Enriquez Elizabeth Limouze
Terence Cardinal Cooke Health Care Center, 1249 Fifth Avenue, New York, NY 10029, USA.
Ostomy Wound Manage. 2004 Jun;50(6):24-43.
Urinary incontinence is a widespread but often ignored problem among elderly women residing in nursing homes. Despite numerous research studies performed within this setting, few have been able to demonstrate lasting change in the care of and enduring outcomes in this population. However, neither the most commonly used definitions of incontinence nor current management approaches are meeting the needs of institutionalized frail elderly, particularly women, who are twice as likely as men to demonstrate symptoms of the condition. Costs in terms of quality of life and expense of care are staggering. Because many believe that a holistic approach may provide direction for management of urinary incontinence, and because nursing is a holistic profession, a solution to the challenges involved in treating incontinence among the elderly potentially lies in utilizing a nursing as opposed to medical framework for the analysis of factors and care. Specifically, the complexities of testing necessary to differentiate current diagnoses might be simplified by classifying incontinence in a different way, such as using nurse-identified levels of need as opposed to physiologically-based factors. The use of nursing theory to guide patient assessment and an evaluation of systems of care provides a fresh approach to this long-standing problem.
尿失禁是居住在养老院中的老年女性中普遍存在但常常被忽视的问题。尽管在这种环境下进行了大量研究，但很少有研究能够证明在该人群的护理方面有持久的改变和持久的结果。然而，无论是最常用的尿失禁定义还是当前的管理方法，都无法满足机构化体弱老年人的需求，尤其是女性，她们出现这种病症症状的可能性是男性的两倍。在生活质量和护理费用方面的成本高得惊人。由于许多人认为整体方法可能为尿失禁的管理提供指导，并且由于护理是一个整体专业，解决老年人尿失禁治疗中所涉及挑战的潜在办法可能在于利用护理而非医学框架来分析因素和进行护理。具体而言，通过以不同方式对尿失禁进行分类，例如使用护士确定的需求水平而非基于生理的因素，可能会简化区分当前诊断所需测试的复杂性。运用护理理论来指导患者评估和护理系统评价为这个长期存在的问题提供了一种全新的方法。
