Urinary Incontinence UI has been identified as a common problem of health

Urinary Incontinence (UI) has been identified as a common problem of health and further, its occurrence intensifies not only with functional impairment but also with age (Engberg and Sereika, 2016). According to Engberg and Sereika (2016), Gorina and colleagues in data analysis on the prevalence of UI reported 43.8 percent of older adults (community-dwelling) stated having involuntary urine loss while 24 percent stated having moderate to austere UI. More so, 40.2 percent of recipients of home health care stated having a hard time controlling their bladder. In homebound older adults, what is the effect of a biofeedback-taught pelvic floor muscle training (PFMT) intervention on urinary incontinence (UI) reduction and enhancing general UI- specific and health-linked life quality compared with nonhomebound older adults? Therefore, as explained by Gorina et al. (2014), UI presents an enormous financial weight not only to the person affected but also to the society as a whole; that is, United States (U.S) in this case. The UI cost in the U.S amongst the older individuals was approximated at 19.5 billion U.S dollars in 2000 with community residents incurring 14.2 billion U.S dollars while institutional residents incurring 5.3 billion U.S dollars (Gorina et al., 2014). More so, between 50 and 75 percent of the yearly cost of UI in 2010 was attributed to resources utilized for routine care and management of UI. As explained in Gorina et al. (2014), there are various comorbidities associated with UI which include mobility and cognitive impairment and chronic illnesses such as stroke and diabetes. Hence, comparing the effect of PFMT intervention between and within nonhomebound and homebound older adults is also important since studies scrutinizing the PFMT’s effectiveness are more inadequate in older individuals than in younger individuals. Three Facts (Knowledge) the Quantitative Research Article Added on the Topic There are various facts the quantitative research article added on my knowledge on the topic as regards the effectiveness of PFMT intervention between and within nonhomebound and homebound older adults. One of the facts, as stated in the discussion section, encompasses the improvement of UI. According to Engberg and Sereika (2016), in spite of the considerably higher functional impairment rates and more austere UI at reference points in the nonhomebound and homebound participants, there was no significant difference in PFMT’s effectiveness between the two categories. The two categories of individuals accomplished considerable decreases in voids and episodes per day. Hence, Engberg and Sereika (2016) found out the utilization of PFMT intervention can decrease the UI for homebound older adults by 64.5 percent. However, in as much as the variance was not significant statistically at the 6-week PFMT intervention end, a lower proportion of homebound subject was continent than the nonhomebound subjects (15.1 percent vs. 23.8 percent). The second fact encompasses the outcomes of the scrutiny of the reported self-adherence to the recommended or suggested PFMT schedule at each visit of intervention as stated in the article’s discussion section. As explained in Engberg and Sereika (2016) the rates of adherence were higher, in both nonhomebound and homebound participants, for undertaking the day-to-day exercises of PFM than for using strategies of stress and urge when appropriate. Furthermore, there was no statistically significant difference found after the two group’s comparison as regards the rates of adherence. More so, the third fact concerns the treatment efficacy and self-efficacy or PFMT and UI-specific life quality within and between the nonhomebound and homebound participants. As explained in Engberg and Sereika (2016), PFMT intervention efficacy was significantly higher amongst nonhomebound participants than among the homebound participants and consequently, at baseline, nonhomebound participants had significantly better UI-specific life quality than the homebound participants which would definitely suggest the lower austerity of their UI. Reliability: Critique of the Reliability of the Quantitative Research ArticleAccording to Grove, gray and Burns (2015), reliability means the degree or extent to which research methods exemplified by methods of measurement and methods of data collection produce consistent and stable results. Therefore, as explained in Engberg and Sereika (2016), the functional status was scrutinized at the reference point (baseline) encompassing affective function, ADL (Activities of Daily Living), cognitive function and mobility. Therefore, data were collected and measured using the OARS (Older Americans Research Study) Instrumental and Physical ADL scales. Engberg and Sereika (2016) explain the scales were administered with the principal motive of examining the self-reported need for help with instrumental and physical ADL. The interrater and test-retest reliability types were used, in this article, to determine the extent to which the tools of measurement produced consistent and stable results. As explained in Grove, Gray, and Burns (2015), the test-retest reliability encompasses repeated measures with an instrument or a scale to determine not only the instrument’s stability but also its consistency in measuring a concept. On the other hand, interrater reliability compares two judges or observers in research to conclude or decide their equivalence in judging events or making observations (Grove, Gray, and Burns, 2015). Therefore, as explained in Engberg and Sereika (2016), the OARS Instrumental and Physical ADL scores have a 0.71 to 0.82 reliability of test-retest and a 0.74 reliability of interrater as examined utilizing Kendall’s concordance coefficient. More so, the Geriatric Depression Scale (GDS) administered to examine the affective function had an internal consistency reliability score founded on the Cronbach α of 0.94. As explained in Grove, Gray, and Burns (2015), the internal consistency or homogeneity reliability is principally utilized with scales of multi-item where every item on the scale is interconnected or linked with other items to conclude the scale’s consistency in measuring a concept. Validity: Critique of the Validity of the Quantitative Research ArticleAccording to Grove, Gray, and Burns (2015), validity refers to the degree to which scores from a measure characterize or describe the variables they are envisioned or projected to represent. Content validity, in this case, would best depict the soundness of the quantitative research article. As explained in Grove, Gray, and Burns (2015), content validity scrutinizes the degree to which a method of measurement encompasses all the principal elements pertinent or significant to the concept that is being measured. In other words, content validity is the degree to which the construct of interest is “covered” by a measure. Therefore, since content validity is not quantitatively scrutinized, it is examined by checking the method of measurement against the construct concept definition. As explained in Engberg and Sereika (2016) one of the methods of measurement used in the quantitative research article includes the OARS Instrumental and Physical ADL scales. In spite of the extensive utilization of the OARS Instrumental and Physical ADL scales, there is inadequate evidence to suggest the measure’s validity. However, as explained in Engberg and Sereika (2016) concerning the content validity with regard to the OARS Instrumental and Physical ADL scales, there are some theoretical justification for the inclusion and selection of the items identified on the scale. Some of the items included are exemplified by the amount of time needed to propel a wheelchair or walk fifteen feet to the toilet, the position for toileting, and the need for help in toileting (Engberg and Sereika, 2016).One Strength and One Weakness of the Quantitative Research ArticleThe article has various strengths and weakness. One of the strengths of the research is a detailed explanation of the sampling method and sampling procedure utilized in selecting the subjects for participation in the study. According to Engberg and Sereika (2016), the sample involved participants who concluded the baseline intervention of PFMT which took place for six weeks. Furthermore, while originally the plan was for the inclusion of homebound subjects only, Engberg and Sereika (2016) reiterate the funding agency permitted the expansion of the research to include nonhomebound subjects. As the article explains, the inclusion of the nonhomebound subjects provided the researchers with amplified capabilities not only for subject recruitment but also offered them a chance to make a comparison of the intervention’s efficacy between and within nonhomebound and homebound subjects. On the other hand, one of the weaknesses of the quantitative research study involves the utilization of the OARS Instrumental and Physical ADLs as scales or measurement tools in the research. There is a fundamental limitation of the scale with respect to the research. An elderly individual would be expected to be ADL dependent gradually and progressively in an orderly manner. Thus, items that are more advanced in the scale would require assistance before more frequent and less sophisticated performed items. However, in the ADL scale incontinence episodes, experience renders an individual dependent in this ADL item. Therefore, as explained in Engberg and Sereika (2016), considering the high UI occurrence in elderly persons, many independent individuals would be defined as dependent erroneously as per the ADL scale. Clinical Practice GuidelineThe name of the clinical practice guideline is “Nonsurgical Treatments for Urinary Incontinence in Adult Women: A Systematic Review Update.” This guideline is also known as the 2012 AHRQ Review. The guideline for clinical practice has been retrieved from the Agency for Health Research and Quality (AHRQ) website. As explained in AHRQ (2017), this guideline is reviewed in intervals of five years. This is supported by the fact that the current or the most recent guideline was published in 2017 while the preceding guideline named “Nonsurgical Treatments for Urinary Incontinence in Adult Women: Diagnosis and Comparative Effectiveness” was published in 2012. Therefore

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