From Passive Subjects To Well-Informed Active Participant: The Impact Of A Citizens' Jury On Urinary Incontinence Self-Management

Study design, materials and methods The design comprised a quasi-experimental, prospective cohort study, utilising a Citizens Jury approach,(1) with two repeated measures (questionnaires) of post-learning behaviours, one immediately following the 3.5-hour education session and another at 3 months. Study participants were elderly women, recruited through widely-posted advertisements: newspapers, a relevant foundation, continence clinics and a pre-established research bank of potential participants. Inclusion criteria required that the participants be elderly women (60 or older), ambulatory, present with UI symptoms (stress, urge or mixed) for 3 consecutive months during the past 12 months, give informed consent, and agree to complete the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI9) (2) and a 3-day bladder diary. Participants were excluded if they had medical problems, functional impairments or co-morbidities that could have interfered with the jury process. The 3-day bladder diary had to be returned to the research team on the day of the Citizens Jury to confirm the presence, type and severity of UI, which was initially determined through the ICIQ-UI9. The 1-day Citizens Jury was divided into two 3.5-hour sessions. The results below are specific to the first 3.5-hour session, which comprised a brief introduction; an interactive, multidisciplinary educational presentation; and an evaluation. UI experts (1 urogynaecologist, 1 physiotherapist, 1 radiologist and 2 urologists) presented the latest evidence-based literature on UI outcome measures and interventions (3): 1) UI measurement tools, 2) UI lifestyle interventions and physical therapies, 3) incontinence pessaries, 4) UI medications, and 5) UI surgeries. Each presentation was followed by a 15-minute discussion segment in which participants were invited to ask questions. In the evaluation component, participants completed 1) a learner satisfaction questionnaire and 2) a learning behaviour questionnaire designed to identify newly-acquired knowledge or behaviours that the learner wants or intends to employ. Three months later, a follow-up learning behaviour questionnaire was mailed to each participant to determine the participant’s actions and progress (i.e., behaviours adopted) in relation to managing their incontinence problem.