Dingwall Lindsay, McLafferty Ella
SPQ Care of Older People, Assessment and Rehabilitation, School of Nursing and Midwifery, University of Dundee, Dundee, Scotland.
J Clin Nurs. 2006 Oct;15(10):1276-86. doi: 10.1111/j.1365-2702.2006.01381.x.
The aim of this paper is to explore whether nurses working in elderly medicine and in acute medical settings promote urinary continence in older people or in reality use containment strategies.
Untreated urinary incontinence in older adults can result in prolonged hospital admission and increased risk of admission to long-term care. Urinary incontinence can also have severe psychosocial effects on older people. Most studies relating to this topic have relied on quantitative approaches to data collection with a seeming lack of qualitative investigation into how nursing staff promote urinary continence in hospitalized older people.
Focus groups and one-to-one semi-structured interviews were carried out in two NHS regions in Scotland. Registered and non-Registered Nurses were invited to participate. Five focus groups (n = 17) and four single interviews (n = 4) were conducted. Data generated were analysed thematically using QSR N-VIVO 2.
Some nurses believe that older people accept urinary incontinence as a consequence of ageing. Lack of assessment results in older people being labelled as incontinent of urine. Assessment strategies in medicine for the elderly tend to focus on product identification and management of incontinence. Although nurses from all clinical areas identify the importance of promoting continence, the problem continues to be contained rather than treated. Conflicting clinical priorities, varying staff approaches to urinary continence and deficits in education are cited among the barriers to promoting continence.
The results suggest that nurses continue to contain urinary incontinence rather than promoting continence in older people.
Nursing staff need to be aware of the impact of untreated urinary incontinence on older people. Practitioners should promote continence rather than employing containment strategies. A validated assessment tool for older people needs to be developed. Views of older people should be sought regarding their attitudes towards urinary incontinence.
本文旨在探讨从事老年医学和急性医疗工作的护士是否在促进老年人尿失禁康复，或者实际上是否采用了控制策略。
老年人未经治疗的尿失禁会导致住院时间延长以及入住长期护理机构的风险增加。尿失禁还会对老年人产生严重的心理社会影响。大多数关于该主题的研究依赖于定量数据收集方法，似乎缺乏对护理人员如何促进住院老年人尿失禁康复的定性调查。
在苏格兰的两个国民保健服务（NHS）地区开展了焦点小组和一对一的半结构化访谈。邀请注册护士和非注册护士参与。进行了五个焦点小组（n = 17）和四次单人访谈（n = 4）。使用QSR N-VIVO 2对生成的数据进行了主题分析。
一些护士认为老年人将尿失禁视为衰老的结果。缺乏评估导致老年人被贴上尿失禁的标签。老年医学的评估策略往往侧重于产品识别和尿失禁管理。尽管所有临床领域的护士都认识到促进尿失禁康复的重要性，但该问题仍持续被控制而非得到治疗。促进尿失禁康复的障碍包括相互冲突的临床优先级、工作人员对尿失禁的不同处理方法以及教育方面的不足。
结果表明，护士在老年人中继续采取控制尿失禁的措施，而不是促进尿失禁康复。
护理人员需要意识到未经治疗的尿失禁对老年人的影响。从业者应促进尿失禁康复，而不是采用控制策略。需要开发一种经过验证的老年人评估工具。应该征求老年人对尿失禁态度的看法。
