Purpose: The objective of this study was to evaluate the effects of a urinary incontinence management program for middle aged women living in a rural area. Method: The research design was a one-group pretest-posttest design. Forty eight women with urinary incontinence aged 40-64, who lived in a rural area were included in the study. The urinary incontinence management program was composed of urinary incontinence education, pelvic floor muscle exercise, behavior management using a voiding diary. The program had three weekly sessions. Knowledge about urinary incontinence, physical symptoms, self-efficacy, and urinary incontinence related quality of life were measured before and after the program. Results: After carrying the urinary incontinence management program, knowledge score improved significantly compared to before the program ($6.31{\pm}3.30$ vs $7.77{\pm}2.55$, p=.01). But the score for self-efficacy, and urinary incontinence related quality of life did not improve. Conclusion: The 3 week urinary incontinence program had an effect on knowledge related to urinary incontinence, but not self efficacy nor urinary incontinence related quality of life. Thus further study is required to better evaluate the effects of the urinary incontinence program.
The Journal of Korean Academic Society of Nursing Education
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v.9
no.1
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pp.51-63
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2003
The purpose of this study was to identify the prevalence of urinary incontinence of community residing climacteric women, and to identify the relationship between urinary incontinence and quality of life. The subjects of this study were 156 women(45 to 59 years old). Data was collected from Sep. 1 to Dec. 1 2002 by an interview or self-reporting by a structured questionnaire. The questionnaire was composed of items of general characteristics, urinary characteristics, and conditions of urinary incontinence, using the modified Henderickson's stress incontinence scale(1981), and the quality of life scale developed by RO, You Ja(1988). The data was analyzed by the SPSS/WIN program using descriptive statistics, Pearson correlation coefficients, t-test and AVOVA. The results of the study were as follows : 1. The prevalence of urinary incontinence was 76.3%. Of the incontinent women, 42.0% had experienced urinary incontinence for a period of one to three years. Frequency of urinary incontinence was once or twice per day for 42.9% of the urinary incontinent women. Most of the participation with urinary incontinence(91.6%) had mild leakage of urine. In the whole urinary incontinent women, 70.6% had never treated or managed their urinary incontinence. Most of the subjects(79.8%) were mildly incontinent, and the prevalence of moderate and severe urinary incontinence was 20.2%. The mean scores among the items of urinary incontinence, in descending order, were increase of abdominal pressure($1.45{\pm}1.05$), coughing($1.16{\pm}0.93$), and sneezing($1.03{\pm}0.92$). 2. The average score in the level in the quality of life variables was 3.12. The urinary incontinence and quality of life were correlated negatively(r=-0.103, p<0.001). 3. There were statistically significant differences in the score of climacteric woman's self reported quality of life according to : amount of urinary incontinence(F=12.68, P=0.001), duration of urinary incontinence(F=6.97, P=0.009), number of urinary incontinence(F=4.77, P=0.03), existence of urinary incontinence(t=148, P=0.05). In conclusion, this study was a preliminary study to provide nursing practice guidelines for climacteric woman with urinary incontinence. Nurses working with climacteric woman should develop and provide adequate care for the incontinent climacteric subjects. In future research, it is recommended to identify comprehensive factors related to urinary incontinence, including the effective management of urinary incontinence.
The purpose of this study was to help the women with stress urinary incontinence lead more comfortable life, by letting them to do pelvic muscle exercise and to learn by direct experience the effect that urinary incontinence is controlled. The research design was a one-group pretest-posttest design. The subjects were 16 middle-aged women(over 38) with stress urinary incontinence. The study was conducted from August 1, to October 11, 1999. Women trained themselves for muscular strength and endurance, every the other day for each exercise for six weeks at home(that means each exercise for more than three days a week) in the pelvic muscle exercise program which was developed by Dougherty et al., and filled out exercise participation card every week. They visited laboratory once a week to get visual feedback, by means of Perineometer, of how the pelvic muscle exercise was going on. Stress Urinary Incontinence Scale that Lee, Young-Sook revised and supplemented Hendrickson's original scale was used for measuring the frequency and situation scores of urinary incontinence, "30 minute pad test" was carried out for measuring the amount of urinary incontinence, and Perineometer was used for measuring maximum vaginal contraction pressure. Percentage, mean, standard deviation and Wilcoxon signed ranks test were used for data analysis by means of SPSS/PC+ WIN 9.0 program. The results were summarized as follows : The hypothesis 1 that after carrying out pelvic muscle exercise program on women with stress urinary incontinence, the weekly degree of urinary incontinence would reduce compared to before the exercise was supported. The hypothesis 1-1 that after carrying out pelvic muscle exercise program on women with stress urinary incontinence, the weekly frequency of urinary incontinence would reduce compared to before the exercise was supported (p=.003). The hypothesis 1-2 that after carrying out pelvic muscle exercise program on women with stress urinary incontinence, the situation scores of urinary incontinence would reduce compared to before the exercise was supported(p=.044). The hypothesis 2 that after carrying out pelvic muscle exercise program on women with stress urinary incontinence, the amount of urinary incontinence would reduce compared to before the exercise was supported(p=.001). The hypothesis 3 that after carrying out pelvic muscle exercise program on women with stress urinary incontinence, the maximum vaginal contraction pressure would increase compared to before the exercise was supported (p=.012). These results suggest that pelvic muscle exercise program has an effect on women with stress urinary incontinence in the degree and amount of urinary incontinence and maximum vaginal contraction pressure. So it is judged that training women with stress urinary incontinence for pelvic muscle exercise is an effective nursing intervention strategy in order to care urinary incontinence.
To assess calcium and sodium and urinary excretion of preschool children in Busan and to evaluate the relationship of intakes of food and nutrient with urinary calcium excretion, calcium and sodium food frequencies of 25 common foods affecting intakes of calcium and sodium per week, nutrient intake by 24hr recall and 24hr urinary calcium and sodium excretion were measured with 97 preschool children. The mean calcium intake was 436.11mg and below RDA. The mean sodium intake was 1890.11mg. The mean urinary calcium and sodium excretion were 42.88mg and 735.25mg respectivery. The mean urinary calcium/creatinine ratio was 0.20. The urinary calcium excretion showed positive significant correlations with weight, intake frequency of pizza consumed per week and urinary sodium excretion (p<0.05, p<0.05, p<0.001). The urinary calcium excretion per milligram of creatinine showed positive significant correlations with intake frequencies of pizza and common squid consumed per week(p<0.01, p<0.05) and negative correlation with intake frequencies of pizza and common squid consumed per week(p<0.01, p<0.05) and negative correlation with age(p<0.05). No significant relations were found between urinary calcium and intakes of calcium, protein and phosphorus. Urinary sodium was found to be the most important determinant of urinary calcium excretion. Intake frequency of pizza consumed per week was found to be the most important determinant of urinary calcium excretion per milligram of creatinine. Based on the results, urinary calcium excretion was related to intake frequency of pizza consumed per week and urinary sodium excretion. Low calcium intake and increase of calcium loss in the urine potentiated by sodium intake during growth may reduce peak bone mass. So nutritional education is needed in order to increase calcium intake and decrease sodium intake, especially from food like pizza.
Pulmonary function is the determinant of blood gas tension. However, Acid-Base disturbances can also alter partial pressures of oxygen and carbon dioxide in arterial blood. During respiratory acidosis $PO_2$ will be lowered and reverse changes will be produced during respiratory alkalosis. On the other hand, in metabolic acidosis $PO_2$ will be elevated and $PCO_2$ will be lowered by the respiratory compensation, and reverse response will be induced in metabolic alkalosis. Urinary gas tension has many influencing factors than arterial blood and difficult to estimate the tendency of its alterations. Urinary $PO_2$ and $PCO_2$ are not always identical level as venous blood. It is to be altered by blood gas tension, flow rate of urine, metabolic rate of kidney, and Acid-Base status of blood. Particularly countercurrent exchange of oxygen and carbon dioxide in the renal medulla will make larger alteration of gas tension than venous blood. After induction of Acid-Base disturbances [disturbances] arterial and urinary $PCO_2$, $PO_2$, urinary volume, and osmolarity were determined in dogs, and the relationships between arterial and urinary $PCO_2$ , $PO_2$ Acid-Base disturbances, urinary volume, and osmolarity were investigated. 1. During the acute Metabolic and Respiratory disturbances urinary pH did not respond on respiratory origin. However, there were immediate urinary response in pH on metabolic origin. 2. Urinary $PO_2$, $PCO_2$, did not always follow arterial or venous gas tension and Acid-Base disturbance. Urinary $PCO_2$, correlate well with the urinary volume. The larger the urinary volume, $PCO_2$ lowered to the venous level. The smaller the urinary volume, urinary $PCO_2$ tends to be higher. However urinary $PO_2$ did not have any particular correlation with urinary volume. 3. Correlation between urinary $PCO_2$ and $PO_2$ were inversely proportional to arterial blood. Differences of $PCO_2$ between arterial blood and urine also did not have any particular correlation with urinary volume. This may suggest that changes on blood gas tensions can influence on urinary $PCO_2$. 4. There were eminent clear inverse correlation between urinary $PCO_2$ and osmolar concentrations of urine. Above results strongly suggest that partial pressure of gas in urine primarily depend upon counter-current exchanges in renal medullary tissues.
This study was performed to investigate the use of urinary catecholamines to monitor changes in the activity of the sympathetic nervous system and to determine the relationship of urinary cortisol and catecholamines in Japanese Shorthorn cows in response to social isolation. One cow was isolated from its group, which consisted of 14 cows (457 to 756 kg BW, 2 to 12 years old), for three days. The isolated cow was in contact with the other cows visually only at meal times. This isolation was repeated for 6 cows. Spontaneously voided urine samples were collected from the experimental animals once a day, before the treatment and on days 1, 2, and 3. Urinary cortisol and adrenaline levels were significantly increased compared with pre-isolation levels on the first day, and then declined to the basal levels during the next two days. Urinary noradrenaline levels changed in the same way as cortisol and adrenaline levels, but the difference was not significant. Urinary cortisol levels tended to be correlated with those of urinary adrenaline, but not noradrenaline. This study suggests that the urinary adrenaline levels can be a non-invasive indicator of stress and that the change of urinary adrenaline is similar to that of urinary cortisol.
Purpose: This study was conducted to investigate the factors that affect the severity of urinary incontinence and the quality of life of women with urinary incontinence. Methods: An exploratory correlation research design was applied and the sixty women who responded that they currently experience involuntary urine leakage at least once per week were invited to participate in the study. Results: According to the study results, the factors that significantly contribute to the severity of urinary incontinence were age, number of parity, and number of normal deliveries. Other influencing factors, such as obesity, menopausal state, hysterectomy, and number of episiotomies, were not significant to predict the severity of urinary incontinence. Urinary incontinence frequency per week and duration of experiencing urinary incontinence were shown to be factors that significantly affect quality of life. Conclusion: In women above 60 years old, multiparity, and multiple experiences of vaginal delivery tended to present a higher level of severity of urinary incontinence. In addition, women with higher frequencies of urinary incontinence per week and a longer duration of urinary incontinence showed a lower level of quality of life.
Purpose: The purpose of this study was to analyze the relationship between lower urinary tract symptoms and urodynamic parameters to investigate the characteristics of mixed urinary incontinence (MUI) and stress urinary incontinence (SUI). Methods: The subjects were 318 women with MUI and 128 women with SUI. Data were collected retrospectively from electronic medical records including Bristol Female Lower Urinary Tract Symptoms-Scored Form (BFLUTS-SF), Incontinence Quality of Life Instrument (I-QOL), voiding diaries, and urodynamic parameters. Results: Compared with the SUI group, the MUI group was older and showed lower I-QOL and more severe urinary tract symptoms. The MUI group had more urinary frequency, more nocturia, and a higher urgency score than the SUI group. In the correlation analysis, the greatest difference between the two groups was that urgency was associated with Qmax, maximal cystometric capacity, and detrusor overactivity only in the MUI group (r = -.175, p= .004; r = -.281, p< .001; r= .232, p< .001, respectively). Conclusion: As a result of this study, we propose that a customized management program that emphasizes the control of urgency for the MUI group, and one that effectively strengthens the weak pelvic floor for the SUI group.
Song, Young Ae;Lee, Jung Hee;Jung, Ji Young;Kim, Nan Ji;Yang, Yi Eun;Shin, Chae Won;Cho, Moon Suk
Journal of Korean Clinical Nursing Research
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v.22
no.2
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pp.132-141
/
2016
Purpose: The aims of this study were to develop and apply the urinary elimination facilitation program for stroke patients with urinary disorders and evaluate the effectiveness of the program. Methods: This study was conducted using the non-equivalent control group pre- posttest design. The participants included 23 patients in the control group and 22 in the experimental group. Data were collected from Nov. 25, 2013 to Nov. 25, 2014 in acute rehabilitation inpatient wards. For the final analysis, 35 patients' data were utilized 17 in the control group and 18 in the experimental group. The developed urinary elimination facilitation program was continued for 7 days and the program consisted of logging urination, monitoring timely voiding, assisting urinary elimination, and stimulating urination using sound. The data were analyized using the SPSS-win (version 21). Results: The number of urinary catheterization and the urinary discomfort were significantly improved in the experimental group compared to the control group. However residual urine and the occurrence of urinary tract infections were not significantly different between the experimental and control groups. Conclusion: The results of this study indicated that the urinary elimination intervention program for stroke patients with urination disorder could be useful in decreasing the number of urinary catheterization and the urinary discomfort.
Purpose: Although the 24-hours urinary copper excretion is useful for the diagnosis of Wilson disease (WD), there are practical difficulties in the accurate and timed collection of urine samples. The purpose of this study was to verify if the spot morning urinary Copper/Zinc (Cu/Zn) ratio could be used as a replacement parameter of 24-hours urinary copper excretion in the diagnosis of WD. Methods: A cross-sectional study was conducted at the Department of Pediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from June 2019 to May 2021 on 67 children over three years of age who presented with liver disease. Twenty-seven children who fulfilled the inclusion criteria for WD were categorized into the test group, and the remaining forty children were considered to have non-Wilsonian liver disease and were categorized into the control group. Along with other laboratory investigations, spot morning urinary samples were estimated for the urinary Cu/Zn ratio in all patients and were compared to the 24-hour urinary copper excretion. The diagnostic value of the Cu/Zn ratio was then analyzed. Results: Correlation of spot morning urinary Cu/Zn ratio with 24-hours urinary copper excretion was found to be significant (r=0.60). The area under ROC curve with 95% confidence interval of morning urinary Cu/Zn ratio measured using 24-hours urine sample was 0.84 (standard error, 0.05; p<0.001). Conclusion: Spot morning urinary Cu/Zn ratio seems to be a promising parameter for the replacement of 24-hours urinary copper excretion in the diagnosis of WD.
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