Nursing Workloads and Lower Urinary Tract Symptoms Among Chinese Female Nurses: The Mediating Role of Delayed Voiding Behaviors

Abstract

Study Need and Importance: A healthy nursing workforce is the cornerstone of advancing global health, whereas lower urinary tract symptoms (LUTS) are a challenge to the healthy nursing workforce. Female nurses are more susceptible to LUTS than women in general, and this should be attributed to their demanding working environment. Nurses confront various objective and subjective nursing workloads in clinical settings, but less is known about how nursing workloads influence their LUTS. To address this research gap, this work tested the mediating role of a frequently observed behavior in nurses, delayed voiding behaviors, on the relationships between nursing workloads and their LUTS. What We Found: Data from 13,191 female nurses were analyzed, and their median age was 31 years (IQR 27-37). More than half (51%) of the nurses had LUTS; urinary urgency (26%) and stress urinary incontinence (18%) were the most common LUTS. Delayed voiding behaviors significantly mediated the relationships between nursing workloads and LUTS. Specifically, after adding delayed voiding behaviors into the model, the direct effects of objective nursing workloads (ie, working environment, working hours, and working schedule) on LUTS became nonsignificant, but the direct effect of the subjective nursing workload (ie, perceived stress) on LUTS remained significant (Figure). Limitations: This study was designed with the assumption that nurses work in a demanding working environment that has detrimental effects on their health, so the resources in the working environment that may benefit the individuals were not considered. Also, the working schedule might include multiple parameters but was simplified as night shifts in this study. Interpretation for Patient Care: Strategies tailored to delayed voiding behaviors would bring benefits for nurses' bladder health, and they may synergize stress-reducing strategies to help develop a healthy nursing workforce.