Effects of introducing a specialized nurse in the care of community-dwelling women suffering from urinary incontinence.

Research shows that urinary incontinence often remains inadequately treated. Clinicians fail to diagnose the underlying cause or to recommend treatment. In the literature, there are indications that the continence nurses' diagnoses and the treatment advices are beneficial in terms of clinical outcomes. However, the precise short and long term effects are unclear. This study investigates the short and long term effects of the introduction of a continence nurse in the care of community-dwelling women suffering from urinary incontinence. In a cluster randomized study 101 GPs were randomly assigned to the intervention (50 GPs) and control group (51 GPs). Patients visiting their GP in the intervention group received care by the continence nurse. Patients visiting their GP in the control group received usual care. At baseline, after 3, 6 and 12 months data on frequency and volume of incontinence, quality of life, and patient satisfaction were collected.

It is hypothesized that care given by a continence nurse will lead to a reduction in episodes of urinary incontinence and an improvement in quality of life.

N/A

The intervention involved a registered nurse specialized in the care of incontinent patients. Over a period of one year, this nurse advised and guided patients suffering from stress, urge or mixed incontinence. Based on her knowledge and experience, the nurse assessed the patients, using history-taking and postvoid residual urine measurement. the nurse advised the patient about the best treatment, guided by a protocol written by a multidisciplinary team. This protocol presented a management plan including evidence-based interventions for the treatment of stress, urge and mixed incontinence. Also the nurse provided lifestyle and behavioural interventions tailored to the individual patient as well as information about pads. All patients returned after 3,6, and 12 months for follow-up and review of bladder diaries and questionnaires. After each visit, the nurse reported her findings to the patient's GP, who remained responsible for the care of the patient.




Control:

Usual care comprised care delivered by the GP and access to health care workers
in the field of continence care (e.g., physiotherapist, urologist). In most cases
pelvic floor muscle exercises are given by a physiotherapist). Depending on the GP
women are asked to return after 3 or 6 months for follow up.