Stroke survivors’ and carers’ experiences of a systematic voiding programme to treat urinary incontinence after stroke

Gibson, Josephine; Thomas, Lois H; Harrison, Joanna; Watkins, Caroline L; groups, carer involvement

doi:10.1111/jocn.14346

Cited by 8 publications

(11 citation statements)

References 32 publications

(49 reference statements)

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“…( 2016 ), Gibson et al. ( 2018 ) and Holroyd ( 2019 ). Evidently, such interventions can only be conducted through nurses that have undergone a training programme.…”

Section: Discussionmentioning

confidence: 96%

“…Gibson et al. ( 2018 ) concur with that; they also concluded in their study that the effectiveness of a systematic voiding programme may partly lie in its educational component and individual adaptation of the programme and the ability to incorporate it alongside other aspects of care are likely to be key factors influencing implementation. According to the current Cochrane review by Thomas et al.…”

Section: Introductionmentioning

confidence: 81%

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Promoting urinary continence in people suffering a stroke: Effectiveness of a complex intervention—An intervention study

et al. 2022

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According to Béjot et al. (2016), stroke is a devastating disease and approximately 1.1 million Europeans suffered a stroke each year. More than 80% of stroke survivors report one or more abnormal urinary symptoms at 3 or 12 months, with nocturia being the most frequent (Williams et al., 2012). Further, more than 50% of stroke survivors suffer from urinary incontinence in the acute stage; this value is reduced to 33% after 1 year (Kolominsky-Rabas et al., 2003). Urinary incontinence is defined as the complaint of any involuntary leakage of urine (Abrams et al., 2002). Urinary frequency, urgency and urge incontinence are the predominant symptoms in stroke survivors (Marinkovic & Badlani, 2001). Incontinence negatively affects the course of the disease; incontinent patients showed a worse functional outcome compared to continent patients (Pizzi et al., 2014).Urinary incontinence is a prognostic factor in the subacute phase after stroke for daily living activities (Meijer et al., 2003). Stroke survivors who are incontinent in the acute stage have a fourfold higher risk of institutionalization after a year, and urinary incontinence as initial presentation in acute stroke is associated with a high mortality rate (Kolominsky-Rabas et al., 2003;Marinkovic & Badlani, 2001).Urinary incontinence further negatively impacts the quality of life in persons with underlying neurologic conditions (Tapia et al., 2013).

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“…( 2016 ), Gibson et al. ( 2018 ) and Holroyd ( 2019 ). Evidently, such interventions can only be conducted through nurses that have undergone a training programme.…”

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 81%

Promoting urinary continence in people suffering a stroke: Effectiveness of a complex intervention—An intervention study

et al. 2022

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“…Twelve studies from Netherlands [36,[47][48][49][50][51][52][53][54][55][56][57] Nine from England [24,[58][59][60][61][62][63][64][65] Six from USA [66][67][68][69][70][71] Five from Scotland [38,39,[72][73][74] Three from Australia [75][76][77] Three from Canada [78][79][80] Two from Germany [81,82] One from Norway [83] One international [16] One UK study [35] More than 4000 patients with a range of LTNCs were in receipt of interventions: stroke featured in 22 studies, dementia in seven, Parkinson's disease in four, multiple sclerosis and mixed LTNCs in three, Huntingdon's disease in two, motor neurone disease and spinal cord injury in a single study each. The complex interventions delivered were:…”

Section: Resultsmentioning

confidence: 99%

“…Exercise-based interventions in twelve [16,50,51,58,67,68,70,71,73,[76][77][78] Home-based rehabilitation in eight studies [35,36,49,52,53,56,60,82] Psychosocial and educational interventions in seven [48,54,57,64,74,75,83] Communication in three [62,72,79] Continence rehabilitation in three [38,61,65] Motor imagery interventions in two [47,59] Constraint-induced movement therapy in two [63,81] Vocational rehabilitation [24], music therapy [55], oral care [84], memory aids [66], bathing [69], selfmanagement [80] in a single study each More than 400 healthcare professionals delivered the interventions and included, in order of prevalence: occupational therapists, physiotherapists, speech and language therapists, psychologists, music therapists, recreational therapists, nurses, physicians, rehabilitation assistants and social workers. Not all studies reported how many professionals, or which profession was involved.…”

Section: Resultsmentioning

confidence: 99%

Factors affecting the delivery of complex rehabilitation interventions in research with neurologically impaired adults: a systematic review

et al. 2020

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Background Rehabilitation research does not always improve patient outcomes because of difficulties implementing complex health interventions. Identifying barriers and facilitators to implementation fidelity is critical. Not reporting implementation issues wastes research resources and risks erroneously attributing effectiveness when interventions are not implemented as planned, particularly progressing from single to multicentre trials. The Consolidated Framework for Implementation Research (CFIR) and Conceptual Framework for Implementation Fidelity (CFIF) facilitate identification of barriers and facilitators. This review sought to identify barriers and facilitators (determinants) affecting implementation in trials of complex rehabilitation interventions for adults with long-term neurological conditions (LTNC) and describe implementation issues. Methods Implementation, complex health interventions and LTNC search terms were developed. Studies of all designs were eligible. Searches involved 11 databases, trial registries and citations. After screening titles and abstracts, two reviewers independently shortlisted studies. A third resolved discrepancies. One reviewer extracted data in two stages; 1) descriptive study data, 2) units of text describing determinants. Data were synthesised by (1) mapping determinants to CFIF and CFIR and (2) thematic analysis. Results Forty-three studies, from 7434 records, reported implementation determinants; 41 reported both barriers and facilitators. Most implied determinants but five used implementation theory to inform recording. More barriers than facilitators were mapped onto CFIF and CFIR constructs. “Patient needs and resources”, “readiness for implementation”, “knowledge and beliefs about the intervention”, “facilitation strategies”, “participant responsiveness” were the most frequently mapped constructs. Constructs relating to the quality of intervention delivery, organisational/contextual aspects and trial-related issues were rarely tapped. Thematic analysis revealed the most frequently reported determinants related to adherence, intervention perceptions and attrition. Conclusions This review has described the barriers and facilitators identified in studies implementing complex interventions for people with LTNCs. Early adoption of implementation frameworks by trialists can simplify identification and reporting of factors affecting delivery of new complex rehabilitation interventions. It is vital to learn from previous experiences to prevent unnecessary repetitions of implementation failure at both trial and service provision levels. Reported facilitators can provide strategies for overcoming implementation issues. Reporting gaps may be due to the lack of standardised reporting methods, researcher ignorance and historical reporting requirements. Systemic review registration PROSPERO CRD42015020423

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“…All patients will receive a regular course of rehabilitation therapy [ 29 ], nursing management of the bladder [ 30 , 31 ] and necessary medications (to control blood pressure, blood sugar and cholesterol, but not for bladder dysfunction) during the 4-week period of intervention or following the administration of sham stimulation.…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of repetitive transcranial magnetic stimulation against poststroke urinary incontinence: a study protocol for a randomized controlled trial

Jiang

Tang

Song

et al. 2022

Trials

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Background and purpose Poststroke urinary incontinence (PSI) is prevalent in stroke survivors, and high-quality evidence is required to guide clinical practice. Previous studies have demonstrated the curative effect of repetitive transcranial magnetic stimulation (rTMS) for urinary incontinence in individuals with multiple sclerosis (MS), Parkinson’s disease (PD), and spinal cord injury (SCI). Here, we describe the protocol for a randomized controlled trial to evaluate the efficacy and safety of low-frequency rTMS on the contralesional primary motor cortex (M1) for the treatment of PSI. Methods and analysis In this single-centre randomized controlled trial for poststroke urinary incontinence, a total of 140 eligible patients will be randomly allocated into two groups. The rTMS group (n = 70) will receive low-frequency rTMS at the M1 along with routine medical care, while the control group will receive sham rTMS along with routine medical care. All participants will undergo 20 treatment sessions, five times a week for 4 weeks. The primary outcome measures will be the changes in the urodynamic test at baseline versus 4 weeks after intervention. The secondary outcomes include the International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF), Overactive Bladder Symptom Score (OABSS), and pelvic floor muscle function. Ethics and dissemination The Institutional Review Board and Hospital Research Ethics Committee of the Second Affiliated Hospital of Chongqing Medical University approved this trial, and the approval number is No. 2020-153. All methods will be carried out in accordance with the principles of the Declaration of Helsinki and relevant ethical guidelines covering informed consent, confidentiality, and data storage. After the study had been thoroughly described to the participants by a physician, all participants will provide written informed consent indicating their willingness to participate. The results will be disseminated to most of the population, including participants, researchers, healthcare providers, and sponsors. Trial registration URL: https://www.chictr.org.cn; Unique identifier: ChiCTR2100042688. Date of Registration: 2021-01-26.

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Stroke survivors’ and carers’ experiences of a systematic voiding programme to treat urinary incontinence after stroke

Abstract: Urinary incontinence is common after stroke. To maximise benefits from a systematic voiding programme, nurses should support stroke survivors to overturn erroneous beliefs, to participate in tailoring of the programme, and in self-management where appropriate.

Cited by 8 publications

References 32 publications

Promoting urinary continence in people suffering a stroke: Effectiveness of a complex intervention—An intervention study

Promoting urinary continence in people suffering a stroke: Effectiveness of a complex intervention—An intervention study

Factors affecting the delivery of complex rehabilitation interventions in research with neurologically impaired adults: a systematic review

Effectiveness of repetitive transcranial magnetic stimulation against poststroke urinary incontinence: a study protocol for a randomized controlled trial

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