007

Adherence to a behavioral program to prevent incontinence.

This exploratory study assesses factors predicting adherence to a behavioral intervention to prevent urinary incontinence. Community-dwelling, post-menopausal women (N = 164) were taught pelvic floor muscle training (PFMT) and bladder training (BT) and followed with surveys for 1 year. Content analysis of open-ended responses coded descriptions of approaches participants used to incorporate PFMT into daily life. Exploratory bivariate and logistic regression analyses determined predictors of approach used and adherence. Results indicate women incorporated PFMT into their lives using either a routine or ad hoc approach. Those using a routine approach at 3 months were 12 times more likely to adhere (odds ratio [OR] = 12.4, confidence interval [CI] = 4.0-38.8, p < .001) at a high level at 3 months and significantly more likely to maintain that level 12 months post-intervention (OR = 2.7, CI = 1.2-6.0, p < .014). Practicing BT was related to high adherence.

Aged↗
PubMed2006

Factors associated with prevalent and incident urinary incontinence in a cohort of midlife women: a longitudinal analysis of data: study of women's health across the nation.

To compare the characteristics of and baseline factors associated with prevalent and incident urinary incontinence in a diverse cohort of midlife women, the authors analyzed the baseline and first five annual follow-up visits of the Study of Women's Health Across the Nation (SWAN), 1995-2001. From responses to annual questionnaires, the authors defined prevalent incontinence as at least monthly incontinence reported at baseline and incident incontinence as at least monthly incontinence first reported over follow-up. They used multiple logistic regression for their comparison. The mean age of their cohort at baseline was 45.8 (standard deviation: 2.7) years. Prevalent incontinence was 46.7%, and the average incidence was 11.1% per year. Most women reported stress, but a higher proportion developed urge incontinence (15.9% vs. 7.6% at baseline). African Americans (29.5%) and Hispanics (27.5%) had the lowest prevalence of incontinence; African Americans (11.6%) and Caucasians (13.4%) had the highest average annual incidence. Parity, diabetes, fibroids, and poor social support were associated with prevalent incontinence, while high body mass index, high symptom sensitivity, and poor health were associated with incident incontinence. In midlife women, incident incontinence is mild with different characteristics and baseline risk factors; overweight women have a higher risk of developing incontinence.

Adult↗
PubMed2006

Evaluation of a mass mailing recruitment strategy to obtain a community sample of women for a clinical trial of an incontinence prevention intervention.

OBJECTIVES: Questions exist about using mass mailings to recruit representative samples to participate in clinical trials. The MESA Prevention Study (Medical, Epidemiologic and Social Aspects of Aging), a randomized controlled clinical trial to prevent urinary incontinence (UI), utilized a mass mailing recruitment procedure to recruit a representative sample of women to participate in a behavioral modification program. This paper seeks to expand the literature of mass mailing recruitment strategies for prevention studies by describing the procedures used to recruit healthy, continent, post-menopausal women aged 55-80 years. METHODS: Sociodemographic data collected from recruited subjects is compared with on-line national census data to evaluate the representativeness of the sample recruited from a purchased mailing list. RESULTS: The mass mailing procedure resulted in 3.3% positive response. Of those that returned a positive response, 37.6% were deemed eligible at first screening. Comparisons of study demographic data with state and county census data indicate that the sample obtained was representative of the communities. CONCLUSIONS: The mass mailing strategy was an effective means of recruiting a representative sample of women, aged 55-80. Short falls and recommendations for successful community sample recruitment strategies for clinical trials in older adult women are elaborated upon.

Aged↗
PubMed2005

Learning outcomes of a group behavioral modification program to prevent urinary incontinence.

This study describes acquisition of knowledge and motor skill in bladder training (BT) and pelvic floor muscle training (PFMT) and adherence following a behavioral modification program (BMP). Essentially continent (0-5 episodes in past year) community-dwelling older women (n = 359) were randomized to treatment (n = 164), a 2-h group education session supplemented by one brief individualized session of approximately 10 min, or control (n = 195), no instruction, and followed for 12 months. Knowledge, motor skill, and adherence to the BMP were documented. Changes in pelvic muscle function and voiding interval were used to validate self-reported adherence. Following group instruction, mean BT and PFMT knowledge was 90 and 86%, respectively; 68% demonstrated correct PFMT technique without additional instruction, 29% required brief instruction, and 3% were unable to learn PFMT technique. Adherence ranged from 63 to 82% for PFMT and 58 to 67% for BT. Group instruction supplemented with brief individual instruction as needed is an effective teaching method for BT and PFMT.

Aged↗
PubMed2004

Prevention of urinary incontinence by behavioral modification program: a randomized, controlled trial among older women in the community.

PURPOSE: We determined whether a behavioral modification program (BMP) taught to groups of continent older women would decrease the incidence of urinary incontinence, increase pelvic muscle strength and improve voiding control. MATERIALS AND METHODS: We performed a randomized, controlled trial comparing a BMP treatment group to a control, no treatment group in ambulatory, postmenopausal, continent women (0 to 5 days of incontinent episodes in the previous year) 55 years and older who were followed for 12 months. Qualified volunteers from 4 Michigan counties were randomly assigned to a control or a treatment group, consisting of a 2-hour classroom presentation on BMP followed 2 to 4 weeks later with individualized evaluation to test knowledge, adherence and skills in behavioral techniques, and brief reinforcement of the technique as needed. Followup was done by telephone and mail every 3 months except month 12, when all participants underwent final clinical evaluation. Outcome measures were continence status, pelvic floor muscle strength and voiding frequency/intervoid interval. RESULTS: A total of 195 control and 164 treated participants completed the study. Baseline data on the 2 groups were not statistically different. At 12 months the treatment group was statistically significantly better than the control group in continence status (p = 0.01), pelvic muscle strength (pressure score p = 0.0003 and displacement score p <0.0001), improved voiding frequency (p <0.0001) and intervoid interval (p <0.0001). CONCLUSIONS: To our knowledge we report the first randomized, controlled trial of BMP for preventing urinary incontinence in older women. It demonstrated feasibility and efficacy in improving continence status, pelvic muscle strength and voiding control as long as a year after treatment.

Aged↗
PubMed2003

Behavioral intervention: the first-line treatment for women with urinary incontinence.

Urinary incontinence is a women's health problem that imposes major consequences for personal quality of life and for national health care costs. The evidence base for the efficacy of the behavioral interventions of bladder training and pelvic muscle training to treat urinary incontinence in women is strong. Bladder and pelvic muscle training should be considered as basic health promotion education for all women. Screening for incontinence should be a routine component of women's health care and bladder and pelvic muscle training should be prescribed by clinicians as a first-line treatment for women who screen positive. This article summarizes the relevant research and outlines intervention strategies that clinicians can readily translate into everyday practice.

Adult↗
PubMed2003

Indices for studying urinary incontinence and levator ani function in primiparous women.

Urinary incontinence (UI) is a complex phenomenon that is prevalent in pregnant and parous women and requires the use of sophisticated measures to adequately reflect functioning of the continence system. The purpose of this study was to develop reliable and valid measures of UI and levator ani function for use in research and clinical settings. A Leakage Index (LI) and a Levator Ani Function Index (LAFI) were developed using data from a longitudinal study of primiparous women. Reliability and validity tests were conducted to: (i) estimate the internal consistency reliability of each index, (ii) determine whether the indices captured change in continence status and pelvic floor function during pregnancy through 1 year postpartum, and (iii) estimate association between the indices as a test of predictive validity. Cronbach's alpha ranged from 0.72 to 0.84 for the LI and from 0.53 to 0.79 for the LAFI across the six data collection time points of the study. Average LI scores increased late in pregnancy and decreased postpartum, though not significantly. Average LAFI scores decreased significantly at 35 weeks gestation (t = 4.84, P = 0.000) and increased significantly at 12 months postpartum (t = -3.51, P = 0.002) relative to baseline. The LI and LAFI were significantly associated at 20 weeks gestation (Pearson r = -0.40, P = 0.007) and at 6 weeks postpartum (Pearson r = -0.33, P = 0.029). The findings suggest the LI and LAFI are reliable and valid measures of UI and levator ani function in primiparous women, which can be used with confidence in clinical and research settings.

Adolescent↗
PubMed2002

Urinary incontinence predictors and life impact in ethnically diverse perimenopausal women.

OBJECTIVE: To document prevalence of mild, moderate, and severe urinary incontinence among ethnically diverse perimenopausal women, identify risk factors, and assess the effect of severity on women's daily lives using treatment seeking, bother, and nighttime voiding as indicators. METHODS: Baseline data from the longitudinal cohort of the Study of Women's Health Across the Nation, a prospective, multiethnic, multisite study of the natural history of menopausal transition was used (n = 3302). Interview and self-completed questionnaires assessed most variables of interest. Body mass index and diabetes mellitus were measured clinically. Incontinence severity was derived by multiplying frequency by volume leaked. Risk factors and effect on treatment seeking, bother, and nighttime voiding were assessed by the construction of multiple logistic regression models for each ethnic group and the total population. RESULTS: Mean age was 46.4 years. Incontinence prevalence was 57%, with nearly 15% categorized as moderate and 10% as severe. Biologic factors constituted the most important risk for severity, specifically perimenopausal compared with premenepausal status (odds ratio [OR] 1.35), body mass index (OR 1.04), diabetes mellitus (OR 1.55), and current smoking (OR 1.38). Nonwhite groups had lower risk, but the relationship of ethnicity is complex. Severity was associated with likelihood of discussing with a health care provider, with bothersomeness, and with likelihood of nighttime voiding. CONCLUSION: Large numbers of perimenopausal women experience urinary incontinence with 25% wearing protection or changing undergarments on several days per week. Mutable factors predicting severity included body mass index and current smoking.

Age Factors↗
PubMed2002

Midlife development and menopause in African American and Caucasian women.

Little is known about factors that enhance midlife women's well-being and even less about whether these factors differ for African Americans and Caucasians. We conducted focus groups with 30 women, grouped by ethnicity and menopausal status. Women identified midlife as a time of opportunity for self-development. Pre/perimenopausal women expressed more fears about severe emotional changes than did their postmenopausal counterparts. These fears were in sharp contrast to the women's descriptions of enhanced self-esteem. Caucasian women were primarily concerned about menopause as a harbinger of physical aging and the ensuing disadvantage of divergence from society's ideal of a youthful appearance, while African American women viewed menopause as a normal, even welcome, part of life. A language of emancipation and awareness of gender bias were prominent in the women's stories regardless of menopausal status or race. Further study should assess the role that feminist insights may play in the well-being of midlife women.

Adaptation, Psychological↗
PubMedDate not supplied

Nickel-and-Dimed in America: underserved, understudied, and underestimated.

This article examines circumstances in the contemporary United States that increase health disparities. Minority women are particularly vulnerable because of environmental stress. Furthermore, absent or inadequate healthcare coverage deters the use of preventive healthcare practices. Organizing themes are as follows: underserved, which describes factors that contribute to health disparities and examines the consequences, particularly for underserved minority groups; understudied, which examines potentially fruitful, but as yet insufficiently investigated, avenues of research needed to better understand the basis for health disparities; and underestimated, which argues that without trusting researcher-community partnerships, interventions to address health disparities will be flawed and ineffective.

Community-Institutional Relations↗
PubMedDate not supplied

Prevention of urinary incontinence in adults: population-based strategies.

BACKGROUND: Urinary incontinence (UI) affects large numbers of adults, especially older adults, with an estimated 200 million adults worldwide having this life-altering condition. OBJECTIVES: To identify key populations at risk for urinary incontinence and propose population-based strategies to promote continence with a substantive focus on UI prevention. METHODS: Critical review of extant literature and iterative synthesis were undertaken to generate an action plan to guide future UI prevention research. RESULTS: Key populations identified to be at risk for UI are women in selected occupations, childbearing women, older adults with lifestyle risk factors, older adults with comorbid conditions, and nursing home residents. Population-based research activities are proposed. Growing evidence supports the benefit of pelvic floor muscle training to prevent childbirth and prostatectomy-related UI. Bladder training has demonstrated preventive capacity. CONCLUSIONS: Because of its high prevalence and chronic but preventable nature, UI is most appropriately considered a public health problem. Nursing research is needed to test prevention programs for UI using a population-based public health focus.

Adult↗
PubMedDate not supplied

Provider support of spontaneous pushing during the second stage of labor.

OBJECTIVE: To describe the association between provider communication and actual maternal pushing behavior in second-stage labor and to test differences in length of second stage and total maternal pushing time by maternal pushing behavior. DESIGN: Descriptive. SETTING: Midwest hospital birth unit. PARTICIPANTS: Twenty primigravidas who gave birth vaginally. INTERVENTION: Type of provider communication (supportive of spontaneous or directed pushing). MAIN OUTCOME MEASURE: Maternal pushing behavior (spontaneous or directed) documented by videotape review. RESULTS: The percentage of provider communication supporting spontaneous pushing versus directed pushing and the percentage of actual spontaneous versus directed maternal pushing behavior were associated (Pearson r = .80, p = .001, for spontaneous and r = .89, p = .001, for directed). Neither duration of second stage (t = .06, p = .95) nor time spent pushing (t = .15, p = .89) differed by spontaneous versus directed pushing style. CONCLUSION: The proportion of spontaneous pushing by the birthing woman was positively and significantly associated with the proportion of caregiver communication supporting and encouraging spontaneous pushing. Importantly, spontaneous pushing did not significantly lengthen the duration of second-stage labor or total time spent pushing.

Adult↗