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

Figures & data

Table 1 Flow chart of study protocol

Day 0	#NOF surgery
Day 3	Project Research Nurse (PRN): recruited patient to study randomised to intervention or control group (from provided schedule) alerted Research Interviewer for five day post-surgery survey
Day 5	Research Interviewer surveyed patient, blind to study status (intervention or control).
Day 5–6	For each intervention patient, PRN: completed “Bladder and Bowel Management Checklist” for each intervention patient, after pre-surgery and five day post-surgery measures obtained approached relevant staff if patient had continence issues (eg, NUM, ward case manager, OT, PT, dietician, pharmacy) talked to patient about bladder management, using “Waterworks” Booklet as an aid, provided copy of Booklet
Day 6 to discharge	For each intervention patient, PRN: completed Bladder and Bowel Management Checklist updated relevant staff
12-weeks	Research Interviewer surveyed patient, blind to study status
	Study team sent “Waterworks” Booklet to control patients
	Research Nurse completed Medical Record Audit

Table 2 Self-reported incontinence symptoms, pre-surgery, post-surgery and at follow-up, according to treatment group

Storage symptoms	Control (N = 19)			Intervention (N = 15)
	Pre N	Post N	Follow-up N	Pre N	Post N	Follow-up N
Daytime frequency	1	1	0	2	2	1
Night time frequency	6	7	5	7	4	7
Leakage on way to toilet	1	1	0	3	3	2
Leakage physical activity	1	0	0	2	3	1
Leakage unprompted	0	0	0	2	3	2
Irritative symptoms	Pre	Post	Follow-up	Pre	Post	Follow- up
Burning stinging	0	1	0	0	1	0
Urgency	5	6	2	3	3	6
Bladder pain	0	0	0	0	0	0
Voiding symptoms
Faltering stream	0	2	0	3	1	4
Weak stream	0	0	0	1	0	3
Initiation	1	1	0	1	0	1
Retention	2	2	1	2	0	1

Table 3 Self-report of problematic bladder symptoms, pre-surgery, post-surgery and at follow-up, according to treatment group

	Control			Intervention
	Pre N	Post N	Follow-up N	Pre N	Post N	Follow-up N
Day time frequency	2	2	0	2	3	2
Night time frequency	3	5	1	2	4	2
Leakage on way to toilet	3	3	0	2	3	2
Leakage with physical activity etc.	0	0	0	1	2	1
Leakage unprompted	0	0	0	2	3	2
Burning-stinging	0	1	0	0	0	0
Urgency	3	2	1	2	4	2
Faltering stream	0	0	0	0	0	1
Weak stream	0	0	0	1	1	2

Table 4 Summary of incontinence scores and severity indices and hypothesis testing on these indicators, according to time period and treatment group

Incontinence Score	Control			Intervention
	Pre	Post	Follow- up	Pre	Post	Follow- up
N	19	19	19	15	15	15
Mean	3.7	4.6	0.7	7.1	7.8	5.9
Median	0	1	0	1	2	0
Range	(0–18)	(0–22)	(0–5)	(0–46)	(0–40)	(0–50)
Incontinence Severity Index	Pre N	Post N	Follow-up N	Pre N	Post N	Follow-up N
None	12	14	14	5	8	7
Slight	2	1	3	3	1	4
Moderate	3	2	1	4	1	3
Severe	2	1	1	2	4	1
Total	19	18	19	14	14	15
Hypothesis test	Pre-surgery differences	Follow-up differences
Severity Index	p = 0.4	p = 0.2
Continence Score	p = 0.3	p = 0.3

Table 5 Selected items from Bladder and Bowel Management Checklist

Item	Number of patients (N = 21)
Number of times B and B Checklist completed
1–2	7
3 or more	14
Ever experienced urinary incontinence	9
Accurate fluid balance chart started	19
Ever had adequate fluids	21
Ever had special diet	8
Ever had dietitian referral	7