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

Joanne Booth, Suzanne Kumlien, Yuli Zang, Barbro Gustafsson, Debbie Tolson

Research output: Contribution to journalArticle

Abstract

AIM: To explore nurses' practices and influences in relation to urinary incontinence following stroke, in the UK, Sweden and China.

BACKGROUND: Urinary incontinence following stroke is common, under-recognised and poorly researched. Before appropriate rehabilitation interventions can be developed, an understanding of nurses' current management approaches and cultural influences is required.

DESIGN: Qualitative.

METHODS: Semi-structured interviews were undertaken with ten registered nurses from at least four different stroke units in three countries (n = 30). Interviews were carried out in the participants' first language, using an agreed interview guide. Following translation, thematic analysis focusing on manifest meaning was undertaken, using an iterative approach involving electronic and face-to-face discussions.

RESULTS: The consequence of only superficial assessment was no systematic identification of types or causes of urinary incontinence and no individualised plans developed. A process model of practice, common to all three countries, was identified for stroke survivors with urinary incontinence. Routine core activities were followed by the palliative pathway (most frequently), where urinary incontinence was contained to protect the stroke survivors' safety and ensure social continence; or the rehabilitative route (more rarely), where simple continence promoting activities were implemented with the purpose of facilitating recovery of bladder function.

CONCLUSIONS: Nurses' reactively manage urinary incontinence following stroke, adopting a routinised approach based on local custom and practice. Promotion of urinary continence is not a priority area of stroke rehabilitation for nurses in western or eastern countries.

RELEVANCE TO CLINICAL PRACTICE: 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.

Original languageEnglish
Pages (from-to)1049-58
Number of pages10
JournalJournal of Clinical Nursing
Volume18
Issue number7
DOIs
Publication statusPublished - Apr 2009

Fingerprint

Cross-Cultural Comparison
Urinary Incontinence
Rehabilitation
Stroke
Nurses
Urinary Bladder
Interviews
Survivors
Recovery of Function
Sweden
China
Nursing
Language
Safety

Keywords

  • Attitude of Health Personnel
  • China
  • Cross-Cultural Comparison
  • Delivery of Health Care
  • Evidence-Based Nursing
  • Female
  • Great Britain
  • Health Knowledge, Attitudes, Practice
  • Health Promotion
  • Humans
  • Male
  • Nurse's Role
  • Nursing Assessment
  • Nursing Methodology Research
  • Nursing Staff, Hospital
  • Qualitative Research
  • Rehabilitation Nursing
  • Stroke
  • Surveys and Questionnaires
  • Sweden
  • Urinary Incontinence

Cite this

Booth, Joanne ; Kumlien, Suzanne ; Zang, Yuli ; Gustafsson, Barbro ; Tolson, Debbie. / Rehabilitation nurses practices in relation to urinary incontinence following stroke : a cross-cultural comparison. In: Journal of Clinical Nursing. 2009 ; Vol. 18, No. 7. pp. 1049-58.
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Rehabilitation nurses practices in relation to urinary incontinence following stroke : a cross-cultural comparison. / Booth, Joanne; Kumlien, Suzanne; Zang, Yuli; Gustafsson, Barbro; Tolson, Debbie.

In: Journal of Clinical Nursing, Vol. 18, No. 7, 04.2009, p. 1049-58.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Rehabilitation nurses practices in relation to urinary incontinence following stroke

T2 - a cross-cultural comparison

AU - Booth, Joanne

AU - Kumlien, Suzanne

AU - Zang, Yuli

AU - Gustafsson, Barbro

AU - Tolson, Debbie

PY - 2009/4

Y1 - 2009/4

N2 - AIM: To explore nurses' practices and influences in relation to urinary incontinence following stroke, in the UK, Sweden and China.BACKGROUND: Urinary incontinence following stroke is common, under-recognised and poorly researched. Before appropriate rehabilitation interventions can be developed, an understanding of nurses' current management approaches and cultural influences is required.DESIGN: Qualitative.METHODS: Semi-structured interviews were undertaken with ten registered nurses from at least four different stroke units in three countries (n = 30). Interviews were carried out in the participants' first language, using an agreed interview guide. Following translation, thematic analysis focusing on manifest meaning was undertaken, using an iterative approach involving electronic and face-to-face discussions.RESULTS: The consequence of only superficial assessment was no systematic identification of types or causes of urinary incontinence and no individualised plans developed. A process model of practice, common to all three countries, was identified for stroke survivors with urinary incontinence. Routine core activities were followed by the palliative pathway (most frequently), where urinary incontinence was contained to protect the stroke survivors' safety and ensure social continence; or the rehabilitative route (more rarely), where simple continence promoting activities were implemented with the purpose of facilitating recovery of bladder function.CONCLUSIONS: Nurses' reactively manage urinary incontinence following stroke, adopting a routinised approach based on local custom and practice. Promotion of urinary continence is not a priority area of stroke rehabilitation for nurses in western or eastern countries.RELEVANCE TO CLINICAL PRACTICE: 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.

AB - AIM: To explore nurses' practices and influences in relation to urinary incontinence following stroke, in the UK, Sweden and China.BACKGROUND: Urinary incontinence following stroke is common, under-recognised and poorly researched. Before appropriate rehabilitation interventions can be developed, an understanding of nurses' current management approaches and cultural influences is required.DESIGN: Qualitative.METHODS: Semi-structured interviews were undertaken with ten registered nurses from at least four different stroke units in three countries (n = 30). Interviews were carried out in the participants' first language, using an agreed interview guide. Following translation, thematic analysis focusing on manifest meaning was undertaken, using an iterative approach involving electronic and face-to-face discussions.RESULTS: The consequence of only superficial assessment was no systematic identification of types or causes of urinary incontinence and no individualised plans developed. A process model of practice, common to all three countries, was identified for stroke survivors with urinary incontinence. Routine core activities were followed by the palliative pathway (most frequently), where urinary incontinence was contained to protect the stroke survivors' safety and ensure social continence; or the rehabilitative route (more rarely), where simple continence promoting activities were implemented with the purpose of facilitating recovery of bladder function.CONCLUSIONS: Nurses' reactively manage urinary incontinence following stroke, adopting a routinised approach based on local custom and practice. Promotion of urinary continence is not a priority area of stroke rehabilitation for nurses in western or eastern countries.RELEVANCE TO CLINICAL PRACTICE: 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.

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KW - China

KW - Cross-Cultural Comparison

KW - Delivery of Health Care

KW - Evidence-Based Nursing

KW - Female

KW - Great Britain

KW - Health Knowledge, Attitudes, Practice

KW - Health Promotion

KW - Humans

KW - Male

KW - Nurse's Role

KW - Nursing Assessment

KW - Nursing Methodology Research

KW - Nursing Staff, Hospital

KW - Qualitative Research

KW - Rehabilitation Nursing

KW - Stroke

KW - Surveys and Questionnaires

KW - Sweden

KW - Urinary Incontinence

U2 - 10.1111/j.1365-2702.2008.02688.x

DO - 10.1111/j.1365-2702.2008.02688.x

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JO - Journal of Clinical Nursing

JF - Journal of Clinical Nursing

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