Relationships among occupational stress, toileting behaviors, and overactive bladder in nurses: A multiple mediator model.

AIMS: To investigate: (a) the prevalence of overactive bladder among male and female operating room nurses; (b) the unhealthy toileting behaviours that nurses adopt to void their bladders; and (c) the mediating roles that different toileting behaviours play in the relationship between occupational stress and overactive bladder. DESIGN: A cross-sectional design was used. METHODS: This study was conducted from July - September 2016 in Jinan, China. Four hundred eligible operating room nurses in five hospitals were recruited. Data were collected through survey questionnaires including the nurse job stress scale, the toileting behaviours scale and the overactive bladder symptom score questionnaire. Multivariate linear or logistic regression models, as appropriate, were used to test the mediation effect of each toileting behaviour on the relationship between occupational stress and overactive bladder. RESULTS: Overactive bladder was highly prevalent in both male and female nurses working in operating rooms. Approximately one of three nurses reported experiencing an overactive bladder. The most common unhealthy toileting behaviour was delayed voiding. Unhealthy toileting behaviours mediated the relationship between occupational stress and overactive bladder. With high levels of occupational stress, nurses tended to adopt unhealthy toileting behaviours to empty their bladders. The more the nurses engaged in unhealthy toileting behaviours (e.g. delayed voiding and straining to void), the greater the likelihood of having overactive bladders. CONCLUSIONS: This study highlights the mediating role of toileting behaviours on occupational stress and overactive bladder. To accommodate occupational stress, nurses engaged in unhealthy toileting behaviours that were detrimental to their bladder health.

CE: Overactive Bladder in Women.

: Overactive bladder is a term used to describe a group of lower urinary tract symptoms that are prevalent in women, particularly as they age. Those with overactive bladder often experience related physical and psychological symptoms or conditions and report a poorer quality of life than other women. Many factors that increase the risk of developing overactive bladder are modifiable; therefore, lifestyle and behavioral interventions are first-line treatments. More treatment options are becoming available to women as research provides new information about the underlying pathophysiology of overactive bladder. Nurses play a major role in its screening, assessment, and management in women, many of whom do not seek help and try to self-manage symptoms, leading to a continuing cycle of unpredictable urgency and incontinence.

Coping with patients suffering from overactive bladder: experiences of family caregivers in Hong Kong.

This article examines the experiences of family caregivers working with patients affected by overactive bladder (OAB) in Hong Kong. Chronic diseases create physical and emotional burdens not only for patients but also for family caregivers, who often experience physical and emotional burnout and social impairment. Extensive literature has pertained to caregiver experiences in western and non-western settings; however, few studies have addressed the livelihoods and experiences of family caregivers of patients with OAB in ethnic Chinese communities. Because of the increasing prevalence of OAB worldwide, this study investigated the experiences of such caregivers in Hong Kong, examining their emotional and social needs. A qualitative research design with individual semistructured interviews was adopted, and snowball sampling was used to recruit 35 family caregivers who were referred by patients with OAB. The participants were interviewed individually from May to August 2013. A phenomenological approach was adopted in the data analysis. The data revealed that all participants had unpleasant experiences in caring for family members with OAB. A sense of powerlessness, helplessness, confusion and guilt, as well as grievances and social withdrawal, was prevalent, causing great physical and emotional suffering and subsequent physical and emotional burnout. These negative experiences were often caused by confusion regarding caretaking duties. The negative emotions of the participants and their family members also caused a lack of communication and mutual understanding about the disease, causing care-giving to be even more confusing and difficult. Furthermore, because of traditional Chinese cultural values and gender expectations, male participants experienced the triple burden of employment, domestic duties and care-giving. More holistic social and healthcare support services should be provided for care-giving family members of patients with OAB patients, empowering such caregivers to attend to family members and care for their own emotional well-being.

Overactive bladder in women.

Overactive bladder in women is a common chronic condition of urinary storage, affecting a significant proportion of the population. It is defined as a symptom diagnosis that indicates lower urinary tract dysfunction, in which patients experience urinary urgency, with or without urge incontinence, usually accompanied by frequency and nocturia. The diagnosis and treatment of overactive bladder are straightforward and systematic in line with national and international guidelines. However, women are required to disclose their bladder symptoms, and be motivated to make changes to their lifestyle to see improvements. This article focuses specifically on idiopathic detrusor overactivity; its diagnosis, treatment and psychological effects on women. Healthcare professionals require an understanding of the pathophysiology and treatment rationale for the condition to ensure appropriate management strategies for patients presenting to primary and secondary care are implemented.

Patient Satisfaction With Nurse-Led Telephone Follow-up in an Ambulatory Setting.

OBJECTIVES: We studied our practice of using nurse telephone follow-up under physician direction to assess symptom improvement and patient satisfaction. METHODS: Women were recruited when their clinical care merited nurse telephone follow-up in the opinion of the attending physician. Women specified a preferred telephone number and completed a symptom questionnaire at the time of enrollment. Nursing telephone follow-up was completed at an interval prescribed by the attending physician to answer specified clinical questions. Approximately 3 months after the initial in-office visit, a satisfaction questionnaire and repeat symptom measure were mailed to the subjects. RESULTS: A convenience sample of 83 women was analyzed. Of those, 91.6% were reached by telephone, and 47.0% returned the follow-up questionnaire. Mean (SD) age was 56.8 (16.6) years (range, 20-89 years). Younger women were less likely to be able to be contacted by telephone (P = 0.02) and less likely to return the questionnaire (P = 0.02). Most common diagnoses were overactive bladder and mixed urinary incontinence. Satisfaction rates were high, and level of convenience for patients was high. Women indicated an ease of speaking over the telephone about their condition and confidence in the treatment plan. Satisfaction with telephone follow-up did not significantly differ based on age or diagnosis. CONCLUSIONS: Patient satisfaction was high for nurse telephone follow-up to replace in-office visits for selected diagnoses. This care strategy deserves further consideration for reimbursement purposes as health care evolves.

Vaginal oestrogen for overactive bladder in post-menopausal women.

This article asks the question 'Should nurses recommend vaginal oestrogen for overactive bladder in post-menopausal women?' The article will review the evidence for use of vaginal oestrogen and consider the potential side-effects and risks. The main finding is that vaginal oestrogen is effective for treatment of overactive bladder in post-menopausal women with vaginal atrophy. However, vaginal atrophy is undertreated. This article identifies some of the barriers that may prevent diagnosis and treatment, and suggests changes in practice. Nurses should take the initiative and ask post-menopausal women about symptoms. Nurses should be trained to examine women, diagnose vaginal atrophy and discuss treatment.

Efficacy of solifenacin for overactive bladder symptoms, symptom bother, and health-related quality of life in patients by duration of self-reported symptoms: a secondary analysis of the VIBRANT study.

In this post-hoc analysis of data from patients with overactive bladder (OAB) in VIBRANT patients receiving solifenacin showed statistically significantly greater improvement versus placebo in most outcome measures regardless of OAB symptom duration (less than five years and five years or longer).

Traces: making sense of urodynamics testing--Part 9: Evaluation of sensations detrusor response to bladder filling.

Part 9 of the Traces series continues the discussion of how urodynamic clinicians generate usable data from a filling cystometrogram. This article focuses on the question: "What is the detrusor's response to bladder filling?" Answering this question requires the clinician to identify and differentiate detrusor contractions from abdominal events, artifacts, or low bladder wall compliance; documentation of the volume of the contraction; and assessment of its clinical relevance as an overactive or subclinical detrusor contraction.

Behaviour change to treat overactive bladder syndrome.

Overactive bladder syndrome has a negative impact on quality of life. This article discusses a definition of the condition and its the prevalence and aetiology, as well as some of the more common behavioural therapies. Although there is a good evidence base for bladder retraining, there is often conflicting research to support other interventions including caffeine reduction, the amount and types of fluid recommended, smoking cessation and weight reduction. A standardised approach from a national level is needed; nurses also need to demonstrate more robustly the effectiveness of their interventions.

Characteristics and impact of interrupted sleep in women with overactive bladder.

Women who self-report symptoms of overactive bladder (OAB), including nocturia, experience significant sleep deficits and a diminished quality of life. These deficits and their impacts are greater among women who awaken two or more times per night. When evaluating patients with OAB, it is important for clinicians to assess sleep habits and practices in addition to bladder symptoms to fully gauge the health and well-being of women with OAB.

Gelnique (oxybutynin chloride) 10% gel for overactive bladder.

This article provides an overview of oxybutynin transdermal gel (Gelnique), its uses, and product information.

[Input from a specialized nurse consultation in the management of detrusor overactivity treated with intradetrusor injections of botulinum toxin in urology department. Pilot study]. / Apports d'une consultation infirmière spécialisée dans la prise en charge de l'hyperactivité détrusorienne traitée par injections intradétrusoriennes de toxine botulique dans un service d'urologie. Expérience pilote.

OBJECTIVES: To adapt in daily practice, in a urology department, recommendations for good clinical practice for follow-up of neurological patients with neurogenic detrusor overactivity treated with injections of botulinum toxin type A by involving a referent nurse in neuro-urology. METHOD: A nurse consultation in neuro-urology has been created in June 2007 to intervene at each follow-up consultation at D0, D8, D45, then by phone until reappearance of functional signs to organize a new injection of botulinum toxin. This pilot study evaluated the faisability, the input on clinical workload, and the benefit on relationship between the patient and the caregiver. RESULTS: An improvement of the quality of care has been given to the patient since first contact to follow-up. The number of neurological patient transfers and waiting time between the recurrence of functional signs and new therapeutic care were reduced. The number of medical consultations has been reduced saving time to redistribute on other activities. Knowledge improvement and privileged relationship with the patient and the doctor were reported by the referent nurse. CONCLUSION: The participation of a referent nurse in neuro-urology has improved the quality of care of these patients from first contact to follow-up and has allowed adaptation of the recommendations in the practice of caring of an urology department.

The use of botulinum toxin type A in urological procedures.

Botox is a sterile, vacuum-dried, purified BoNT-A produced from fermentation of Clostridium botulinum. There is an abundance of literature to support the use of Botox in urology, and its off-label use continues to grow. While there are no FDA-approved clinical indications, there are ongoing phase II and III studies to approve Botox for use in some urological conditions. This article will explore the use of Botox in urology and provide a brief review of the literature supporting its use.