Urinary incontinence nursing diagnoses in patients with stroke

METHOD

A cross-sectional study with 156 patients treated in a neurological clinic. Data were collected through interviews and forwarded to nurses for diagnostic inference.

RESULTS

92.3% of the patients had at least one of the studied diagnoses; OUI showed the highest prevalence (72.4%), followed by FUI (53.2%), RUI (50.0%), UUI (41.0%) and SUI (37.8%). Overdistended bladder and reports of inability to reach the toilet in time to avoid urine loss were the most prevalent defining characteristics. A statistically significant association of the defining characteristics with the studied diagnosis was verified.

CONCLUSION

The five incontinence diagnoses were identified in the evaluated patients, with different prevalence.

Descriptors
Nursing Diagnosis; Urinary Incontinence; Stroke

	Training 1				Training 2
ND	E	FN	FP	T	E	FN	FP	T
Nurse 1
SUI	1	0	0	1	1	0	0	1
UUI	0.8974	0	0.5	-	1	0	0	1
FUI	0.8974	0.0555	0.1428	2.1413	0.9555	0.0555	0	0
OUI	0.9743	0	0.0476	-	1	0	0	1
RUI	0.92	0.1666	0	0	1	0	0	1
Nurse 2
SUI	0.9230	0.1666	0	0	1	0	0	1
UUI	0.9743	0	0.0555	-	1	0	0	1
FUI	0.8974	0.1666	0.0476	0.3531	1	0	0	1
OUI	0.9743	0.0555	0	0	1	0	0	1
RUI	1	0	0	1	1	0	0	1
Nurse 3
SUI	1	0	0	1	1	0	0	1
UUI	0.9743	0	0.0555	-	1	0	0	1
FUI	0.8461	0.1666	0.1428	0.9112	0.9743	0	0.0476	0
OUI	0.8974	0	0.1904	-	1	0	0	1
RUI	1	0	0	1	1	0	0	1
Nurse 4
SUI	0.9230	0	0.1428	-	1	0	0	1
UUI	0.7179	0.1428	0.4444	1.7714	1	0	0	1
FUI	0.9743	0	0.0476	-	1	0	0	1
OUI	0.8461	0	0.2857	-	1	0	0	1
RUI	1	0	0	1	1	0	0	1

Variables	N	%		N	%	P^* * Pearson's Chi-square test;	PR^ Prevalence ratio. Note: (N = 156).
Diagnostics			Defining characteristics
Overflow urinary incontinence	113	72.4	Bladder distention	111	98.2	0.001	3.39
			Nocturia	98	86.7	<0.001	3.76
			Involuntary leakage of small volume of urine	47	41.5	<0.001	1.60
			High post-void residual volume	38	33.6	<0.001	1.52
Functional urinary incontinence	83	53.2	Voiding prior to reaching toilet	67	80.7	<0.001	5.41
			Sensation of need to void	67	80.7	<0.001	0.51
			Time between sensation of urge and ability to reach toilet is too short and involuntary voiding	66	79.5	<0.001	5.29
			Completely empties bladder	62	74.6	0.114	0.76
			Early morning urinary incontinence	40	48.1	<0.001	5.41
Reflex urinary incontinence	78	50.0	Inability to voluntarily inhibit voiding	55	70.5	<0.001	2.33
			Sensation of urgency to void without voluntary inhibition of bladder contraction	41	52.5	<0.001	3.00
			Absence of urge to void	28	35.8	0.079	1.33
			Sensation of bladder fullness	22	28.2	0.002	1.72
			Inability to voluntarily initiate voiding	19	24.3	<0.001	2.19
			Absence of voiding sensation	17	21.7	<0.001	2.13
			Absence of sensation of bladder fullness	8	10.2	0.004	2.11
			Predictable pattern of voiding	6	7.6	0.012	2.08
Urge urinary incontinence	64	41.0	Inability to reach toilet in time to avoid urine loss	60	93.7	<0.001	19.41
			Urinary urgency	58	90.6	<0.001	8.50
			Involuntary loss of urine with bladder spasms	29	45.3	<0.001	3.48
			Involuntary loss of urine with bladder contractions	29	45.3	<0.001	3.48
Stress urinary incontinence	59	37.8	Involuntary leakage of small volume of urine with sneezing	38	64.4	<0.001	5.61
			Involuntary leakage of small volume of urine with coughing	36	61.0	<0.001	5.21
			Involuntary leakage of small volume of urine with laughing	28	47.4	<0.001	4.12
			Involuntary leakage of small volume of urine in the absence of overdistended bladder	19	32.2	<0.001	3.42
			Involuntary leakage of small volume of urine on exertion	18	30.5	<0.001	3.36
			Involuntary leakage of small volume of urine in the absence of detrusor contraction	11	18.6	<0.001	3.02

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Telma Alteniza Leandro. Av. João Pessoa, 3912, Apto 08 - Bairro Damas. CEP 60425-812 - Fortaleza, CE, Brazil.telmaleandro21@yahoo.com.br

Brasil

Brasil

Urinary incontinence nursing diagnoses in patients with stroke * * Extracted from the dissertation "Prevalência de diagnósticos de enfermagem de incontinência urinária em pacientes com acidente vascular cerebral," Universidade Federal do Ceará, 2014.

Diagnósticos de enfermería de incontinencia urinaria en pacientes con accidente vascular cerebral

Abstract

OBJECTIVE

METHOD

RESULTS

CONCLUSION

Urinary incontinence nursing diagnoses in patients with stroke ^* * Extracted from the dissertation "Prevalência de diagnósticos de enfermagem de incontinência urinária em pacientes com acidente vascular cerebral," Universidade Federal do Ceará, 2014.