Promoting urinary continence in people suffering a stroke: Effectiveness of a complex intervention-An intervention study.

The study was a single-centre, non-randomised before-after intervention, with patients assigned to control or intervention by study phase rather than random allocation. Only 46 patients were included (35 control, 11 intervention), and the planned 44 per group was not achieved. The intervention group started with worse urinary incontinence and a lower Incontinence Quality of Life Social Embarrassment score than the control group. Very few intervention-group patients had 3-month follow-up data (4 for continence, 3 for quality of life). The intervention was complex, including training, screening, assessment, individualized treatment, communication, and evaluation, so the effect of any single component cannot be separated. Self-care ability improved in both groups, but the between-group difference was not significant, so the study does not show an effect on independence. Nurse time and cost-effectiveness were not established; descriptive time was higher in the intervention group, but no significant group difference over time was observed. Patients' lived experiences were not evaluated. The Discussion says nurse time was significantly higher, while the reported group comparisons were not significant.

The authors declared no competing interest. The sponsor was Eastern Switzerland University of Applied Sciences.

Do not conclude that this continence programme has been proven to work in stroke rehabilitation. The study was small and nonrandomized, the intervention group had worse continence at admission, and several components were delivered together, so the contribution of any single part cannot be separated.