Continence for women: a test of AWHONN's evidence-based protocol in clinical practice. Association of Women's Health Obstetric and Neonatal Nurses.
OBJECTIVE
To test the effectiveness of an evidence-based protocol for urinary incontinence in increasing identification of women with the condition and improving their outcomes.


METHODS
Prospective formative evaluation study.


METHODS
Twenty-one public, private, and other women's health care sites.


METHODS
Women in ambulatory care settings (N = 1,474) provided descriptive statistics. Clinical outcomes were tested in 132 cases for whom pre- and posttreatment data were available.


METHODS
Standardized screening and baseline follow-up forms were used to minimize time burden on clinicians; bladder and pelvic floor muscle training materials were provided to clinicians for distribution.


METHODS
Self-reported frequency, volume, and quality of life related to incontinence and cost of self-management were used to assess protocol effectiveness.


RESULTS
Frequency of incontinence episodes, estimated volume lost per episode, and the cost of self-management decreased. Quality of life improved, as reflected in decreased bother attributed to incontinence and in the number of women avoiding activities such as shopping, exercising, or travel because of incontinence.


CONCLUSIONS
This simple program of pelvic floor muscle and bladder training, as it has been systematically implemented in a variety of ambulatory women's health care settings, has benefited women's continence status. The results of this project strongly support widespread application.
Sampselle
C M
CM
University of Michigan, School of Nursing, Ann Arbor 48109-0482, USA. csampsll@umich.edu
Wyman
J F
JF
Thomas
K K
KK
Newman
D K
DK
Gray
M
M
Dougherty
M
M
Burns
P A
PA
D000328:Adult; D019317:Evidence-Based Medicine; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014342:Truth Disclosure; D014549:Urinary Incontinence / Q000175:diagnosis* / Q000451:nursing / Q000628:therapy*