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Learning Objective 1: The learner will be able to state the issues related to the translation of evidence into practice in culturally-appropriate care.
Learning Objective 2: The learner will be able to discuss specific points that warrant attention when providing behavioral interventions in Chinese populations.
Prompted voiding (PV) is a behavioral modification used to teach people with or without cognitive impairment to initiate their own toileting through positive reinforcement from caregivers. PV has been found to be an effective continence maintenance measure in Western countries. No publications have been found to date on the use and effect of PV in Asia. This paper reports on cultural differences observed in the use of an evidence-based protocol for prompted voiding.
Methods
Fifty-two nursing home residents recruited from five nursing homes were randomly allocated to experimental and control groups. Each participant was measured four times (T0a and T0b – double baselines, T1 – twelve weeks post-intervention, and T2 – six months post-intervention). Staff training was provided until all staff members were verified to be proficient in delivering the protocol. Data about the staff’s proficiency in maintaining PV over time were also collected.
Results
In the implementation of the PV protocol, the most frequently forgotten items included: (i) asking whether the participants had been to the toilet in the previous two hours; (ii) reminding the participants that they will be back again in two hours, and (iii) asking the participants three times if the latter said that they did not want to go to the toilet when approached. The staff were uncomfortable with showing mild disapproval when the residents were unable to maintain continence (which is part of the protocol). Moreover, some residents disliked being asked three times whether they would like to go to the toilet when they had already stated that they did not need to go.
Conclusion
The findings are useful to both nursing home residents and their families, as well as to long-term care staff when adopting PV to promote continence. This paper provides important information about the use of PV in Chinese culture.