Improving Soldier Access to Urinary Incontinence Therapy

Previous studies have shown that nearly one third of female soldiers have significant problems with exercise induced urinary incontinence. The use of biofeedback for treatment of urinary incontinence in female soldiers has shown that (a) biofeedback is very effective for treatment of exercise-induced urinary incontinence, and (b) most soldiers simply can not get the required biofeedback treatments because their jobs make it difficult to seek continued care at a medical center. Thus, exercise induced urinary incontinence is a highly prevalent problem for which female soldiers can not get effective treatment due to access to care barriers.

This proposed study represents the investigation of an innovative health care delivery intervention that may be successful in alleviating some of the problems related to access to care for female soldiers with exercise-induced urinary incontinence. This will be accomplished by increasing the availability of portable biofeedback equipment and a trained biofeedback nurse in the troop medical clinic environment. The study aims to compare access to care for female soldiers receiving biofeedback treatment for urinary incontinence in the troop medical clinic environment with those receiving similar treatments at a medical center.

The hypotheses are: For female soldiers with exercise-induced urinary incontinence:

(1) treatment obtained at the troop medical clinic will significantly increase actual access to care compared to treatment obtained at the medical center; and

(2) patient satisfaction will be significantly higher when treatment is received at the troop medical clinic and lower when treatment is received at the medical center.

Descriptive statistics will be used to summarize central tendency and dispersion and to identify variables that are not normally distributed. Pretreatment differences in demographic and descriptive information will be compared using t-tests (continuous variables) or chi-square (categorical variables) to evaluate the similarity of the groups. The Mann-Whitney U test will be used instead of the t-test for any variable that departs significantly from normality.

The proposed study has military significance and is very important to nursing because it is a direct attempt to increase potential access to a successful treatment for exercise-induced urinary incontinence and to evaluate the effect of increased potential access on actual access for this group of female soldiers.