A KNOWLEDGE BASED SYSTEM FOR CONTINENCE

尿失禁问题是老年女性的健康问题，这一群体的尿失禁患病率估计为38%。对尿失禁的研究已经产生了可以显著减少尿失禁症状的行为管理策略。有关尿失禁的信息和行为管理策略尚未有效地传达给老年妇女。因此，有必要传达有关尿失禁的已知信息，并为有尿失禁问题的女性推广无风险行为管理策略。一种有前景的新方法是以基于知识的系统的形式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。这项研究建议开发和测试一个基于知识的系统在向有非自愿性尿失禁、尿频、尿急或夜尿症状的女性交流有关控制健康促进的信息方面的有效性。为了实现这一目标，应聘者将继续进行职业发展计划，包括设计、开发、构建和评估基于知识的系统的培训。培训将用于三个研究阶段的研究：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，根据妇女个人的需要和风险提供促进大小便失禁的信息和建议。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，并对24名老年非卧床妇女进行试点研究，以测试程序和工具。将根据试点研究结果进行修订。第三阶段：在老年非卧床妇女中测试基于知识的系统以促进持续健康，将测试以可控性知识为基础的系统的有效性，将165名年龄在55岁或以上的非卧床妇女随机分为治疗组和等待名单控制组。这些组将在症状苦恼、排尿频率、紧急发作次数、每晚排尿发作、非自愿尿失禁以及生活质量改善方面进行比较。将对所有结果变量进行重复测量和方差分析，并对过程变量进行探索性描述性分析，以确定妇女是否实际实施了建议的战略。

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.