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Biomedical subjects

Jennifer Skelly

Publications and source records attributed to Jennifer Skelly.

6 recordsLinked to original sources
PubMed2005

Evaluating best practice guidelines.

Clinical practice guidelines are developed with the purpose of improving patient care. The Registered Nurses Association of Ontario (RNAO) Nursing Best Practice Guidelines (BPG) Project was implemented in 1999. It has resulted in the development, implementation and evaluation of 17 BPGs with agencies in different healthcare sectors. This article describes the process, challenges and lessons learned by the team responsible for evaluating the BPGs.

Benchmarking↗
PubMed2005

Urinary incontinence: common problem among women over 45.

OBJECTIVE: To examine age-specific prevalence and correlates of urinary incontinence (UI) among community-dwelling women. DESIGN: A questionnaire survey used a modified Dillman method. SETTING: Two family practice clinics in Hamilton, Ont. PARTICIPANTS: Questionnaires were mailed to 1082 women 45 years old and older. Ninety women were disqualified; 606 recipients responded. MAIN OUTCOME MEASURES: Self-reported prevalence of UI and potential risk factors. RESULTS: Overall response rate was 61% (606/992); 51% (311/606; 95% confidence interval 47.3% to 55.3%) reported an episode of UI during the last month. Of the 311 women reporting UI, 35.7% perceived it as a problem, 27% had had it for less than a year, 41.9% had had it for 1 to 4 years, and 31.1% had had it for 5 years or longer. Three kinds of UI were reported: 34% (106/311) reported stress UI, 14.5% (45/311) reported urge UI, and 51.4% (160/311) reported a mixed pattern. In multivariate analysis, the overall prevalence of incontinence increased significantly with "usually having a cough," "being troubled by swollen ankles," "giving birth," "ever smoking cigarettes," and "being troubled by headaches." Stress UI was associated with "usually having a cough" and "ever smoking cigarettes." Urge UI was associated with "having troubles with constipation" and "swollen ankles." Mixed incontinence was associated with "get sick more than other people," "usually having a cough," "taken hormones for menopause," and body mass index in the 50th to 75th percentile or greater. Age was not significantly associated with prevalence of UI or any of its subtypes. Only 40% of incontinent women indicated they had discussed urine loss with their physicians; 70% of these women felt satisfied with physicians' responses. CONCLUSION: Incontinence occurs in more than half of community-dwelling women 45 years old and older. Almost one of five women in the community reported UI that affected normal activities. Treating the effect of incontinence will require further understanding of women's coping skills and self-perceptions. Prevalence does not appear to increase with age.

Activities of Daily Living↗
PubMed2002

Urinary incontinence in Canada. National survey of family physicians' knowledge, attitudes, and practices.

OBJECTIVE: To determine current knowledge, attitudes, and management of urinary incontinence among family physicians in Canada. DESIGN: Cross-sectional mailed survey. SETTING: Family physicians in Canada. PARTICIPANTS: A random sample of 1500 members of the College of Family Physicians of Canada. MAIN OUTCOME MEASURES: Self-assessed knowledge, self-reported attitudes, and rating of various tests and treatments in the investigation and management of incontinence. RESULTS: The overall unadjusted response rate was 43.3% (650/1500). Although most respondents reported that urinary incontinence was common in their practices, less than half (46.0%, 284/617) indicated that they clearly understood incontinence and just 37.9% (232/612) had an organized plan for incontinence problems. Only 35.0% (214/612) of respondents felt very comfortable dealing with incontinence. Physical examination, urodynamic studies, urinalysis, and testing blood sugar levels were all considered important investigations by more than 90% of respondents. CONCLUSION: There are wide variations in knowledge, attitudes, practices, and comfort level among family physicians dealing with urinary incontinence.

Adult↗
PubMed2002

Incontinence Quality of Life Instrument in a survey of primary care physicians.

OBJECTIVE: To assess the performance of the Incontinence Quality of Life (I-QOL) Instrument in measuring the impact of urinary incontinence on the quality of life of family medicine patients. STUDY DESIGN: Postal survey. Multiple imputations of missing answers. Linear regression analysis of I-QOL predictors. Comparison by receiver operating characteristic of the I-QOL and the Short Form 12 (SF-12). POPULATION: Women 45 years or older attending either of 2 family medicine clinics. Response rate was 605 (61%) of 992. OUTCOMES MEASURED: Prevalence of stress, urge, and mixed incontinence. Scores on the I-QOL and SF-12 instruments. RESULTS: Of the 605 respondents, 310 (51%) reported urinary incontinence in the month before the survey. One or more items were missing on 19% of the I-QOL scales and scores were imputed. The relation between I-QOL and the number of leakage episodes was nonlinear. I-QOL scores decreased with the number of episodes, the amount of leakage, and poorer general health. There was no association between the I-QOL and age, education, or type of incontinence. The I-QOL was more sensitive than the SF-12 to the statement, "urinary incontinence is a problem." CONCLUSIONS: The I-QOL is a useful instrument for the investigation of incontinence-related quality of life in the community setting.

Aged↗