The effectiveness of nurse-led continence care services for primary care patients with LUTS

Abstract

INTRODUCTION: The aim of this study was to evaluate the effectiveness of a primary care nurse-led continence care service for adult patients with LUTS. METHODS: A prospective longitudinal study was conducted. An intervention group of 360 primary care patients enrolled into the Nurse and Allied Health Clinic (NAHC) Continence Care services of the Hospital Authority were recruited by consecutive sampling. Patients enrolled in the programme received an initial assessment such as uroflowmetry, pelvic floor muscle strength and post-void residual urine estimation. Subsequent interventions were protocol-based and included conservative measures which were tailored to each patient according to the type of LUTS being experienced. Interventions included pelvic floor muscle exercise, diet modification, bladder training and urethral massage for male patients. A control group of 360 primary care patients with LUTS identified by screening were recruited from the waiting rooms of General Out-patient Clinics. Both groups were monitored at baseline and at 12 months. Outcome measures included International Prostate Symptom Score, Incontinence Impact Questionnaire-7, Patient Enablement Instrument and Global Rating of Change Scale. RESULTS: Independent t-test showed that, at 12 months, the intervention group had greater improvements in LUTS severity (P<0.05) and HRQOL (P<0.05) than the controls. Chi-square test showed that a higher proportion of the intervention group subjects reported increased self-efficacy (43.48% vs. 66.83%, P<0.05) and improved general health (17.74% vs. 41.5%, P<0.05). DISCUSSION: Our findings support that the NAHC Continence Care services are effective in alleviating symptoms, improve HRQOL, and enhancing self-efficacy and general health in patients with LUTS.