Association of a continuous continence self‐management program with independence in voiding behavior among stroke patients: A retrospective cohort study

Abstract

Aims: Many stroke patients cannot urinate independently due to motor and cognitive dysfunctions. This study examined whether a continuous continence self-management program during acute and convalescent phases is associated with independence in voiding behavior.Methods: A retrospective cohort study was conducted among stroke patients registered in the Council of Kaga Local Stroke Network, Japan, from 2015 to 2019. In the intervention group (n = 941), a multidisciplinary continence care team and ward nurses provided continence care in the acute phase and shared the information with the staff in the convalescent ward. The control group (n = 579) received traditional voiding care from ward nurses. The primary and secondary outcomes were independence in voiding behavior at discharge from the convalescent ward and length of hospital stay, respectively.Results: At discharge from the convalescent wards, the proportion of patients who voided at the toilet or bedside commode was higher in the intervention group than in the control group (76.3% vs. 62.4%, p < 0.001). The continuous continence self-management program was associated with independence in voiding behavior (adjusted odds ratio: 1.801, 95% confidence interval [CI]:[1.102, 2.942]; p = 0.019) and length of hospital stay (β: −0.178, 95% CI: [−14.320, −7.607]; p < 0.001) after adjusting for other variables. Conclusions: The program was associated with increasing independent voiding behavior and shortened the length of hospital stay, suggesting the importance of promoting treatments for lower urinary tract symptoms and rehabilitation by a multidisciplinary continence care team for stroke patients.

Role of Urological Botulinum Toxin-A Injection for Overactive Bladder and Voiding Dysfunction in Patients with Parkinson’s Disease or Post-Stroke

“…Direct stroke-induced damage to the neuromicturition pathway causes involuntary leakage of urine accompanied by urgency in 40% to 60% of people admitted to hospital after a stroke [ 64 ]. First-line behavioral therapy may increase independent voiding behavior to control LUTS [ 64 , 65 ]. Second-line therapies of antimuscarinics and mirabegron also may improve OAB symptoms and not affect cognitive function during short-term observation [ 64 , 66 ].…”

Uropathogenic distribution and antibiotic resistance patterns according to multidrug-resistant bacteria colonization status in patients with stroke

“…[1,3,4] Although self-clean intermittent catheterization might be used to minimize the infection and vesico-ureteral reflux depending on the patients, [5] indiscriminate continuation of indwelling Foley catheter is still often seen in stroke patients. [6] UTI can occur frequently due to various causes including extended Foley catheterization, [1,3,7,8] and it is currently well known that extended Foley catheterization and various risk factors such as female sex, older age, and post-void residual volume are related with the risk of UTI multifactorially in acute stroke patients. [2,9,10] The authors have no funding and conflicts of interest to disclose.…”

Factors Contributing to Complete Oral Intake in Dysphagic Stroke Patients with Enteral Feeding Tubes in Convalescent Rehabilitation Wards

“…Therefore, in this study, we used the large database of the Kaga Regional Cooperation Clinical Pathway for Stroke (KRCCPS) featuring data collected over a prolonged period from multiple centers, 27 , 28 , 29 , 30 ) including 19 acute care hospitals and 11 hospitals with CRWs. The aim of this study was to investigate factors contributing to COI at the time of discharge from CRWs for stroke patients with enteral feeding tubes in the local clinical setting.…”