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Biomedical subjects

Mary H Palmer

Publications and source records attributed to Mary H Palmer.

At least 19 recordsLinked to original sources
PubMed2007

Prevalence of lower urinary tract symptoms among female elementary school teachers in Taipei.

The aim of this study was to estimate the prevalence of lower urinary tract symptoms (LUTS) among female elementary school teachers in Taipei. A total of 520 self-administered surveys were distributed to 26 elementary schools in Taipei City. Data analyses were based on 445 usable surveys. The prevalence rates for different types of LUTS ranged from 9.9 to 44.5%. The prevalence of urinary incontinence (UI; 26.7%) and nocturia (16.0%) fell within the prevalence estimates of these LUTS in North American and European women. Employed women in this study were more likely to experience LUTS than women in previous epidemiological or community studies. This study extended research on UI into other LUTS among employed women in Asia. Study results suggest that the working environment may affect LUTS in female elementary school teachers. This preliminary study is important for developing future behavioral interventions for female LUTS in the workplace.

Adult↗
PubMed2006

Bladder control educational needs of older adults.

Bladder control problems, especially urinary incontinence (UI) and urinary freqency and urgency, are prevalent among older adults. The purpose of this project was to determine older adults' educational needs, preferred format, and interest in bladder control educational materials. Eighty-one older adults participated in focus groups conducted at senior centers, churches, and senior apartment dwellings located in Philadelphia, PA. A doctorally prepared nurse acted as the moderator, using a questionnaire that included items on general health issues and specific questions about bladder control issues. Participants showed interest in learning more about bladder control issues, discussed their preferences in relation to format for receiving health-related information, and expressed their interest in bladder control educational materials. This information can be used to devise an educational program about bladder control that is acceptable to older adults and can be easily accessed in settings where they reside or recreate.

Adaptation, Psychological↗
PubMed2004

Physiologic and psychologic age-related changes that affect urologic clients.

Because older adults can present with complex and multiple conditions, geriatrics is a truly multidisciplinary field. A review of physiologic and psychologic changes associated with aging that may affect urologic clients is presented. The implications of these changes to urologic nursing practice are examined.

Age Distribution↗
PubMed2002

Urinary incontinence in working women: a comparison study.

OBJECTIVES: To compare the findings of two surveys concerning the nature of urinary incontinence and management strategies used by full-time employed working women. METHODS: The first study was conducted in an urban academic setting with a survey distributed to 2000 women. The second study was conducted with 500 women in a rural pottery manufacturing facility. RESULTS: Twenty-one percent of the women working in an academic setting (group A) and 29% (p = 0.002) of the women working in a manufacturing setting (group B) reported being incontinent of urine at least monthly. More women in group B reported antecedents mixed incontinence (i.e., antecedent to both stress and urge incontinence). More women in group B also used panty liners to manage urine loss (p = 0.003), whereas more women in group A used voiding schedules (p = 0.008) and pelvic muscle exercises (p = 0.04). More women in group A reported that they did not know if their incontinence could improve (40% vs. 1%, p = 0.00). The majority in both groups said that getting treatment was of no or little importance, yet, overwhelmingly, most women (group A 81%; group B 86%) wanted more information about incontinence. CONCLUSIONS: Incontinence is a prevalent condition in working women. Discrepancies exist in the nature of the urine loss and strategies used to manage incontinence. Treatment also differs for those women who report urine loss to healthcare providers. Most women want to learn more about incontinence. Secondary prevention strategies need to be tailored and tested to meet symptoms and concerns for women in different work settings.

Adult↗
PubMed2002

Risk factors for hospital-acquired incontinence in elderly female hip fracture patients.

BACKGROUND: The objective of this study was to estimate the incidence of, and identify risk factors for, incontinence in female hip fracture patients. The study was a secondary analysis of data abstracted from medical records in hospitals in Pennsylvania, Texas, New Jersey, and Virginia. METHODS: The study included women aged 60 years and older who were admitted to one of the study hospitals with hip fracture. Measurements included incontinence at discharge as recorded in the medical records, demographic information, cognitive and functional status, and two measures of severity of illness (Charlson Comorbidity Index and Sickness at Admission Scale score). RESULTS: Data from 6516 women were analyzed. Twenty-one percent (n = 1365) became incontinent during hospitalization. After adjusting for confounders (i.e., age, race, malnutrition, comorbidity, and severity of illness), admission from a nursing home or other long-term care facility (odds ratio [OR] 1.68, 95% confidence interval [CI] 1.29-2.19), confusion (OR 3.44, 95% CI 2.79-4.24), use of a wheelchair or device for walking (OR 1.53, 95% CI 1.29-1.83), and prefracture dependence on others for ambulation (OR 2.51, 95% CI 1.64-3.85) significantly increased the odds of developing incontinence during hospitalization. CONCLUSION: Hospital-acquired incontinence affects 21% of female hip fracture patients. Certain easily identifiable patient characteristics place female hip fracture patients at high risk. Interventions to increase staff awareness of this vulnerable population need to be tested to minimize the incidence of hospital-acquired incontinence.

Age Factors↗
PubMed2002

Primary prevention research on incontinence in older adults.

Primary prevention research on urinary incontinence in older adults is in its nascent phase. Most clinical research has focused on secondary or tertiary prevention, that is, testing interventions to cure, improve, or manage incontinence. When urinary incontinence is recognized as a public health issue, resources become available to reduce the risk of incontinence and prevent its occurrence. Methodological issues that face nurse researchers desiring to conduct primary prevention research include inadequate theory and outcome development, need for gender and culturally sensitive measurement instruments, and sampling and design issues. Rather than viewing primary prevention as a futile endeavor, nurse researchers must combine the roles of researcher and advocate, articulating the vision for primary prevention, and developing sound clinical studies to prevent urinary incontinence in the older adult population.

Aged↗
PubMed2002

The impact of urinary incontinence in working women: a study in a production facility.

OBJECTIVES: The objectives of this study were to identify the impact of self-reported UI on working women, to describe urine loss symptoms, strategies used to control urine loss, and help-seeking behavior among full-time women working in a rural production facility. METHODS: A cross-sectional survey design was used and questionnaires were distributed to 500 women (response rate, 54%). Items elicited information on demographics, health, parity, symptoms and duration of urine loss, strategies to manage urine loss, effects of UI on work activities, level of knowledge about UI and treatment options, perceived importance of getting professional help, and actual help seeking behavior. RESULTS: Twenty-nine percent (n = 78) reported UI at least monthly. Incontinent women were older (44.8 years vs. 38.1 years) than continent women (t = -5.22, p < .001) and incontinent women had a significantly higher average body mass index (BMI) than continent women (t = -4.3, p < .001). More women reported urine loss with coughing, lifting, bending, and when hands were in water, and were more likely to use pads at work to control urine loss. Few women had reported UI to a health care provider (36%) and most wanted more information about UI (85%). CONCLUSIONS: UI is a prevalent problem for working women. Workplace programs designed to assist women with prevention, treatment, and management of UI are crucial.

Adolescent↗
PubMedDate not supplied

Developing and validating a Chinese instrument to measure lower urinary tract symptoms among employed women in Taiwan.

Lower urinary tract symptoms (LUTS), including urinary incontinence, negatively affect women's quality of life. Employed women are particularly prone to experiencing the negative aspects of LUTS due to their irregular access to toilet facilities. In Taiwan, about 70% of women 25-44 years of age are employed, yet little research on LUTS in the workplace has been conducted. In this article, the development of a Chinese instrument for estimating prevalence of LUTS and identifying factors related to LUTS among employed women is discussed. After instrument-generation and translations, content validity of the instrument was assessed and found to be satisfactory. Following a pilot test, psychometric testing of the instrument (which included test-retest reliability and internal consistency) was conducted. Test-retest reliability for the majority of the items and internal consistency for the construct LUTS were adequate. Based on initial psychometric testing, the authors suggest the instrument is appropriate for use with women in Taiwan. Additional testing is recommended before being used with other populations.

Adaptation, Psychological↗
PubMedDate not supplied

Shaping future directions for incontinence research in aging adults: executive summary.

BACKGROUND: The Center for Gerontological Nursing, School of Nursing, University of Minnesota, as part of the John A. Hartford Foundation's Geriatric Nursing Initiative, convened an invitational nursing research summit on incontinence in St. Paul, Minnesota on October 16-18, 2003. OBJECTIVE: To identify new approaches for conducting urinary and fecal incontinence research in aging adults, identify strategies for reinvigorating and better positioning nursing research on incontinence, and develop recommendations for attracting new nurse investigators to incontinence research and facilitating their research training and mentorship. METHOD: Forty-seven researchers, project officers, clinician leaders, doctoral students, and consumer advocates from the United States, Canada, United Kingdom, Japan, Norway, and Australia attended a 1(1/2) day conference involving trigger talks, reaction papers, and small and large group discussions around broad thematic areas on incontinence research. Recommendations with suggested strategies were derived from the discussion groups. RESULTS: Participants identified issues related to each of the summit objectives and discussed potential strategies to overcome these challenges. Twenty-one recommendations were derived: eleven recommendations focused on new approaches to incontinence research; eight on reinvigorating and repositioning nursing research on incontinence; and two on attracting and mentoring new investigators. CONCLUSIONS: The summit model used effectively engaged an international cadre of researchers and clinicians in stimulating discussions that yielded the identification of strategic directions for conducting and funding incontinence research and strategies for reinvigorating and repositioning nursing research on incontinence.

Aged↗
PubMedDate not supplied

Use of health behavior change theories to guide urinary incontinence research.

BACKGROUND: Urinary incontinence in adults has been the focus of researchers for over 40 years. Health behavior change theories, predominantly operant conditioning, have guided much of the intervention research. In recent years cognitive theories have been used to guide behavioral interventions for urinary incontinence. Most research has focused on individual rather than group or community behavior. Few, if any, health behavior change theories have been tested on population-based interventions. OBJECTIVES: To explore urinary incontinence research guided by health behavior change theories. METHODS: Existing literature on health behavior change theories was analyzed to generate a plan for future research. RESULTS: Gaps in knowledge are identified and discussed and recommendations for future research are made. CONCLUSIONS: The development and testing of new theories will guide the next generation of incontinence researchers and ultimately lead to reducing the incidence and prevalence of incontinence.

Attitude to Health↗
PubMedDate not supplied

Translating research on incontinence into practice.

BACKGROUND: Translating research evidence into clinical practice (TRIP) is an important initiative for health services so that care delivered is cost-effective, is efficient, and improves patient outcomes. Most TRIP studies have reported on disseminating and implementing clinical practice guidelines, protocols, or care pathways and have been undertaken in acute rather than community settings. OBJECTIVES: To identify the factors that influence incontinence TRIP and to present key international studies on incontinence TRIP. METHODS: Existing literature on TRIP was analyzed to generate a plan for future research. RESULTS: Several methods to effect incontinence TRIP are described, including clinical practice guidelines and protocols, clinical pathways, partnerships between organizations, a model for incorporating UI research based on generic questions, and implementation strategies that incorporate change theory and consideration of barriers. CONCLUSIONS: Future research is needed on incontinence TRIP in the following areas: barriers, the best theoretical approaches, the effectiveness of empowerment approaches, the value of mentors, effective strategies for nurses and unlicensed personnel, the impact of international collaboration, and regulations across settings.

Critical Pathways↗
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

Incontinence-associated dermatitis: a consensus.

Incontinence-associated dermatitis (IAD) is an inflammation of the skin that occurs when urine or stool comes into contact with perineal or perigenital skin. Little research has focused on IAD, resulting in significant gaps in our understanding of its epidemiology, natural history, etiology, and pathophysiology. A growing number of studies have examined clinical and economic outcomes associated with prevention strategies, but less research exists concerning the efficacy of various treatments. In the clinical and research settings, IAD is often combined with skin damage caused by pressure and shear or related factors, sometimes leading to confusion among clinicians concerning its etiology and diagnosis. This article reviews existing literature related to IAD, outlines strategies for assessing, preventing, and treating IAD, and provides suggestions for additional research needed to enhance our understanding and management of this common but under-reported and understudied skin disorder.

Clinical Protocols↗