A KNOWLEDGE BASED SYSTEM FOR CONTINENCE

尿失禁问题是老年妇女的一个健康问题，这一群体的尿失禁患病率估计为38%。 尿失禁的研究导致了行为管理策略，可以显着减少尿失禁症状。 有关尿失禁和行为管理策略的信息尚未有效地传达给老年妇女。 因此，有必要沟通什么是已知的尿失禁，并促进无风险的行为管理策略，为妇女的尿失禁问题。 一个很有前途的新方法是以知识为基础的系统形式的基于计算机的健康促进，它可以以方便的方式提供个性化的信息。 本研究提出开发和测试的有效性的知识为基础的系统，在沟通信息的非自愿尿量减少，尿频，尿急，或排尿困难的症状的妇女的健康促进。 为了实现这一目标，候选人将追求一个职业发展计划，包括在设计，开发，建设和基于知识的系统的评估培训。 培训将分三个研究阶段应用于研究：第一阶段;基于知识的系统设计和开发将构建一个基于知识的系统，以提供针对妇女个人需求和风险的信息和建议。 第二阶段;基于知识的系统建设，试点研究和修订将完成可用性和有效性测试，并进行试点研究，以测试程序和仪器与24岁的门诊妇女。 将根据试点研究结果进行修订。 第三阶段：在老年门诊女性中进行基于知识的控制健康促进系统的测试将测试基于知识的控制系统的有效性，比较年龄在55岁或以上的门诊女性（n=165），随机分配到治疗组或等待列表对照组。 将比较各组的症状困扰、排尿频率、尿急发作次数、每晚排尿次数、不自主尿失禁发作次数以及生活质量改善情况。 将对所有结局变量进行重复测量ANCOVA，并对过程变量进行探索性描述性分析，以确定女性是否实际执行了推荐的策略。

Urinary continence problems are a health concern for older women and the prevalence rate of urinary incontinence in this group is estimated at 38 percent. The study of urinary incontinence has resulted in behavioral management strategies that can reduce urinary incontinence symptoms significantly. Information about urinary incontinence and behavioral management strategies has not been communicated effectively to older women. Thus, there is a need to communicate what is known about urinary incontinence and to promote risk-free behavioral management strategies for women with continence problems. A promising new approach is computer- based health promotion in the form of a knowledge-based system, which can provide individualized information in a convenient manner. This study proposes to develop and test the effectiveness of a knowledge-based system in communicating information on continence health promotion to women with symptoms of involuntary urine loss, urinary frequency, urinary urgency, or nocturia. To accomplish this, the candidate will pursue a career development program consisting of training in the design, development, construction, and evaluation of knowledge-based systems. The training will be applied to research in three study phases: Phase 1; Knowledge-Based System Design and Development will construct a knowledge-based system to provide continence promotion information and advice tailored to individual women's needs and risks. Phase 2; Knowledge-Based System Construction, Pilot Study and Revision will complete usability and validity testing, and conduct a pilot study to test procedures and instruments with 24 older ambulatory women. Revisions will be made based on pilot study findings. Phase 3: Test of the Knowledge-Based System for Continence Health Promotion in Older, Ambulatory Women will test the effectiveness of the continence knowledge-based system comparing ambulatory women (n=165), aged 55 years or older, randomized to a treatment group or to a wait-list control group. The groups will be compared on symptom distress, frequency of voiding, number of episodes of urgency, voiding episodes per night, and episodes of involuntary urine loss, and in improving quality of life. Repeated measures ANCOVA will be conducted for all outcome variables and exploratory descriptive analysis will be performed on the process variables to determine whether or not the women actually carried out the recommended strategies.