Request for Funding
Medical Student Research Fellowship for Summer 2004
Mentor: Vivyenne Roche
Department: Geriatrics Section, Internal Medicine
Room number: Charles Sprague building 8.202
Mail Code: 8889
Phone number:214 648 9012
E-mail: Vivyenne.Roche@utsouthwestern.edu
Two Projects
Project I title: Urinary symptoms and effect on quality of life
Human subjects IRB approved project number (where applicable): IRB 8843
Animal subjects IRB approved project number (where applicable): n/a
Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects) Patient-based
Brief Description of Project: Purpose: 1) To evaluate frequency and bother
of urinary problems in a community based elderly cohort who do not present with
urinary problems 2) To compare the consistency of AUA symptom index and UDI-6
questionnaires in an individual patient 3) Determine the impact of these symptoms
on their quality of life. Urinary symptoms are very common but elderly patients
frequently accept urinary symptoms as normal aging and fail to seek help. The
prevalence of urinary incontinence is known in urology clinics but there are
no data from primary care clinics. Urogenital Distress Inventory- 6,
UD1-6 is a validated questionnaire that assesses lower urinary tract symptoms,
including incontinence, in women, and has also been studied in men.
American Urolologic Association (AUA) symptom index score is a 7-item questionnaire
validated in men to assess lower urinary tract symptoms including urinary incontinence
and has also been used in women. AUA has been performed in women and evaluates
the aging bladder. Quality of life is a visual scale from 0-10 to reflect their
feelings about their urinary problem. There are no prospective studies so far,
comparing the validity and consistency of the AUA symptom index and UDI-6 scores
in the same subject in order to determine which questionnaire helps to assess
patient's quality of life. Community based patients aged 65 years and older
who present for routine primary care will complete the questionnaire with these
research tools.
Work closely with Dr Roche. Prepare Abstract for submission to the American Geriatric Society annual meeting.
Project II title: Foley catheter use in an acute care setting
Human subjects IRB approved project number (where applicable): Submitted
Animal subjects IRB approved project number (where applicable):
Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects) Patient-based
Brief Description of Project: Determine Foley catheter use in acutely ill medical
patients and initiate an intervention to optimize their use. There are 4 indications
for Foley catheter placement 1)Neurogenic bladder 2) Fluid status monitoring
in acutely ill patients that directly impacts medical treatment (result in a
change of treatment within 48 hours) 3) Stage 3 or Stage 4 pressure ulcers located
on the buttocks 4) Dying patients. However Foley catheter may be placed for
invalid reasons like urinary incontinence and incur discomfort, inadvertent
removal, hematuria, urology consult, infection, false passage and unnecessary
cost.
Phase 1: Prospective study to determine Foley catheter use in patients over
65 years admitted to the medicine service at PMH, including location of placement
(ER or medical ward), indication, correct positioning, duration, voiding history
prior to admission, and medications.
Duration: 4 weeks or until 100 patients enrolled.
Phase 2: Document Foley catheter placement in patients admitted to medical units
at PMH with the variables listed in Phase 1: Attend sub-intern one hour conference
once a week. For last ten minutes of sub-intern conference inform the sub-interns
of indications and outcomes of catheter placement. Provide the sub-interns with
a written list of patients with Foleys in place on service. Continue to follow
the patients in-house and determine subsequent use and outcomes of Foley catheters.
Duration: 4 weeks or until 100 patients enrolled.
Work closely with Dr Roche. Prepare Abstract for submission to the American Geriatric Society annual meeting. Proposal submitted to IRB. Patients do not have to sign a consent form and the sub-intern course director coordinator has approved the study so we anticipate an expedited IRB approval.
Previous Research Activities or Publications with Medical Students:Worked with
medical student 2 years ago and poster was accepted for national meeting presentation.
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