Implications for nursing practice are explored and include focused questioning, providing for safety concerns, acknowledging significance and sensitivity of disclosed information and acting on the disclosure.

A usability study of a Virtual Reality Sterile Urinary Catheter Insertion Game (VR SUCIG) was conducted to understand user needs in regards to this game. Background: Learning and retention of psychomotor skills in health care is essential to safe clinical practice. Bauman suggests games are most useful when they are part of a layered-learning approach; in other words, they support various forms of learning and serve as cognitive aids ( Bauman et al., 2014 ). Intervention: The VR Sterile Urinary Catheter Insertion Game (VRSUCIG) was created by nurses and a computer gaming developer to provide nursing students with a cost-effective way to practice sterile catheter insertion skills in a systematic, evidence-based manner. A usability study and user reaction survey were conducted to gain a deep understanding of user’s needs. Methods: Three hundred nursing students, from 9 US nursing schools participated. Participants played the VR SUCIG and completed the System Usability Scale (SUS) and a User Reaction Survey (URS). Results: The SUS for the 2nd generation of the VR SUCIG was 57, or medium usability. The URS demonstrated the game motivated them to keep practicing. The VR SUCIG promoted repetitive practice of the skill and visually accentuated the concept of sterility. Conclusions. User reactions indicate that nursing students were eager and excited to utilize this technology. Usability scores indicate further refinement of technology is needed.

PURPOSE: The purpose of this study was to examine effects of urinary incontinence (UI) on midlife women's relationships with their intimate partners, from the perspective of both women and their partners. DESIGN: A cross-sectional, mixed-methods design. SUBJECTS AND SETTING: Purposive, convenience/snowball sampling strategies and community-based recruitment strategies were used to enroll partnered, midlife women living with UI. Participants were 43 community-dwelling midlife couples residing in the southwestern United States; female participants had stress, urgency, or mixed UI by self-report. Data were also collected from their intimate partners. METHODS: Participants completed confidential mailed study packets comprising questionnaires on demographic information and lower urinary tract symptom profile, valid measures of the quality of the relationship, and open-ended questions to explore the effect of UI on the relationship in the participants' own words. The packet included several validated instruments: the Incontinence Severity Index, Couples Satisfaction Index, Sexual Quality of Life-Female/Male, Relational Ethics Scale, and Couples' Illness Communication Scale. Quantitative data were analyzed using tests of differences between groups and correlation analysis. Qualitative data were explored for themes and tested for significant differences in word choice by z-score analysis. RESULTS: We found no significant differences between women and their partners in measures of the relationship and no significant associations between UI symptom severity and relationship satisfaction. Distressed partners had significantly poorer scores on sexual quality of life (P < .001), relational ethics (P = .002), and communication about UI (P = .03). Distressed couples used significantly more words than did nondistressed couples who described the woman's withdrawal from shared activities (P = .005) and avoidance of physical intimacy (P = .003), which they attributed to UI. CONCLUSIONS: Distressed couples demonstrated the negative effects of UI on emotional and physical intimacy. Distress was attributed to how the woman coped with symptoms but not with the severity of UI symptoms.

Objective To explore associations among symptoms of urinary incontinence, severity of symptoms, and measures of psychosocial health that may be assessed during a well-woman screening examination and the possible contribution of these variables to the relationship satisfaction of partnered midlife women living with urinary incontinence. Design Exploratory correlational design using self-report questionnaires. Setting Community recruitment by posted fliers, advertisements, and social media. Participants Partnered women, aged 45 to 65 years, with urinary incontinence (N = 57). Methods Self-report measures of severity of incontinence symptoms, relationship satisfaction, self-concept/emotional health (self-esteem, body image, depression, anxiety), and relationship factors (sexual quality of life, incontinence-related communication). Data were analyzed using Spearman rho correlation with an exploration of the contribution of study factors to relationship satisfaction through standard multiple regression. Results The severity of urinary incontinence symptoms had no significant correlation with scores on relationship satisfaction or psychosocial health. Measures of self-concept/emotional health and relationship factors were significantly correlated with each other (rs = .40 to .75, p < .01) and with relationship satisfaction (rs = .35 to .71, p < .05). Preliminary exploration of the contribution of study factors to relationship satisfaction through exploratory regression analysis demonstrated unique contributions from sexual quality of life (18.7%, p < .001) and depression (8.7%, p = .004). Conclusion Midlife women with urinary incontinence, regardless of symptom severity, might benefit from screening for poorer sexual quality of life and mild depression symptoms because these two study factors significantly contributed to poorer intimate relationship satisfaction among this study's participants.