The addition of coaching to cognitive strategies: interventions for persons with compromised urinary bladder syndrome

Compromised urinary bladder syndrome (CUBS) is defined as urinary frequency (UF) and/or urinary incontinence (UI) sufficient to be a problem. This term is an expansion of separate mainstream concepts referring to UF and UI, because the new term entails both phenomena considered at one time. Cognitive strategies (CS) offer one way to enhance the effectiveness and implementation of behavioral interventions directed to assist persons with CUBS. Two hypotheses predicted that persons receiving bladder health information would show less improvement on the outcomes than those receiving CS only or those receiving CS plus coaching after adjusting for type of UI. Secondly, persons receiving CS only would show less improvement on the outcomes than those receiving CS plus coaching. Data were collected at 3 time points, and the outcomes measured were comfort, bladder function, incidents of UF/UI (as recorded by participants in a diary), and perception of health. Neither hypothesis was fully supported. However, persons receiving information and information with CS plus coaching improved on comfort and UI/UF; all groups increased on bladder function; and perception of health did not change in any of the groups. Explanations for the mixed findings are proposed. In general, these findings support the application of conservative, noninvasive cognitive interventions innovatively applied through the use of pamphlets and audiotapes to help persons with CUBS experience increased comfort and improved bladder function. Implications for clinical practice are to provide a two-tiered intervention: education followed by CS with coaching if needed to enhance bladder function. A nursing role (as coaching) to augment specific interventions for CUBS is supported and should be differentiated for persons with symptoms of urgency.