Department of Health Behavior & Health Education, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC 27599, USA.
J Clin Nurs. 2011 Jan;20(1-2):156-65. doi: 10.1111/j.1365-2702.2010.03493.x. Epub 2010 Nov 15.
To determine, qualitatively and quantitatively, how individuals use fluid manipulation to self-manage the urinary symptoms of daytime frequency, urgency and urine leakage and the underlying rationale for this behaviour.
Lower urinary tract symptoms are prevalent and burdensome, and little is known about how individuals with lower urinary tract symptoms manipulate their fluid intake.
A mixed methods design included statistical analysis of data from a population-based survey of urologic symptoms and qualitative analysis of in-depth interviews.
Quantitative data came from 5503 participants of the baseline Boston Area Community Health Survey, a population-based, random sample epidemiologic survey of urologic symptoms. Qualitative data came from in-depth interviews with a random subsample from Boston Area Community Health of 152 black, white and Hispanic men and women with LUTS.
Qualitative data showed that some respondents restricted fluid intake while others increased it, in both cases with the expectation of improved symptoms. Quantitative data showed that fluid intake was greater in men and women reporting frequency (p < 0·001). Women with frequency drank significantly more water (p < 0·001), while women with urgency drank significantly less water (p = 0·047).
This study found divergent expectations of the role of fluids in alleviating symptoms, leading some individuals to restrict and others to increase fluid intake. Individuals with lower urinary tract symptoms may need guidance in fluid management.
Nurses should be aware that patients may self-manage lower urinary tract symptoms by restricting fluid intake, putting them at risk for dehydration, constipation and urinary tract infection, but also that they may be increasing their fluid intake, which could worsen symptoms. This study pinpoints a specific area of need among patients with lower urinary tract symptoms and provides a practical opportunity for nurses to assist their patients with behavioural and fluid management by emphasising the clinical guidelines.
定性和定量地确定个体如何通过液体操纵来自我管理日间尿频、尿急和尿失禁的症状，以及这种行为的潜在基本原理。
下尿路症状普遍存在且负担沉重，但对于患有下尿路症状的个体如何操纵液体摄入量知之甚少。
混合方法设计包括对基于人群的尿症状调查的人群数据进行统计分析和对深入访谈的定性分析。
定量数据来自基线波士顿地区社区健康调查的 5503 名参与者，这是一项基于人群的、随机抽样的尿症状流行病学调查。定性数据来自波士顿地区社区健康的 152 名黑、白和西班牙裔男性和女性的随机子样本的深入访谈，这些人患有下尿路症状。
定性数据显示，一些受访者限制液体摄入，而另一些受访者增加液体摄入，两种情况下都期望改善症状。定量数据显示，报告有尿频的男性和女性的液体摄入量更大（p<0.001）。有尿频的女性饮用的水明显更多（p<0.001），而有尿急的女性饮用的水明显更少（p=0.047）。
这项研究发现，人们对液体在缓解症状中的作用存在不同的期望，导致一些人限制液体摄入，而另一些人增加液体摄入。下尿路症状患者可能需要在液体管理方面的指导。
护士应该意识到，患者可能通过限制液体摄入来自我管理下尿路症状，使他们面临脱水、便秘和尿路感染的风险，但也可能增加液体摄入，从而使症状恶化。本研究明确了下尿路症状患者的一个具体需求领域，并为护士提供了一个实际机会，通过强调临床指南，帮助他们的患者进行行为和液体管理。
