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前列腺切除术后的尿失禁:应对前列腺癌手术后的尿失禁问题。

Incontinence after prostatectomy: coping with incontinence after prostate cancer surgery.

作者信息

Palmer Mary H, Fogarty Linda A, Somerfield Mark R, Powel Lorrie L

机构信息

School of Nursing, University of North Carolina, Chapel Hill, NC, USA.

出版信息

Oncol Nurs Forum. 2003 Mar-Apr;30(2):229-38. doi: 10.1188/03.ONF.229-238.

Abstract

PURPOSE/OBJECTIVES: To describe the nature of postprostatectomy urinary incontinence, determine how men manage postsurgery urinary incontinence, identify men's perceptions of adequacy of preoperative counseling, and identify men's expectations regarding the probability of postsurgery incontinence.

DESIGN

Survey.

SETTING

United States.

SAMPLE

Members of US TOO International, who experienced urinary incontinence after surgery.

METHODS

Copies of the survey (N = 370) were mailed to all chapters of US TOO International, a prostate cancer support group, for distribution to members. A letter of invitation also was posted on the US TOO International Web site and in the monthly newsletter. Men who desired to complete the survey (N = 130) called the researcher's office, and a copy of the survey and a stamped return envelope was mailed to them. Surveys returned to the researchers from June 1998 to January 1999 were included in the analyses.

MAIN RESEARCH VARIABLES

Urinary incontinence, management of urinary incontinence, and coping.

FINDINGS

166 men returned surveys. The majority was Caucasian (95%) and married (83%). The median age was 67 years, 87% of the men rated their health as good or excellent, and 114 men (69%) reported becoming incontinent after surgery. Most men experienced stress incontinence symptoms. The majority (89 of 111 men) reported that they were told preoperatively that urinary incontinence was a possible complication. Overall, regardless of length of time since surgery, men (74%) thought that incontinence was an important problem to resolve. Men used containment devices such as pads, special undergarments, and even sanitary napkins as management strategies. The majority of men (54%) used pelvic muscle exercises, especially those who were fewer than two years postsurgery (72%).

CONCLUSIONS

Urinary incontinence is a prevalent postoperative complication for men, even up to five years after surgery, and a source of great distress for some. Men reported stress and urge incontinence symptoms and used an array of strategies to contain their urine. Finding effective treatments for postprostatectomy urinary incontinence and receiving adequate information before surgery is important to these men.

IMPLICATIONS FOR NURSING

As the number of men who undergo surgical treatment for prostate cancer increases, nurses need to be equipped with the necessary knowledge and information to answer preoperative concerns and provide effective strategies for managing postoperative urinary incontinence.

摘要

目的/目标:描述前列腺切除术后尿失禁的性质,确定男性如何应对术后尿失禁,了解男性对术前咨询充分性的看法,并明确男性对术后尿失禁可能性的期望。

设计

调查。

地点

美国。

样本

美国前列腺癌支持组织“US TOO国际”中经历过术后尿失禁的成员。

方法

将调查问卷副本(N = 370)邮寄给前列腺癌支持组织“US TOO国际”的所有分会,以便分发给成员。一封邀请函也发布在美国“US TOO国际”网站和月度通讯上。希望完成调查的男性(N = 130)致电研究人员办公室,研究人员随后将调查问卷副本和已付邮资的回邮信封邮寄给他们。1998年6月至1999年1月返回给研究人员的调查问卷纳入分析。

主要研究变量

尿失禁、尿失禁的管理及应对方式。

研究结果

166名男性返回了调查问卷。大多数为白种人(95%)且已婚(83%)。年龄中位数为67岁,87%的男性将自己的健康状况评为良好或极佳,114名男性(69%)报告术后出现尿失禁。大多数男性经历过压力性尿失禁症状。大多数(111名男性中的89名)报告术前被告知尿失禁是一种可能的并发症。总体而言,无论术后时间长短,男性(74%)认为尿失禁是一个需要解决的重要问题。男性使用诸如尿垫、特殊内衣甚至卫生巾等 containment devices 作为管理策略。大多数男性(54%)进行盆底肌肉锻炼,尤其是术后不到两年的男性(72%)。

结论

尿失禁是男性术后常见的并发症,甚至在术后长达五年都可能出现,对一些人来说是巨大的困扰来源。男性报告了压力性和急迫性尿失禁症状,并采用了一系列策略来控制尿液。找到前列腺切除术后尿失禁的有效治疗方法并在手术前获得充分信息对这些男性很重要。

对护理的启示

随着接受前列腺癌手术治疗的男性数量增加,护士需要具备必要的知识和信息,以回答术前的担忧并提供管理术后尿失禁的有效策略。

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