ABSTRACT
INTRODUCTION: Urinary incontinence is a frequent condition in women; it is estimated that it affects between 10% and 30% of women. The most common types are stress, urgency and mixed incontinence. It is a fact that this condition affects their quality of life. OBJECTIVE: To assess the benefits of applying an integrated and standardized nursing intervention on women with a slight or moderate degree of stress, urge or mixed urinary incontinence. DESIGN: Randomized, controlled clinical trial. LOCATION: Area 6 of primary care in Madrid. PARTICIPANTS: 256 women, 128 per group. INTERVENTION: Systematized care plan for the intervention group (IG) and conventional plan for the control group (CG), depending on urinary incontinence type. RESULTS: 59% of the total sample participated; 103 participants were followed: 48 from the IG (37.5%) and 55 from the CG (42.9%). The average difference in urine loss before and after intervention was 5.7 g (n = 22) for the IG, as opposed to 1.8 g (n = 27) for the CG; this reduction was not significant (p = 0.12), 95% CI [-1.09 - 8.92]. IU degree changes were assed by means of the Sandvik scale and were grouped in "women that improved or cured" and "women that remained the same or got worse" after interention. 40.5% of the women in the IG improved or cured, as opposed to 21% of the women in the CG (p = 0.059). CONCLUSIONS: both care plans showed their efficiency to improve UI in this group of women. The mentioned improvement was greater in the IG than in the CG, with clinically relevant differences. The fact that some of the women gave up the project during the follow-up determined a power reduction of the study.
Subject(s)
Urinary Incontinence/nursing , Female , Humans , Middle AgedABSTRACT
Introducción: La incontinencia urinaria es un problema frecuente en la mujer, se estima que entre el 10% y el 30% la padecen. Los tipos más comunes son la incontinencia de esfuerzo, de urgencia y mixta. Es un hecho probado que afecta a la calidad de vida. Objetivo: Evaluar los beneficios derivados de la aplicación de una intervención de cuidados enfermeros, integral y estandarizada en mujeres con incontinencia de esfuerzo, urgencia o mixta, de grado leve o moderada. Diseño: Ensayo clínico aleatorizado y controlado. Emplazamiento: Atención Primaria, área 6. Madrid Participantes: 256 mujeres, 128 por grupo. Intervención: Plan de cuidados sistematizado para el grupo de intervención y plan convencional para el grupo control. Resultados: La tasa de participación fue del 59%, se siguieron 103, 48 en el grupo de intervención (37,5%) y 55 en el grupo control (42,9%). La diferencia promedio del volumen de pérdidas antes y después de la intervención fue, en las mujeres del grupo de intervención 5,7g (n = 22), frente a 1,8 g (n = 27) en las del grupo control, no siendo esta reducción significativa (p = 0,12), IC al 95% [- 1,09/8,92]. Los cambios producidos en el grado de la IU se valoraron a través de la escala de Sandvik y se agruparon en: mujeres que se curaron o mejoraron y mujeres que permanecieron igual o empeoraron después de la intervención. Mejoran o se curan el 40,5% en el grupo de intervención frente al 21% del grupo control (p = 0,059). Conclusiones: ambos planes de cuidados se han mostrado eficaces para mejorar la IU de este grupo de mujeres. Ésta ha sido de mayor cuantía en el grupo intervención que en el control, con diferencias clínicamente relevantes. Las pérdidas de mujeres en el seguimiento, condicionó la potencia del estudio
Introduction: Urinary incontinence is a frequent condition in women; it is estimated that it affects between 10% and 30% of women. The most common types are stress, urgency and mixed incontinence. It is a fact that this condition affects their quality of life. Objective: To assess the benefits of applying an integrated and standardized nursing intervention on women with a slight or moderate degree of stress, urge or mixed urinary incontinence. Design: Randomized, controlled clinical trial. Location: Area 6 of primary care in Madrid. Participants: 256 women, 128 per group. Intervention: Systematized care plan for the intervention group (IG) and conventional plan for the control group (CG), depending on urinary incontinence type. Results: 59% of the total sample participated; 103 participants were followed: 48 from the IG (37,5%) and 55 from the CG (42,9%). The average difference in urine loss before and after intervention was 5.7 g (n = 22) for the IG, as opposed to 1.8 g (n = 27) for the CG; this reduction was not significant (p = 0.12), 95% CI [-1.09 8.92]. IU degree changes were assed by means of the Sandvik scale and were grouped in women that improved or cured and women that remained the same or got worse after interention. 40.5% of the women in the IG improved or cured, as opposed to 21% of the women in the CG (p = 0.059). Conclusions: both care plans showed their efficiency to improve UI in this group of women. The mentioned improvement was greater in the IG than in the CG, with clinically relevant differences. The fact that some of the women gave up the project during the follow-up determined a power reduction of the study
Subject(s)
Female , Humans , Urinary Incontinence, Stress/nursing , Nursing Care/methods , Clinical Trials as Topic , Case-Control StudiesABSTRACT
OBJECTIVES: To study the epidemiology and the social and health repercussions of urinary incontinence (UI) in women aged between 40 and 65. DESIGN: Observational and descriptive cross-sectional study.Setting. Area 6 of primary care (PC) in Madrid. PARTICIPANTS: Sample of 485 women aged between 40 and 65, obtained by randomised sampling of the census of health cards, stratified by the three kinds of health districts (rural, urban and peri-urban). MAIN RESULTS: Mean age was 52, with 15.4% prevalence of UI (2.6% stress, 10.6% urge and 2.1% mixed). In the multivariate logistic regression, association with the number of vaginal deliveries (OR = 2; 95% CI, 1.2-3.1) and with constipation (OR = 2.5; 95% CI, 1-6) was found. CONCLUSIONS: The prevalence found situates UI as a relevant problem in the population under study. Most women had not consulted the doctor on the problem. Several associated risk factors could be prevented, which justifies the setting-up within PC of coordinated programmes of UI education and prevention for this group of women.
Subject(s)
Urinary Incontinence/epidemiology , Adult , Aged , Cross-Sectional Studies , Female , Humans , Middle Aged , Multivariate Analysis , Prevalence , Random Allocation , Risk Factors , Spain/epidemiology , Surveys and QuestionnairesABSTRACT
Objetivos. Estudiar la epidemiología y la repercusión sociosanitaria de la incontinencia urinaria (IU) en mujeres entre 40 y 65 años de edad. Diseño. Observacional, descriptivo y transversal. Emplazamiento. Área 6 de Atención Primaria (AP) de Madrid. Participantes. Muestra de 485 mujeres entre 40 y 65 años de edad, obtenida por muestreo aleatorio del censo de la tarjeta sanitaria, estratificada por los tres tipos de distritos sanitarios (rural, urbano y periurbano).Resultados principales. La media de edad fue de 52 años, con una prevalencia de IU del 15,4 por ciento (un 2,6 por ciento de esfuerzo, un 10,6 por ciento de urgencia y un 2,1 por ciento mixta). En el análisis de regresión logística multivariante se encontró una asociación con el número de partos vaginales (odds ratio [OR] = 2; intervalo de confianza [IC] del 95 por ciento, 1,2-3,1) y el estreñimiento (OR = 2,5; IC del 95 por ciento, 1-6). Conclusiones. La prevalencia encontrada sitúa la IU como un problema relevante en la población estudiada. La mayoría no ha consultado por el problema. Varios de los factores de riesgo asociados se pueden prevenir, lo que justifica la puesta en marcha de programas coordinados de educación y prevención de la IU en este grupo de mujeres y en el marco de la AP (AU)
