McMillan Isobel, Doxford-Hook Liz, Wood Julie, Fu Yu, McGowan Linda, Iles-Smith Heather
School of Health and Society, The University of Salford, Salford, UK.
Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Womens Health (Lond). 2024 Jan-Dec;20:17455057241295607. doi: 10.1177/17455057241295607.
Approximately 40% of older women in the community report experiencing urinary incontinence (UI); prevalence within secondary care is unknown. Illness, comorbidities, and hospital environments are likely to lead to higher prevalence.
This study aimed to establish UI prevalence in older women admitted to hospitals and understand the views and knowledge of ward nurses in relation to older women's UI.
An explanatory mixed methods study was conducted including a retrospective study of women ⩾55 years admitted to a large NHS hospital and qualitative interviews with nurses to gain an understanding of views, knowledge and perceptions of women's UI and related care.
UI prevalence was determined using the nursing assessment (elimination) and (ICD-10) codes for women ⩾55 years admitted to the hospital (November 2019 to February 2020); continence and demographic electronic patient care records data were extracted. Twenty ward nurses participated in interviews to explore views, knowledge and perceptions of UI care.
11.0% ( = 631) of the cohort (5,757) were recorded as having UI. Nurse interviews revealed six themes: (1) Normalisation and misconceptions of UI: nurses believed UI could not be improved, (2) limited knowledge and training: nurses expressed limited UI knowledge and a training need, (3) pad culture: continence pad use was high, (4) barriers to care: staffing issues were expressed as problematic, (5) UI under-reporting: nurses only categorised women with complete UI and others as "having an accident", (6) catheter use in relation to UI: catheters were reported as a last resort.
As community UI prevalence is 40%, our results (11%) suggest that UI is being underreported. Qualitative findings suggest that nurses have limited knowledge and training on continence care and under-report based on UI misconceptions. Our results suggest that ward nurses require dedicated UI training based on older women's needs.
社区中约40%的老年女性报告有尿失禁（UI）；二级护理中的患病率未知。疾病、合并症和医院环境可能导致更高的患病率。
本研究旨在确定住院老年女性的尿失禁患病率，并了解病房护士对老年女性尿失禁的看法和知识。
进行了一项解释性混合方法研究，包括对一家大型国民保健服务（NHS）医院收治的55岁及以上女性进行回顾性研究，以及对护士进行定性访谈，以了解对女性尿失禁及相关护理的看法、知识和认知。
使用护理评估（排泄）和国际疾病分类第十版（ICD - 10）编码确定2019年11月至2020年2月期间收治的55岁及以上女性的尿失禁患病率；提取了失禁和人口统计学电子患者护理记录数据。20名病房护士参与访谈，以探讨对尿失禁护理的看法、知识和认知。
该队列（5757人）中有11.0%（n = 631）被记录为患有尿失禁。护士访谈揭示了六个主题：（1）尿失禁的常态化和误解：护士认为尿失禁无法改善；（2）知识和培训有限：护士表示尿失禁知识有限且需要培训；（3）尿垫文化：尿失禁垫的使用率很高；（4）护理障碍：人员配备问题被认为是有问题的；（5）尿失禁报告不足：护士仅将完全尿失禁的女性和其他女性归类为“发生意外”；（6）与尿失禁相关的导尿管使用：导尿管被报告为最后手段。
由于社区尿失禁患病率为40%，我们的结果（11%）表明尿失禁报告不足。定性研究结果表明，护士在失禁护理方面的知识和培训有限，并且基于对尿失禁的误解而报告不足。我们的结果表明，病房护士需要根据老年女性的需求进行专门的尿失禁培训。
