School of Nursing, University of Central Lancashire, Preston, UK.
National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care North West Coast, Preston, UK.
J Clin Nurs. 2018 May;27(9-10):2041-2051. doi: 10.1111/jocn.14346.
To explore the views and experiences of stroke survivors and carers about a systematic voiding programme for poststroke incontinence.
Urinary incontinence after stroke is common and associated with poorer functional outcome. Structured assessment and management are potentially effective interventions, but it is important that there is a good understanding of stroke survivors' and carers' views of their acceptability and implementation.
A qualitative study within a feasibility trial.
Sixteen participants (12 stroke survivors and four carers) were interviewed using a structured schedule shortly before discharge from one of six inpatient stroke units across six hospitals. Interviews were audio-recorded and transcribed verbatim, and thematic analysis was conducted.
Participants included seven male and five female stroke survivors (mean age 76 years) and four female carers (two wives and two daughters). Themes relating to the preliminary (assessment) phase of the programme were as follows: physical impact, psychological impact, beliefs about incontinence, and the assessment process itself. Main themes relating to the implementation of the programme included the following: timed voiding decisions, adapting the programme or the timed voiding schedule, and urinary incontinence management techniques. Participants felt that the programme helped them to re-establish a regular pattern of micturition and to regain autonomy.
The effectiveness of a systematic voiding programme may partly lie in its educational component, challenging patients' and carers' assumptions that poststroke incontinence is inevitable. Individual adaptation of the programme and the ability to incorporate it alongside other aspects of care are likely to be key factors influencing implementation.
Urinary incontinence is common after stroke. To maximise benefits from a systematic voiding programme, nurses should support stroke survivors to overturn erroneous beliefs, to participate in tailoring of the programme, and in self-management where appropriate.
探索脑卒中幸存者和照顾者对脑卒中后尿失禁系统排尿方案的看法和经验。
脑卒中后尿失禁很常见，且与较差的功能预后相关。结构化评估和管理是潜在有效的干预措施，但了解脑卒中幸存者和照顾者对其可接受性和实施的看法非常重要。
在一项可行性试验中进行的定性研究。
在六家医院的六个住院脑卒中病房中，在出院前不久，使用结构化时间表对 16 名参与者（12 名脑卒中幸存者和 4 名照顾者）进行了访谈。访谈进行了录音并逐字记录，并进行了主题分析。
参与者包括 7 名男性和 5 名女性脑卒中幸存者（平均年龄 76 岁）和 4 名女性照顾者（2 名妻子和 2 名女儿）。与该方案初步（评估）阶段相关的主题如下：身体影响、心理影响、对尿失禁的信念以及评估过程本身。与方案实施相关的主要主题包括：定时排尿决策、调整方案或定时排尿计划以及尿失禁管理技术。参与者认为该方案有助于他们重新建立规律的排尿模式并恢复自主。
系统排尿方案的有效性可能部分在于其教育组成部分，挑战了患者和照顾者关于脑卒中后尿失禁不可避免的假设。方案的个体化调整以及将其纳入护理其他方面的能力可能是影响实施的关键因素。
脑卒中后尿失禁很常见。为了从系统排尿方案中获得最大益处，护士应支持脑卒中幸存者推翻错误的信念，参与方案的定制，并在适当的情况下进行自我管理。
