Asking patients about incontinence.
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Female↗
Biomedical subjects
K L Pearce
Publications and source records attributed to K L Pearce.
Levels I and II--care in the outpatient setting.
Urinary incontinence affects more than 10 million Americans. Many of these people are community-dwelling men and women of all ages. In most cases, a complex urologic/gynecologic evaluation is not required to establish a diagnosis and to plan treatment. This article focuses on basic practical assessment and management that can be delivered in an outpatient setting by nurses and NPs. The simple, basic activities are considered under Level I; these can be accomplished by an NP in a primary care setting. Level II activities require more expertise but not advanced technology and are within the scope of practice of all NPs in general or specialty practice.
Ambulatory Care↗
Behavioral training for urinary incontinence in elderly ambulatory patients.
Research questions addressed by this study were: 1) Is the treatment of chronic urinary incontinence (UI) in elderly, nondemented ambulatory patients using bladder-sphincter biofeedback as effective when performed by an internist/geriatrician and a nurse practitioner as that reported by behavioral scientists?; and 2) how does bladder-sphincter biofeedback compare to a program of behavioral training that does not utilize biofeedback? Twenty-seven patients with UI were assigned based on the number of baseline accidents documented in a self-maintained log, their sex, and the predominant pattern of symptoms (urge or stress) to one of two treatment groups: biofeedback (13 patients) or behavioral training not utilizing biofeedback (14 patients). Patients were given up to six treatments. Patients in both groups achieved a highly significant (P less than .001) reduction in urinary accidents 1 month following treatments compared with their baseline number of accidents. The average reduction of accidents over this time period was 79% for the biofeedback group and 82% for the group receiving behavioral training without biofeedback. All patients showed improvement and no patient experienced any side effect. A internist/geriatrician and a geriatric nurse practitioner may achieve success utilizing behavioral therapy with or without biofeedback for the treatment of chronic urinary incontinence for ambulatory elderly patients.
Aged↗