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Factors associated with nursing interventions to reduce incontinence in hospitalized older adults
Introduction:
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?
Methods:
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.
Results:
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.
Conclusions:
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.