Hancock R, Bender P, Dayhoff N, Nyhuis A
Methodist Hospital of Indiana, Indianapolis, USA.
Urol Nurs. 1996 Sep;16(3):79-85.
The problem of incontinence in hospitalized elderly patients is rarely documented, and there is little research that determines why nurses choose to help or not help with this problem. Are hospital-based acute care nurses' attitudes and beliefs about incontinence associated with the perceived opportunity to assist the patient with the problem? What do hospital nurses know about causes and interventions relative to incontinence?
Two vignettes, one describing a patient with stress incontinence and one describing a patient with urge incontinence, were created. Questions measuring variables of a help-giving model were developed, and nurses were asked to mark on a Likert-type scale when answering each question.
One hundred-fifty respondents returned completed questionnaires along with three nurse experts. Many hospital nurses believed incontinence was temporary and part of being old. As a group they had a more positive attitude toward intervening for urge incontinence and believed the physician and their nurse manager expected them to assist the patient with urge incontinence. Respondents tended to believe the patient was least likely to expect help. Respondents were evenly divided about opportunity to provide assistance for stress or urge incontinence. Less than half of the nurses correctly listed causes and interventions for stress or urge incontinence.
Other clinical problems perceived as more pressing and lack of knowledge concerning appropriate helping measures affect nurses' perceptions of opportunity to intervene when elderly hospital patients are incontinent. Assessment and intervention are essential to quality nursing care. Undergraduate nursing education and ongoing staff education about incontinence are crucial if assessments and interventions are to be correct. Patients, as health care consumers, have to be more educated about incontinence and choose to have the problem addressed during hospitalization. The Agency for Health Care Policy and Research Clinical Practice Guidelines is a major recommended reference.
住院老年患者的失禁问题鲜有文献记载，关于护士为何选择帮助或不帮助解决这一问题的研究也很少。以医院为基础的急性护理护士对失禁的态度和信念是否与他们认为帮助患者解决该问题的机会有关？医院护士对失禁的原因和干预措施了解多少？
创建了两个病例 vignette，一个描述压力性尿失禁患者，另一个描述急迫性尿失禁患者。开发了测量帮助给予模型变量的问题，并要求护士在回答每个问题时在李克特量表上进行标记。
150 名受访者以及三名护士专家返回了完整的问卷。许多医院护士认为失禁是暂时的，是衰老的一部分。总体而言，他们对干预急迫性尿失禁持更积极的态度，并认为医生和他们的护士长期望他们帮助急迫性尿失禁患者。受访者倾向于认为患者最不可能期望得到帮助。对于为压力性或急迫性尿失禁提供帮助的机会，受访者意见不一。不到一半的护士正确列出了压力性或急迫性尿失禁的原因和干预措施。
其他被认为更紧迫的临床问题以及对适当帮助措施的知识缺乏，影响了护士在老年住院患者失禁时对干预机会的认知。评估和干预对于优质护理至关重要。如果评估和干预要正确，本科护理教育和关于失禁的持续员工教育至关重要。患者作为医疗保健消费者，必须更多地了解失禁问题，并选择在住院期间解决该问题。医疗保健政策与研究机构临床实践指南是主要推荐的参考资料。
