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1.
Nurs Res ; 50(2): 67, 2001.
Article in English | MEDLINE | ID: mdl-11302294
2.
Article in English | MEDLINE | ID: mdl-11005472

ABSTRACT

The aim of this study was to compare pelvic muscle (PM) characteristics (strength, endurance and contractability) before and after 12 weeks of pelvic muscle exercises in two groups of older women: the first composed of women with genuine stress incontinence, and the second made up of women with no symptoms of urinary incontinence or pelvic organ prolapse. This research also investigated the extent to which PM pressure and health-related characteristics could help discriminate between women with and without a clinical sign of PM dysfunction. Within a framework of skeletal muscle fitness, outcome measures were defined and compared. There was no significant difference in the baseline (P = 0.09) and post-PME (P = 0.63) strength, endurance and contractability of the two groups of women. The two groups did differ significantly on change scores (P = 0.05) following PME. A greater improvement in strength for women without a clinical sign of dysfunction was demonstrated. There was a probability of 91% that those with a history of gynecological surgery belonged to the group of women with SUI.


Subject(s)
Exercise Therapy , Pelvic Floor/physiology , Adult , Aged , Female , Humans , Middle Aged
3.
Nurs Res ; 49(3): 121, 2000.
Article in English | MEDLINE | ID: mdl-10882315

Subject(s)
Writing
4.
Comput Nurs ; 17(6): 269-74; quiz 275-7, 1999.
Article in English | MEDLINE | ID: mdl-10609401

ABSTRACT

Designing, implementing, and maintaining a relational database for a complex, longitudinal clinical research project can be the key to the success of a research project. Related issues of data entry, accuracy, confidentiality, security, data analysis, and evaluation of research activities are among the considerations that must be addressed. Our experience with designing a system that was effective and user-friendly to manage the data collected during a 6-year, National Institutes of Health-funded, nursing research project is highlighted. Nurses and other healthcare providers may find our experience with a relational database helpful and applicable to similar clinical research projects.


Subject(s)
Clinical Nursing Research/organization & administration , Database Management Systems/organization & administration , Databases, Factual , Data Collection , Female , Humans , Longitudinal Studies , Models, Nursing , National Institutes of Health (U.S.) , Research Support as Topic , Rural Health , United States , Urinary Incontinence/nursing , Women's Health
5.
J Obstet Gynecol Neonatal Nurs ; 28(6 Suppl 1): 25-33, 1999.
Article in English | MEDLINE | ID: mdl-10608494

ABSTRACT

Approximately 20% of women ages 25-64 years experience urinary incontinence. The symptoms increase during perimenopause, when 31% of women report that they experience incontinent episodes at least once per month. Bladder training and pelvic muscle exercise are the recommended initial treatment and can be taught effectively in the ambulatory care setting. Bladder training enables women to accommodate greater volumes of urine and extend between-voiding intervals. Pelvic muscle exercise increases muscle strength and reduces unwanted urine leakage. Accumulated research results provide evidence-based guidelines for nursing practice. The Association of Women's Health, Obstetric and Neonatal Nurses has identified continence for women as the focus of its third research utilization project. This article presents the rationale, evidence base, and educational strategies compiled by the Research Utilization 3 Nurse Scientist Team. Nurses can enable women to incorporate these noninvasive techniques into self-care.


Subject(s)
Evidence-Based Medicine/methods , Nursing, Team/organization & administration , Urinary Incontinence/epidemiology , Urinary Incontinence/therapy , Adult , Age Distribution , Female , Humans , Incidence , Middle Aged , Nursing Research , Risk Factors , United States/epidemiology , Urinary Incontinence/diagnosis , Urinary Incontinence, Stress/diagnosis , Urinary Incontinence, Stress/epidemiology , Urinary Incontinence, Stress/therapy
7.
Article in English | MEDLINE | ID: mdl-10207763

ABSTRACT

Forty-one women completed the first phase (self-monitoring) of the Behavioral Management for Continence (BMC) intervention, while working with a nurse during home visits to reduce involuntary urine loss as part of the parent study involving older, rural women living at home. A decrease in dietary caffeine intake and an increase in fluid intake were most frequently recommended. The relationship between a decrease in the amount of dietary caffeine consumed and fewer daytime episodes of involuntary urine loss approached significance -P = 0.0744- whereas an increase in the average amount of fluid intake was significantly related to an increase in the average volume of urine voided -P = 0.0479- and not to involuntary urine loss.


Subject(s)
Caffeine/administration & dosage , Drinking , Urinary Incontinence/therapy , Aged , Female , Florida/epidemiology , House Calls , Humans , Life Style , Rural Population , Urinary Incontinence/epidemiology , Urinary Incontinence/prevention & control
10.
Nurs Res ; 47(5): 259, 1998.
Article in English | MEDLINE | ID: mdl-9766452
11.
J Wound Ostomy Continence Nurs ; 25(2): 75-83, 1998 Mar.
Article in English | MEDLINE | ID: mdl-9592469

ABSTRACT

In the past 15 years, research on the effect of pelvic muscle exercise on urinary stress incontinence has contributed substantially to the understanding of the function of the pelvic muscles and the role of pelvic muscle exercise in management of stress urinary incontinence. This literature review addresses pelvic muscle function, pelvic muscle exercise, pelvic muscle exercise training protocols and training aids, changes that result from pelvic muscle exercise, and long-term outcomes of pelvic muscle exercise. Emphasis is placed on results or research that may be used by the clinician with women who experience stress urinary incontinence.


Subject(s)
Exercise Therapy/methods , Pelvic Floor/physiology , Urinary Incontinence, Stress/therapy , Exercise Therapy/standards , Female , Humans , Muscle Contraction , Muscle, Skeletal/physiology
12.
J Gerontol B Psychol Sci Soc Sci ; 52(6): S336-44, 1997 Nov.
Article in English | MEDLINE | ID: mdl-9403527

ABSTRACT

Previous research on race differences in health, we believe, has failed to take into account the initial state of health of the respondents. Other research has demonstrated that elders in poor health are more likely to experience a change in their health over time. It is unclear if the greater probability of decline in health observed among African Americans is a result of being more likely to begin such observations in health states that are worse than those for Whites. This investigation examines declines in health over a 30-month period in a sample of African American and White elders who began the study in similar "good health." Findings support the supposition that African Americans are more likely to report a decline in their health, regardless of the health measure used. Differences by race in the decline of health appear to be a consequence of economic and educational discrepancies between the two groups.


Subject(s)
Black or African American , Health Status , White People , Aged , Female , Florida , Humans , Male , Rural Population , Time Factors , United States , Urban Population
13.
J Obstet Gynecol Neonatal Nurs ; 26(4): 375-85, 1997.
Article in English | MEDLINE | ID: mdl-9252885

ABSTRACT

Approximately 20% of women ages 25-64 years experience urinary incontinence. The symptoms increase during perimenopause, when 31% of women report that they experience incontinent episodes at least once per month. Bladder training and pelvic muscle exercise are the recommended initial treatment and can be taught effectively in the ambulatory care setting. Bladder training enables women to accommodate greater volumes of urine and extend between-voiding intervals. Pelvic muscle exercise increases muscle strength and reduces unwanted urine leakage. Accumulated research results provide evidence-based guidelines for nursing practice. The Association of Women's Health, Obstetric, and Neonatal Nurses has identified continence for women as the focus of its third research utilization project. This article presents the rationale, evidence base, and educational strategies compiled by the Research Utilization 3 Nurse Scientist Team. Nurses can enable women to incorporate these noninvasive techniques into self-care.


Subject(s)
Clinical Nursing Research , Exercise Therapy , Patient Education as Topic , Pelvic Floor , Urinary Incontinence/rehabilitation , Adult , Aged , Evidence-Based Medicine , Female , Humans , Middle Aged , Practice Guidelines as Topic , Premenopause , Self Care , Self-Help Groups , Urinary Incontinence/etiology
14.
J Aging Health ; 9(2): 147-70, 1997 May.
Article in English | MEDLINE | ID: mdl-10182401

ABSTRACT

This investigation was initiated to determine whether older African Americans who live alone are in poorer health than their White counterparts who live under the same circumstances. Data on 5 measures of health were collected in telephone interviews with a stratified random sample of community-dwelling elders (n = 1,189). Analysis of weighted data indicate that there were fewer differences in health by race among older persons who lived alone compared to elders who lived with others. Where racial differences in health did exist among older adults who lived alone, the differences could only sometimes be accounted for by population composition factors that are known to influence health.


Subject(s)
Black or African American , Demography , Health Status , Social Environment , White People , Activities of Daily Living , Aged , Health Surveys , Humans , Rural Population , Socioeconomic Factors , United States , Urban Population
15.
Nurs Res ; 43(3): 164-7, 1994.
Article in English | MEDLINE | ID: mdl-8183658

ABSTRACT

The purpose of the research was to study pelvic muscle changes in the resting phase between voluntary contractions (during pelvic muscle assessment) and in response to pelvic muscle exercise (PME) through secondary analysis of data. The sample consisted of healthy women (N = 38) aged 35 to 54. Analysis of variance showed a significant difference in resting pressure within each assessment (F = 2.92, p < .04). A significant difference in resting pressures within subjects was found (F = 3.54, p < .02). Within-subject variance suggests exercises performed without a warmup may result in incomplete relaxation prior to contraction. Significant change between baseline and Level 1 of the graded PME program suggests slow relaxation of untrained muscles. Increases in resting pressure at Levels 3 and 4 may be a more accurate reflection of muscle hypertrophy. The results of this research indicate that care should be taken in establishing the point from which changes during contractions are measured. It is recommended that the resting pressure be used. Exercise continued for more than 3 or 4 weeks accounts for nearly all strength gains and explains the increases in resting pressure at PME Levels 3 and 4.


Subject(s)
Exercise Therapy , Muscles/physiology , Pelvic Floor/physiology , Rest/physiology , Adult , Exercise Therapy/methods , Female , Humans , Middle Aged , Muscle Contraction/physiology , Muscle Relaxation/physiology , Pressure
16.
J Community Health Nurs ; 11(3): 155-64, 1994.
Article in English | MEDLINE | ID: mdl-7964934

ABSTRACT

Urinary incontinence is a problem for elders in many settings, including rural residential care homes (RCHs). Behavioral techniques for the management of urinary incontinence have been successful with community-dwelling and nursing home populations. A study was undertaken to evaluate the feasibility of implementing bladder diaries and bladder training to assist RCH residents with bladder control. These techniques were found not to be successful in selected rural RCHs. The characteristics of rural RCHs are explored, and the impediments and incentives to the use of behavioral management techniques for urinary incontinence in these settings are examined.


Subject(s)
Behavior Therapy , Homes for the Aged , Nursing Homes , Rural Population , Urinary Incontinence/nursing , Aged , Behavior Therapy/methods , Behavior Therapy/statistics & numerical data , Evaluation Studies as Topic , Female , Florida , Homes for the Aged/statistics & numerical data , Humans , Male , Nursing Assessment/statistics & numerical data , Nursing Homes/statistics & numerical data , Patient Compliance , Rural Population/statistics & numerical data
17.
Psychophysiology ; 30(1): 120-5, 1993 Jan.
Article in English | MEDLINE | ID: mdl-8416056

ABSTRACT

This study validates surface EMG as a measure of pelvic muscle and abdominal activity by showing its high correlation to internal pressure data. Using standardized scores, between-subjects correlation of perineal EMG and intravaginal pressure was r = .75, and the correlation of abdominal EMG and intra-abdominal pressure was r = .72. Discriminant validity was also demonstrated by showing low correlation between standardized abdominal and perineal EMG measurements (r = .10). A repeated measures multivariate analysis of variance demonstrated that visual and auditory biofeedback of EMG during pelvic floor contractions increases intravaginal pressure when compared with trials without biofeedback. Potential benefits of fabric electrodes include reduced invasiveness and risk and the ease with which patients can utilize this technology for home practice.


Subject(s)
Biofeedback, Psychology/instrumentation , Electromyography/instrumentation , Exercise Therapy , Muscle Contraction/physiology , Signal Processing, Computer-Assisted/instrumentation , Vagina/physiology , Abdominal Muscles/physiology , Adult , Female , Humans , Microcomputers , Middle Aged , Reference Values
18.
Nurs Res ; 40(5): 282-5, 1991.
Article in English | MEDLINE | ID: mdl-1896326

ABSTRACT

The wide variation in intravaginal pressure measurements of the circumvaginal muscles (CVM) was studied in five subjects under well-controlled conditions. Previous research and clinical observations have indicated that fluctuations in the measurement of intravaginal pressure may be associated with time of day, day of testing, and existing stress factors. Subjects were assessed four times per day, on four consecutive days, for a total of 16 assessments. At each of the 16 conditions for a given subject, 10 CVM contractions lasting 12 seconds each were recorded and the variables, maximum pressure (MP10), peak maximum pressure (PMP), and abdominal pressure were analyzed. The within-subject variance was 15.5 (SD = 3.9); the between-subject variance was 132.4 (SD = 11.5). The effects of day, time, and stressor were analyzed by ANOVA specifically designed for variance estimates; no significant differences were found. The clinical observations that led to the study were not supported when systematically investigated. However, consistent data collection procedures appeared to reduce within-subject variance.


Subject(s)
Vagina/physiology , Adult , Female , Humans , Manometry , Middle Aged , Muscle Contraction/physiology , Pressure , Sleep Deprivation , Stress, Physiological/physiopathology , Time Factors
19.
J Nurse Midwifery ; 36(4): 221-5, 1991.
Article in English | MEDLINE | ID: mdl-1895170

ABSTRACT

Weakened circumvaginal muscles (CVM) may occur after childbirth and may be associated with obstetric factors such as perineal outcome, episiotomy, length of second stage labor, baby weight, and pushing technique. Pressures developed by the CVM during pregnancy and postpartum were obtained to test the hypothesis that significantly lower pressures would be developed by the CVM in the early postpartum than during pregnancy. The sample consisted of 29 pregnant women who planned to deliver at a birth center. A follow-up study was performed approximately one year after delivery to determine if improvement of the CVM occurred over time. The results supported the hypothesis and indicated that restitution of the CVM occurred after the early postpartum period.


Subject(s)
Muscle Contraction/physiology , Muscles/physiology , Postpartum Period/physiology , Pregnancy/physiology , Vagina/physiology , Adult , Delivery, Obstetric/methods , Female , Follow-Up Studies , Humans , Muscles/injuries , Pressure
20.
Am J Obstet Gynecol ; 164(3): 936, 1991 Mar.
Article in English | MEDLINE | ID: mdl-2003567
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