The Development and Evaluation of an Incontinence Intervention Program for the Elderly Women at Elderly Welfare Center

  • Kim Jeungim (School of Nursing, Soonchunhyang University)
  • Published : 2004.12.01

Abstract

Purpose. The elderly with UI experienced urine leakage for a long time. The prevalence of UI has increased and it makes costly. Particularly, the elderly were reluctant to visit a hospital or a clinic for the reasons of modesty and poverty. To solve this problem, incontinence intervention programs should be provided at the elderly welfare center. The purpose of this research was to develop Incontinence Intervention Program for the Elderly Women (IIPE) and evaluate in its effect. Methods. The study design was quasi-experimental with pre and post-test. The study was performed for ten weeks at one elderly welfare center, Seoul, Korea. The subjects were gathered through an official announcement and informed consent was obtained. IIPE, in this study, was consisted of diagnosis, education, exercise and evaluation. The study variables were PFM exercise adherence, pelvic muscle strength, Continence self-efficacy, geriatric depression and incontinence stress. The effects of the IIPE on PFM exercise adherence, pelvic muscle strength, Continence self-efficacy, geriatric depression and incontinence stress were also evaluated. Results. The mean age of the subjects was 75.2 years. The average attendance was 6.2 times. The IIPE improved PFM exercise adherence, intra-vaginal contraction power and CSE significantly. But it was not significant in incontinence stress and geriatric depression. Other important results were that the two-finger test and urine stream interruption were more useful for elderly women with rigid vaginas in teaching and evaluating. Conclusion. The Findings suggest that IIPE is effective to the community-residing elderly. Further investigation is needed on a long-term basis with control group.

Keywords

References

  1. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A. (2002). Standardization Sub-committee of the International Continence Society. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn, 21(2),167-78
  2. Agency for Health Care Policy and Research (1992). Clinical practice guideline: Urinary incontinence in adults, Rockville, MD: United States Department of Health and Human Services, Public Health Service
  3. Burgio, K.L. Ronbinson, J.C., & Engel, B.T. (1986). The role of biofeedback in Kegel exercise training for stress urinary incontinence. Am. J. Obstet. Gynecol, 154(1), 58-64
  4. Flynn, L., Cell, P., & Luisi, E. (1994). Effectiveness of pelvic muscle exercises in reducing urge incontinence among community residing elders. J Gerontol Nurs, 20(5), 23-27
  5. Herzog, A.P., & Fultz, N.H. (1990). Prevalence and incidence of urinary incontinence in community-dwelling populations. J Am Geriatr Soc, 38, 273-281
  6. Hughes, P., Jackson, S., Smith, P., & Abrams, P. (2001). Can antenatal pelvic floor exercises prevent postnatal incontinence. Neurorol Urodyn, 20(4). 447-448
  7. Ju, Y.H & Kim, J.S. (2000). A study on urinary incontinence of elderly communities. J Korean Comm Nurs, 11(2), 441-452. (in Korean)
  8. Kang, K.J. & Song, M.S. (1997). A study on stress urinary incontinence of community residing elderly women. The Seoul Journal of Nursing, 11(2), 160-174. (in Korean)
  9. Kim, J.I. (2002). Prevalence of urinary incontinence and other urologic symptoms in a community residing elderly, J Korean Acad Nurs, 32(1), 28-39.(in Korean)
  10. Kim, J.I. (2001). Continence Efficacy Intervention Program for community residing women with stress urinary incontinence in Japan, PH N, 18(1), 64-72
  11. Kim, J.I., & Kanagawa, K.(1998). The development of continence self-efficacy scale in urinary incontinence, J of Japan Academy of Gerontol Nurs, 3(1), 72-78. (in Japanese)
  12. Kincade, J.E., Peckous, B.K., & Busby-Whitehead, J.(2001). A pilot study to determine predictors of behavioral treatment completion for urinary incontinence. Urol Nurs. 2(1), 39-44
  13. Mariann Goldstein, M.E. Hawthorne, S. Engeberg, J. McDowell, & Kathryn L. Burgio.(1992). urinary incontinence: why people do not seek help? J Gerontol Nurs, 18(4), 15-20
  14. McCormick, K.A., Scheve, A.A., & Leahy, E. (1988). Nursing management of urinary incontinence in geriatric patients, Nurs Clin North Am, 23, 231-264
  15. Montgomery, E., & Shepherd, A.M. (1983). Electrical stimulation and graded pelvic exercises for genuine stress incontinence. Physiotherapy. 69(4), 112
  16. National Institutes of Health (1990). Consensus Development Conference Statement 1988. Urinary incontinence in adults, 7(5),1-11. Department of Health and Human Services, Public Health and Human Service
  17. Ouslander, J.G., Kane, R.L., & & Abrass, I.B. (1982). Urinary incontinence in elderly nursing home patients, JAMA. 248(10), 1194-1198
  18. Resnick, N.M. (1990). Initial evaluation of the incontinent patient. J Am Geriatr Soc, 38, 311-316
  19. Richard J. Millard (1992). Bladder control: A simple self-help guide, MaClennan & Petty, Australia
  20. Reuben, D.B., Frank, J.C., Hirsch, S.H., McGuigan, K.A., & Maly, R.C. (1999). A randomized clinical trial of outpatient comprehensive geriatric assessment coupled with an intervention to increase adherence to recommendations. J Am Geriatr Soc. 47(3), 269-276 https://doi.org/10.1111/j.1532-5415.1999.tb02988.x
  21. Sampselle, C.M., DeLancey, J.O. (1992). The urine stream interruption test and pelvic muscle function. Nurs Res. 41(2), 73-77
  22. Sartore. A., Pregazzi, R., Bortoli, P., Grimaldi, E., Ricci, G., & Guaschino, S. (2002). The urine stream interruption test and pelvic muscle function in the puerperium. Int J Gynaecol Obstet. 78(3), 235-9 https://doi.org/10.1016/S0020-7292(02)00193-5
  23. Smith, D. A., & Newman, D.K. (1990). Urinary incontinence: a problem not often assessed or treated. Geriatric Care and Rehabilitation, 3(10), 1-8
  24. Song, M.S. (1999). Development and application of urinary incontinence self-management program for community elderly women. The Seoul Journal of Nursing, 13(2), 205-220 (in Korean)
  25. Subak, L.L., Quesenberry, C.P., Posner, S.F., Cattolica, E., & Soghikian, K. (2002). The effect of behavioral therapy on urinary incontinence: a randomized controlled trial. Obstet Gynecol, 100(1), 72-78
  26. Yu, L.C. (1987). Incontinence Stress Index: measuring psychological impact. J Gerontol. Nurs. 13(7). 18-25