Continence promotion for older hospital patients following surgery for fractured neck of femur: pilot of a randomized controlled trial.
Evidence suggests that bladder control problems develop or worsen as a result of fractured neck of femur (#NOF) and its subsequent management. The primary aim of this study was to reduce the prevalence and severity of post surgery continence problems among patients, aged from 60-years, undergoing surgery for #NOF, using a best practice "case-management model" multifactorial intervention. Eligible consenting patients admitted with #NOF were randomized to intervention or control group. Self-report questionnaires compared pre-surgery, post surgery, and follow-up continence status between groups. This pilot randomized controlled trial, which included 45 eligible patients aged 60 to 93-years, found no evidence that the intervention was effective in reducing prevalence of post-surgery incontinence in this acute setting. Staff surveys highlighted the need for open communication between the research team and hospital staff. Unclear results were attributed to the small sample size. A central outcome was evidence that intervention to improve continence management for older people post-surgery is imperative. Focused assessment and treatment for those most at risk of incontinence after #NOF would be more acceptable to staff and a more efficient use of resources. A simple screening tool would ensure that those most at risk are detected, and targeted for care.
Parkinson
Lynne
L
Research Centre for Gender, Health and Ageing, Faculty of Health, The University of Newcastle, NSW, Australia. lynne.parkinson@newcastle.edu.au
Chiarelli
Pauline
P
Byrne
Jennifer
J
Gibson
Richard
R
McNeill
Suzanne
S
Lloyd
Gillian
G
Watts
Wendy
W
Byles
Julie
J
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D011182:Postoperative Care; D015397:Program Evaluation / Q000379:methods; D014549:Urinary Incontinence / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*