258 - A post-market, cluster randomized controlled trial of the effect of a TENA Smart Care Change Indicator on continence care efficiency and skin health in nursing homes.
Notice bibliographique
Résumé
Hypothesis / aims of study Urinary incontinence (UI) is a highly prevalent condition in older residents of nursing homes. In many it cannot be cured, and management consists of achieving contained incontinence by using appropriate products (pads) maintained by toileting and a check and change regimen; this is often poorly managed [1] . The application of digital health technology devices, like urine saturation sensors, in pads may aid appropriate use of these pads, ensure timely change and improve the quality of delivery of continence care 2 , 3 . This study examined the efficacy and safety of the use of the TENA Smart Care Change Indicator (Change Indicator) device for nursing home residents with UI who were dependent on one or more caregivers to change the pad. Study design, materials and methods Methods: Cluster randomised controlled trial of device use in older nursing home residents with UI unable to consistently indicate their needs for toileting, compared to usual care. The co-primary outcomes were care efficiency, the weighted sum of pad checks, pad changes, toilet visits, clothes changes and linen changes (due to pad leakages), divided by the number of recorded diary days for each resident, reported as an average of the daily scores and change in skin health. Secondary resident and caregiver outcomes were also compared. Results Results: Fourteen sites were recruited, nine of which operated routine check and change regimens. Included care units comprised 108 residents, 53 in the intervention group and 49 in the usual care group, and 83 caregivers (31 usual care, 52 intervention). The median age of residents was 87 (range 59 to 101) years and 21.5 % were male. The change in weighted mean score in care efficiency was reduced (improved) by 30 min/day in the intervention group and 16 min/day in the usual care group (p>0.05). There was no statistically significant difference between groups in change in skin health. There were statistically significant between group improvements in sleep quality and total absorbency of pads used, favouring device use. One device related harm, related to skin health, was reported. Other secondary outcomes are shown in the table. Interpretation of results This comparative pragmatic trial of a device designed to improve the delivery of continence care to older residents of nursing homes resulted in reductions in time spent in continence care by 69 min/day, or a 31% reduction. There was no deterioration in skin health. Given that the study failed to demonstrate its primary outcome, it is difficult to assess the clinical relevance of device use, but use allows more control over efficient delivery of continence care. The reduction in pad use and in the number of sleep interruptions are valuable outcomes. A longer-term implementation and efficacy study is warranted to further investigate the impact of use. Concluding message use of the TENA Smart Sensor device was associated with non statistically significant improements in the efficiency of continence care delivery. Use of the device may well facilitate more predictable continence care. Further work is warranted Download: Download high-res image (165KB) Download: Download full-size image Figure 1 . Table 1. Between group change in secondary outcome variables Funding Essity Hygiene and Health AB Clinical Trial Yes Registration Number ClinicalTrials.gov NCT05247047 RCT Yes Subjects Human Ethics Committee Health Research Ethics Board of University of Alberta (Canadian arm) and the Ethics Committee of the German Society for Nursing Science(German arm). Helsinki Yes Informed Consent Yes
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,004 | 0,002 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,002 |
| Communication savante | 0,001 | 0,002 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,003 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,015 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».