In-Home Urinary Incontinence Therapy for Female Soldiers

Previous studies have shown that nearly 20% of female soldiers have significant problems with exercise-induced urinary incontinence. Biofeedback is an evidence-based treatment for 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 troop medical center or a medical center. Thus, exercise induced urinary incontinence is a highly prevalent and curable 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 evidence-based 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 providing portable, in-home biofeedback equipment and a 12-week nurse run biofeedback program to 62 female soldiers with exercise induced urinary incontinence. The study aims to compare access to care and patient satisfaction with care for female soldiers receiving biofeedback treatment for urinary incontinence in the home setting with results from those who previously received biofeedback treatments in the troop medical clinic or medical center environment. Data from 62 prospective and approximately 124 retrospective female soldiers treated with biofeedback for urinary incontinence will be used to address the following hypotheses:

For female soldiers with exercise-induced urinary incontinence:

1. treatment obtained in the home environment will significantly increase realized access to care compared to treatment obtained at the troop medical clinic or the medical center; and
   
   
   
   
2. patient satisfaction will be significantly higher when treatment is received in the home environment and lower when treatment is received at the troop medical clinic or the medical center.
   
   

Descriptive statistics will be used to summarize central tendency and data dispersion. Pretreatment differences in demographic and descriptive information will be compared using ANOVA or Kruskal-Wallis ANOVA for Ranks (continuous variables) or chi-square (categorical variables) to evaluate the similarity of the groups.

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 evidenced-based treatment for exercise-induced urinary incontinence and to evaluate the effect of increased potential access on actual access for this group of female soldiers.