title: A randomized trial of behavioral management for continence with older rural women.
abstract: Urinary incontinence (UI) is a commonly underreported and underdiagnosed condition. The purpose of this trial was to implement and evaluate behavioral management for continence (BMC), an intervention to manage symptoms of UI with older rural women in their homes. Participants were randomized into BMC or a control group, and 178 were followed for between 6 and 24 months. The intervention involved self-monitoring, bladder training, and pelvic muscle exercise with biofeedback. The primary outcome variable-severity of urine loss-was evaluated by pad test. Secondary variables were episodes of urine loss, micturition frequency, voiding interval, quality of life, and subjective report of severity. Urine loss severity at baseline evaluation was not significantly different in the two groups. But using the generalized linear mixed model analysis, at the four follow-ups, severity of urine loss, episodes of urine loss, quality of life, and subjective report of severity were significantly different. At 2 years the BMC group UI severity decreased by 61%; the control group severity increased by 184%. Self-monitoring and bladder training accounted for most of the improvement. The results support the use of simple strategies based on bladder diaries before implementing more complex treatments.
authors.affiliation: University of North Carolina, Chapel Hill, NC 27599-7460, USA.
authors.forename: Molly C
authors.initials: MC
authors.lastname: Dougherty
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Dwyer
authors.forename: Jane F
authors.initials: JF
authors.lastname: Pendergast
authors.forename: Alice R
authors.initials: AR
authors.lastname: Boyington
authors.forename: Barbara U
authors.initials: BU
authors.lastname: Tomlinson
authors.forename: Raymond T
authors.initials: RT
authors.lastname: Coward
authors.forename: R Paul
authors.initials: RP
authors.lastname: Duncan
authors.forename: Bruce
authors.initials: B
authors.lastname: Vogel
authors.forename: Larry G
authors.initials: LG
authors.lastname: Rooks
mesh_terms: D000368:Aged / Q000523:psychology; D000369:Aged, 80 and over; D001676:Biofeedback, Psychology / Q000379:methods*; D003131:Combined Modality Therapy; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005431:Florida; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D017773:Pelvic Floor; D011788:Quality of Life; D012424:Rural Population; D012648:Self Care / Q000379:methods* / Q000523:psychology; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014039:Toilet Training; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000145:classification / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation*; D014930:Women / Q000523:psychology