This proposal is a resubmission with revision and clarifications; it seeks to continue the aims of an earlier project which has been refined with substantive improvement in measurement and procedure during its first three years. Specifically, 550 community living women self described as having uncontrolled urine loss and/or excessive day toileting such that they would wet themselves otherwise will comprise the diagnostic sample. Subjects will be 21 years of age or older, independent in self-care, and able to contract the pelvic muscles. Appropriate exclusion criteria will be met. The sample will be comprehensively evaluated via history, physical, intake/output diary, urinalysis, vaginal smear, urodynamic evaluation (uroflowmetry, cystometry, urethral/bladder pressures), pad test, and pelvic muscle measures (clinical and vaginal myography). Research questions will be explored with the diagnostic data. Major impetus to these questions is relevance to Nursing Practice, and development of useful and needed clinical measures. A minimum of 220 subjects from the diagnostic phase will enter the treatment program if they have a diagnosis of stress or mixed incontinence, negative urinalysis, and do not meet appropriate exclusion criteria. Subjects will be randomly assigned to one of four groups: (1) Resistive pelvic muscle exercise and urine control health promotion, (2) Active pelvic muscle exercise and urine control health promotion, (3) urine control health promotion, and (4) urine control monitoring (Self-Insight). Treatment protocols are five months in length with monthly measures for groups 1-3. Post-treatment measures include urodynamic and pelvic muscle measures. Groups 1 and 2 will be evaluated and compared to groups 3 and 4. This behavioral treatment trial evaluates interventions within the domain of Nursing.
| Krause, Carolyn; Wells, Thelma; Hughes, Susan et al. (2003) Incontinence in women: effect of expectancy to regain control and severity of symptoms on treatment outcomes. Urol Nurs 23:54-61 |
| Chiverton, P A; Wells, T J; Brink, C A et al. (1996) Psychological factors associated with urinary incontinence. Clin Nurse Spec 10:229-33 |
| Mayer, R; Wells, T J; Brink, C A et al. (1994) Correlations between dynamic urethral profilometry and perivaginal pelvic muscle activity. Neurourol Urodyn 13:227-35 |
| Brink, C A; Wells, T J; Sampselle, C M et al. (1994) A digital test for pelvic muscle strength in women with urinary incontinence. Nurs Res 43:352-6 |
