February 2020 Wound and Ostomy Journal
Prevalence of urinary and faecal incontinence in men and women with chronic low back pain
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Bethany Sobesto 4/7/2020
ReplyDeleteDescribe the method used by the author of the study.
A cross-sectional cohort study was conducted at Out Patient Rehab Services, Bendigo Health. It was done from January 2013 to January 2014 using adults 18 and over who attended the musculoskeletal rehab or pain clinics. The patients were asked to complete a questionnaire about their pain and urinary incontinence or fecal incontinence, if those chose to participate. The data from this study were compared to the study of the Australian community dwelling population, from 2006.
Discuss the limitations of the article.
A limitation of the article is that there may have been selection bias. The patients with bladder and bowel incontinence symptoms may have been more likely to participate in the research project than patients who did not have symptoms. Also, MDs may have encouraged patients with bladder or fecal incontinence to participate. In this way the MD can create a selection bias. Another limitation is that the accuracy of reporting may have been poor due to patient's poor literacy. A third limitation is the small subgroup sizes.
ReplyDeleteARTICLE 3: Prevalence of urinary and faecal incontinence in men and women with chronic low back pain
1. What are the advantages and disadvantages to the proposed recommendations in the article?
It is mentioned in the article about implementing early treatment. This an eye-opening article for the clinicians that will bring awareness of the problem thereby that may lead to an early inpatient education regarding management strategies and this is to the patients' advantage. Clinicians may include prompt routine screening of patients for bladder and bowel symptoms. Raising the topic provides patients the opportunity to access assistance for symptoms of pelvic floor disorders. Enabling timely and appropriate intervention should reduce the magnitude of the personal and societal burden of pelvic floor disorders.
2. Discuss the limitations of the article: limited sample size, design flaws, and/or author bias
One of the limitations of this is due to inflated bias.
The results may not be representative of the prevalence of these symptoms in the care-seeking, chronic pian population.
The other limitation is its size. A sample size that is too small reduces the power of the study and increases the margin of error, which can render the study meaningless or less significant for conclusion.
Stephanie Smith (9/1.2020)
ReplyDelete1. Discuss the sample size in this study.
This sample size is 81 patients who self enrolled into the study.
2. Discuss the limitations of the article:
There is a very limited sample size, which won't give you a good picture of what is happening on a wide scale.
This comment has been removed by the author.
ReplyDeleteDiscuss the sample size used in the study:
ReplyDeleteThe sample size of this study consisted of 81 participants out of 1584 from the Outpatient Rehabilitation Services, Bendigo Health of Australia. The rehab center was for those in need of musculoskeletal rehab or pain clinic. Of the 81 participants, 29 were men and 52 were women, all of which were 18 years of age or older. From the sample of women, the median age was 58 years with a range from 26-83 years. From the sample of men, the median age was 59 years with a range from 33-83 years.
Describe the method used by the author of the study:
The method used was a cross-sectional cohort study within the Outpatient Rehabilitation Services between January 2013 and January 2014. Participants whom had chronic pain to any part of their body from the rehab center volunteered to participate in the study. Recruiting participants was obtained through invitation from treating health care professionals and public display of study in common waiting rooms within the rehab center. However, those patients from the pelvic floor and continent clinic were not recruited. Healthcare workers followed a specific script for recruiting participants. Those participants whom volunteered to be apart of the study, filled out a questionnaire. The questionnaire collected demographic information, which body part had chronic pain, and the presence of urinary and fecal incontinence. The severity and burden level of urinary incontinence was measured via the Urinary Distress Inventory Short Form. The presence of involuntary loss of stool was measured using the Wexner/Cleveland Clinic Faecal Incontinence Score. The questionnaire was anonymous in its form and did not have any participant identification information. To keep anonymity, questionnaires were dropped off by participants in secure post box.
How does this research article compare to our practice, policy and/or procedure?
ReplyDeleteWhile this article recommends that clinicians consider the use of a screening tool for incontinence in patients with chrnc low back pain, we at PSJMC do not routinely screen for incontinence or conditions that might contribute to it. I would go so far as to say that we often do not explore causes of incontinence in our patients, usually just cleaning them without truly investigating the cause. Perhaps part of this lies in the fact that incontinence is still considered a "taboo" subject that can create a barrier between open & honest communication about symptoms and causes.
Discuss the sample size used in the study.
A total of 81 participants were enrolled in the study, in addition they were all outpatient clinic patients, all diagnosed with lower back pain. Urinary incontinence of reported by over half of the participants, and was almost three times as much Australia's national average. In addition, fecal incontinence was reported by 48% of the participants, while the national average is only 8%. It can therefore be concluded that lower back pain and incontinence share a common link. However, this is a comparatively small sample size, and a larger sample should be considered for further testing.