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A Clinical Trial of a Behavioral Therapy to Reduce Urinary Incontinence in Nursing HomesOutcome and Implications
Teh-wei Hu, PhD;
Jessie F. Igou, DrPH, RN;
D. Lynne Kaltreider, MEd;
Lucy C. Yu, PhD;
Thomas J. Rohner, MD;
Patrick J. Dennis, MD;
W. Edward Craighead, PhD;
Evan C. Hadley, MD;
Marcia G. Ory, PhD
JAMA. 1989;261(18):2656-2662.
Abstract
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One hundred thirty-three incontinent women in seven nursing homes were assigned randomly to a 13-week behavior therapy program for urinary incontinence or to a control group that received usual incontinence-related care. The therapy became effective after 6 weeks of training. By the final month of training, the treatment women's wet episodes had been reduced by 0.6 episodes per day, a 26% reduction over baseline. This reduction in the number of wet episodes was statistically significant, both with respect to this group's baseline levels of incontinence and in comparison with the performance of the control women. The number of wet episodes in the control group remained about the same throughout training and the 22-week follow-up period. The treatment women improved partly because they learned to request help, a response prompted and reinforced by the program. Trainees with a high frequency of incontinence during baseline, the more cognitively intact residents, and residents with normal bladder capacity responded better to this behavior therapy program.
(JAMA. 1989;261:2656-2662)
Author Affiliations
From the Department of Social and Administrative Health Sciences, School of Public Health, University of California, Berkeley (Dr Hu); the Nursing Practice Center, Pennsylvania Nurses Association, Harrisburg (Dr Igou); the Institute for Policy Research and Evaluation (Ms Kaltreider) and the Departments of Health Planning and Administration (Dr Yu) and Urology (Drs Rohner and Dennis), Pennsylvania State University, and Hershey Medical Center (Drs Rohner and Dennis), Hershey, Pa; the Department of Psychiatry, Duke University Medical Center, Durham, NC (Dr Craighead); and the Geriatrics Branch (Dr Hadley) and Social Science Research on Aging, Behavioral and Social Research Program (Dr Ory), National Institute on Aging, Bethesda, Md.
Footnotes
Reprint requests to Department of Social and Administrative Health Sciences, School of Public Health, University of California, Berkeley, CA 94720 (Dr Hu).
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