Overactive Bladder Clinical Trial
Official title:
The Effect of a Counseling and Training Program on the Treatment of Women With Overactive Bladder
The study concluded that HLSB training reduced OAB symptoms among women, improved the quality of their lives, changed their HLSBs, and positively affected their mental states. Thus, a holistic approach to the treatment of women with OAB increased the success of the treatment.
The population of this study included all women who received treatment in the Urogynecology
Outpatient Clinic of the Gynecology and Obstetrics Department in İstanbul Faculty of Medicine
at İstanbul University between January 2015 and October 2016. Permission was obtained for the
study from the Ethics Committee of İstanbul University Cerrahpaşa Faculty of Medicine and
İstanbul University İstanbul Faculty of Medicine. The study sample included 100 women
diagnosed with OAB syndrome. Of them, 50 were selected for the intervention group and 50 were
selected for the control group.
Detailed information was given to the women beginning pharmacological treatment who met the
inclusion criteria, and their consent was obtained using an Informed Voluntary Consent Form.
During the pharmacological treatment, anticholinergic drugs, which contained active
ingredients such as tolterodine 4 mg/day, trospium cl 60 mg/day, fesoterodine 4-8 mg/day, and
solifenacin 5 or 10 mg/day were prescribed. The women in each group were instructed to take
the prescribed anticholinergic drugs regularly, informed about the side effects of these
drugs, and advised on the situations when they should seek immediate treatment before their
next scheduled appointment. The women with OAB were divided into groups using random
allocation (by drawing lots). To set an equal distribution of patients into the intervention
and control groups, the group of the first patient was determined by lot, and the next
patient was allocated to the other group.
The control group was not provided with training. In addition to the pharmacological
treatment, the intervention group was provided with a counseling and training program that
consisted of a 45-minute presentation based on Pender's Health Promotion Model. Within the
scope of the counseling and training program, the patients were given information about the
female reproductive system, anatomy and physiology of the urinary system, OAB definition, OAB
symptoms, and HLSBs (adequate fluid intake, diet, prevention methods for urinary tract
infections, weight control, regular bowel movements, smoking cessation, treatment of chronic
diseases, and regular medication). The patients were informed about the importance of
concentration, learning about pelvic floor muscle contraction and exercises and performing
them regularly, as well as designing bladder training programs and sticking to them to manage
urgency and urinary incontinence. They were also given "A Manual for Training on Healthy
Lifestyle Behaviors among Women with Overactive Bladder". Figure 1 shows the HLSB development
based on Pender's Health Promotion Model in OAB treatment.
The intervention group was requested to follow a weekly-scheduled bladder training program,
keep records on the Urinary Diary form for six weeks, and bring this form at the end of each
week. The researcher called each patient 8-10 times: every week during the first six weeks
and once a month afterwards to encourage implementation of the practices for three months
starting from the first interview. During the phone calls, the patients were asked about
their drug use, average daily fluid intake, and any concerns as well as state of performing
pelvic floor muscle contraction and exercises, sticking to the scheduled bladder training
hours, and weight loss. The data obtained through these calls were recorded on the Practice
Registration Form. The control group, on the other hand, was called once a month and
instructed to continue taking their drugs, which was also recorded on the form.
In the first interview and in the third month, the women in the intervention and control
groups were administered the Introductory Information Form, Urinary Diary (4-day), 24-hour
Standard Pad Test, Overactive Bladder Questionnaire (OAB V8), King's Health Questionnaire
(KHQ), Healthy Lifestyle Behavior Scale II (HLSB II), and Brief Symptom Inventory (BSI). In
addition, an Inspection Form was administered in the third month.
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