A KNOWLEDGE BASED SYSTEM FOR CONTINENCE

尿失禁问题是老年妇女的健康问题，这一群体的尿失禁患病率估计为38%。对尿失禁的研究产生了行为管理策略，可以显著减少尿失禁症状。关于尿失禁和行为管理策略的信息没有有效地传达给老年妇女。因此，有必要交流关于尿失禁的知识，并促进对有尿失禁问题的妇女的无风险行为管理策略。以知识为基础的计算机健康促进系统是一种很有前途的新方法，它可以方便地提供个性化的信息。本研究旨在开发并测试一套以知识为基础的系统，对有失禁、尿频、尿急或夜尿症状的女性进行失禁健康宣传的有效性。为了实现这一目标，候选人将参加一个职业发展计划，包括知识系统的设计、开发、构建和评估方面的培训。培训将分三个阶段应用于研究：第一阶段；以知识为基础的系统设计与开发将建立一个以知识为基础的系统，提供针对女性个体需求和风险的促进失禁的信息和建议。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名老年流动妇女进行试点研究，以测试程序和仪器。将根据初步研究结果进行修订。第三阶段：基于知识的系统对老年、门诊妇女失禁健康促进的测试将测试基于知识的系统的有效性，比较55岁及以上的门诊妇女（n=165），随机分配到治疗组或等候名单对照组。将比较两组患者的症状窘迫、排尿频率、尿急次数、每晚排尿次数、非自愿尿失次数以及生活质量的改善。将对所有结果变量进行重复测量ANCOVA，并对过程变量进行探索性描述性分析，以确定妇女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.