COST EFFECTIVENESS EVALUATION OF BLADDER TRAINING

这项研究将评估膀胱训练疗法的成本效益。 基于行为改变原理治疗尿失禁 在老年人中。使用的程序是增加液体摄入量， 促使人们按规定的时间间隔上厕所， 加强适当的如厕行为。 该项目的目标是(1)评估心理社会、健康和 老年人尿失禁的资源成本，(2)测量 膀胱训练疗法的临床疗效，(3)确定 影响治疗效果的因素；(4)比较 带管理的膀胱训练疗法的成本和效果 这并不是基于膀胱训练。 该项目将基于一项随机对照试验，其中175 宾夕法尼亚州中部三到四家养老院的居民将被 随机分配到膀胱训练组或对照组。 那些表现为尿失禁的人将接受泌尿科检查 包括身体检查，包括骨盆和直肠检查， 神经学评估，留置尿管和 膀胱计量学研究。大部分的研究设计，招募方案， 膀胱训练方案和器械已经在我们的 目前的初步研究。 膀胱训练的效果将用三个指标来衡量 结果。第一个是大小便失禁患病率的变化 每天或每周大小便失禁发作的频率，在此之前， 在治疗过程中和之后。第二个衡量标准是 通过身体表现的个人、身体和心理功能 评估，如健康状况、肤色、气味、体力活动、 以及心理压力水平。第三个结果衡量标准是 护理尿失禁所需的资源。这些 资源是根据所花费的人小时数和 在该时间段内使用的供应品。这项研究的结果将 为护理专业人员、决策者、 还有老年人。

The study will assess the cost-effectiveness of a bladder training therapy based on principles of behavior change for treating urinary incontinence among elderly persons. The procedures used are increasing fluid intake, prompting individuals to toilet at regularly scheduled intervals, reinforcing appropriate toileting behavior. The aims of the project are to (1) estimate the psychosocial, health, and resource costs of urinary incontinence among the elderly, (2) measure the clinical effectiveness of a bladder training therapy, (3) identify those factors which influence the effectiveness of the therapy, and (4) compare the cost and effectiveness of the bladder training therapy with management which is not based on bladder training. The project will be based on a randomized controlled trial in which 175 residents of three to four nursing homes in central Pennsylvania will be randomly assigned to either a bladder training group or a control group. Those exhibiting urinary incontinence will undergo a urological examination consisting of physical examination including pelvic and rectal examination, neurological evaluation, catheterization for residual urine and cystometrogram study. Much of the research design, recruiting protocol, bladder training protocol, and instrumentation have been refined in our current pilot study. The effectiveness of the bladder training will be measured with three outcomes. The first is changes in the prevalence of incontinence in terms of the frequency of incontinence episodes per day or per week, both before, during, and after the treatment program. The second measure is changes in personal, physical and psychological functioning expressed through physical assessment, such as health status, skin color, odor, physical activities, and psychological stress levels. The third outcome measure is changes in the required resources needed for the care of urinary incontinence. These resources are measured in terms of person hours spent and the amount of supplies used over the time period. The findings of this study will provide significant information for nursing professionals, policymakers, and the elderly.