Prompted Voiding Treatment of Urinary Incontinence in Nursing Home Patients: A Behavior Management Approach for Nursing Home Staff
ABSTRACT This study evaluated a treatment procedure in which 126 incontinent nursing home patients were checked on an hourly basis, asked if they needed toileting assistance (prompted), and socially reinforced for appropriate toileting. Urodynamic analysis (including cystometrogram), provocative stress test, and behavioral assessment revealed that the nursing home patients were severely debilitated, with 65% demonstrating bladder abnormalities, 87% incapable of independent toileting, and 25% failing to score on the Mini-Mental Status Exam (average score, 8.0). The treatment procedures were evaluated with a multiple baseline design in which subjects were randomly divided into immediate or delayed treatment groups after a baseline observation period. During treatment, the frequency of incontinence per 12 hours changed from a baseline average of 3.85 to a treatment average of 1.91. Three behavioral measures that can be easily collected by nursing staff significantly predicted continence levels during treatment (multiple R, 0.79) and change in incontinence during treatment (multiple R, 0.64). These prognostic criteria offer nursing staff a cost-effective method for selecting the most responsive patients for prompted-voiding treatment.
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ABSTRACT: We investigated the occurence and causes of anaemia and other haematological abnormalities in 142 elderly patients (43 men, 99 women; median age 79 and 80 years), admitted to long-term care. Healthy 81-year-old subjects (n = 220) were used as reference group. Anaemia according to the WHO definition was much more common in the studied population (41%) than in a representative sample of 81-year-old subjects (10%). Somatically fit patients were less often anaemic (30%) than those with somatic illness (68%). The main causes for anaemia were: chronic disease (14.9%), recent haemorrhage (7.8%), iron deficiency (5.7%); and often multifactorial. Secondary leuko- or thrombocytosis occurred in 14 and 23%, drug-induced thrombocytopenia in 2.8% of the patients. Anaemia and other haematological abnormalities seen in elderly patients hospitalized for long-term care are often secondary to chronic or acute disorders. However, they also occur in patients without severe somatic impairment and many of them are reversible. Such findings should therefore not be neglected, but properly investigated, and if possible treated.Archives of Gerontology and Geriatrics 05/1992; 14(3):263-72. DOI:10.1016/0167-4943(92)90026-Z · 1.53 Impact Factor
- Tijdschrift voor Verpleeghuisgeneeskunde 06/2006; 31(3):100-105. DOI:10.1007/BF03075160
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ABSTRACT: Examined the effects of staff performance feedback delivered by a supervisor verbally and combined with written feedback on 47 geriatric nursing assistants' (GNAs) completion of assigned prompted voiding (PV). The basic staff management system included GNA self-monitoring of their performance of PV, periodic supervisory monitoring, and verbal and graphic feedback provided to all GNAs on their performance. The system later included letters of praise or disapproval sent bi-weekly to all GNAs based on their performance of the PV procedure. Also, a letter was sent to all GNAs every 3 mo summarizing their performance during this period. Although individual verbal feedback alone resulted in acceptable maintenance of PV, the addition of written feedback produced significant improvements in the number of assigned PV completed. Results display the utility and practicality of using formalized staff management procedures in nursing homes. (PsycINFO Database Record (c) 2012 APA, all rights reserved)Journal of Organizational Behavior Management 01/1992; 13(1):137-150. DOI:10.1300/J075v13n01_09 · 1.23 Impact Factor