Continence promotion for older hospital patients following surgery for fractured neck of femur: Pilot of a randomized controlled trial

Original Research

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Authors: Lynne Parkinson, Pauline Chiarelli, Jennifer Byrne, Richard Gibson, Suzanne McNeill, et al

Published Date January 2007 Volume 2007:2(4) Pages 705 - 714

DOI: http://dx.doi.org/10.2147/CIA.S1302

Lynne Parkinson^1,2, Pauline Chiarelli³, Jennifer Byrne¹, Richard Gibson¹, Suzanne McNeill⁴, Gillian Lloyd⁵, Wendy Watts⁶, Julie Byles¹

¹Research Centre for Gender, Health and Ageing, Faculty of Health, The University of Newcastle, NSW, Australia; ²Hunter Ageing Research, Faculty of Health, The University of Newcastle, NSW, Australia; ³Faculty of Health, The University of Newcastle, NSW, Australia; ⁴NC Trauma Orthopedics, John Hunter Hospital, New Lambton Heights, NSW, Australia; ⁵Hunter New England Health, Wallsend Community Health Centre, Wallsend, NSW, Australia; ⁶Royal Newcastle Centre, John Hunter Hospital, New Lambton Heights, NSW, Australia

Abstract: 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.

Keywords: urinary incontinence, prevention, management, fractured neck of femur, hip surgery, randomized controlled trial, elderly