COST EFFECTIVENESS EVALUATION OF BLADDER TRAINING

这项研究将评估膀胱训练疗法的成本效益 基于治疗尿失禁的行为改变原则 在老年人中。 使用的程序是增加液体摄入量， 促使人们定期如厕， 加强适当的锻炼行为。 该项目的目的是（1）估计心理社会，健康， 老年人尿失禁的资源成本，（2）测量 膀胱训练疗法的临床有效性，（3）确定那些 影响治疗效果的因素，以及（4）比较 膀胱训练疗法的成本和效果与管理 这不是基于膀胱训练。 该项目将基于随机对照试验，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。 那些表现出尿失禁将接受泌尿科检查 包括体格检查，包括盆腔和直肠检查， 神经学评估，残余尿导管插入术， 膀胱测量图研究。 大部分的研究设计，招募协议， 膀胱训练协议，和仪器已经完善，在我们的 目前的试点研究。 膀胱训练的有效性将通过三个 结果。 首先是尿失禁患病率的变化， 每天或每周失禁发作的频率，之前， 在治疗过程中和治疗后。 第二项措施是 个人的、身体的和心理的功能通过身体的 评估，如健康状况，肤色，气味，身体活动， 和心理压力水平。 第三个衡量结果是 尿失禁的治疗方法有哪些？ 这些 资源是以花费的人时和 在这段时间内使用的用品。 这项研究的结果将 为护理专业人员，决策者， 和老年人。

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.