Rehabilitation nurses practices in relation to urinary incontinence following stroke: a cross‐cultural comparison

Abstract

The dearth of evidence-based interventions available to rehabilitate bladder function following stroke means that stroke nursing practice is an experience-based endeavour. This study explains the nurses' focus on containment and social continence and highlights the need to systematically assess stroke survivors' bladder rehabilitation needs, identify types of urinary incontinence and adopt appropriate urinary continence promoting practices.

Identifying Continence OptioNs after Stroke (ICONS): an evidence synthesis, case study and exploratory cluster randomised controlled trial of the introduction of a systematic voiding programme for patients with urinary incontinence after stroke in secondary care

“…12 This lack of implementation in stroke clinical practice is in keeping with a recent and growing recognition that the implementation of research in practice is influenced not only by individual clinicians, but also by the organisational context in which they operate. [39][40][41][42][43][44] Organisational context has been defined as 'the environment or setting in which the proposed change is to be implemented'.…”

“…A similar focus on containment rather than rehabilitative activities has been reported elsewhere. 12,75 Continence care was usually couched in terms of being 'time consuming' and staff appeared to make trade-offs between the level of continence care that could be provided, and other pressures.…”

“…Improvements in continence have not kept pace with those in other aspects of stroke care, for example establishing a safe swallow, where the proportion assessed has increased from 63% to 83% over the same period. Although continence is already recognised as a component of organised stroke care, it is known that nurses find managing continence in the context of stroke challenging, 12 with over-reliance on urinary catheterisation as a management strategy especially in the acute phase of illness. 13 There are medical therapies which can be appropriately used to assist continence but these need to be based on appropriate first-line assessment and behavioural management in line with national guidelines.…”

Clinical protocols related with urinary incontinence post stroke: a literature review

“…Quatro estudos consideraram o doente também na fase de sequelas, durante transição do internamento para a comunidade e após a sua permanência no domicilio. 9,14,[18][19] Relativamente à tipologia dos artigos seleccionados, oito são originais, têm por base dados empiricos produzidos em investigações. [9][10][11][14][15][16][17]19 Os restantes são artigos de revisão da literatura.…”

“…9,14,[18][19] Relativamente à tipologia dos artigos seleccionados, oito são originais, têm por base dados empiricos produzidos em investigações. [9][10][11][14][15][16][17]19 Os restantes são artigos de revisão da literatura. 8,[12][13]18 No que respeita à caracterização da produção cientifica analisada,os dados revelam que os artigos originais resultam na sua maioria de investigações exploratórias de natureza quantitativa e qualitativa.…”