Abstract
BackgroundThe aim of this study was to evaluate whether community-based nurse-led continence care interventions are effective in improving outcomes for adult Chinese primary care patients with lower urinary tract symptoms (LUTS).Research Design and SubjectsA case-controlled intervention study was conducted. An intervention group of 360 primary care patients enrolled into a nurse-led continence care programme were recruited by consecutive sampling. A control group of 360 primary care patients with LUTS identified by screening were recruited from the waiting rooms of primary care clinics by consecutive sampling. Both groups were monitored at baseline and at 12 months.MeasuresOutcome measures included symptom severity, health-related quality of life (HRQOL), self-efficacy, global health and self-reported health service utilization at 12-months. The effect of the continence care programme on symptom severity and HRQOL was assessed by the difference-in-difference estimation, using independent t-test and multiple liner regression. Chi-square test was used to compare the self-efficacy, global health and self-reported health service utilization between the two groups at 12-months.ResultsAfter adjusting for baseline severity and socio-demographics, the intervention group had significant improvements in LUTS severity (P<0.05) and HRQOL (P<0.05). Improvements in the amount of urine leakage were not significantly different between the two groups. A higher proportion of subjects in the intervention group reported increased self-efficacy (43.48% vs. 66.83%), improved global health condition (17.74% vs. 41.5%), having doctor consultation (18.5% vs. 8.06), having medication due to LUTS (26.50% vs.11.29%) and having non-drug therapy due to LUTS (59.5% vs.9.68%).ConclusionsCommunity-based nurse-led continence care can effectively alleviate symptoms, improve health-related quality of life, and enhance self-efficacy and the global health condition of Chinese male and female primary care patients with LUTS.
Highlights
As a result of population ageing and shifts in patient needs, there has been an increased demand for chronic disease management delivered in the community
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
Such delivery models are currently in their infancy in Asia, with little established evidence for its efficacy or effectiveness. In their 2008/2009 Policy Agenda, the Hong Kong SAR Government announced plans to enhance primary care and introduce new initiatives to strengthen support for chronic disease management. One of these was the introduction of Nurse and Allied Health Clinic Continence Care services (NAHC-CC), which have been established within the government-funded General Outpatient Clinics (GOPC) of the Hospital Authority (HA) of Hong Kong
Summary
As a result of population ageing and shifts in patient needs, there has been an increased demand for chronic disease management delivered in the community. Such delivery models are currently in their infancy in Asia, with little established evidence for its efficacy or effectiveness In their 2008/2009 Policy Agenda, the Hong Kong SAR Government announced plans to enhance primary care and introduce new initiatives to strengthen support for chronic disease management. One of these was the introduction of Nurse and Allied Health Clinic Continence Care services (NAHC-CC), which have been established within the government-funded General Outpatient Clinics (GOPC) of the Hospital Authority (HA) of Hong Kong. A control group of 360 primary care patients with LUTS identified by screening were recruited from the waiting rooms of primary care clinics by consecutive sampling.
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