Patients’ experiences of urinary retention and bladder care – A qualitative study in orthopaedic care

Madeleine Winberg , Maria Hälleberg Nyman , Erika Fjordkvist , Eva Joelsson-Alm , Ann Catrine Eldh
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Abstract

Background

Urinary retention is a common complication associated with hip surgery. There are easily available, evidence-based clinical practice guidelines prescribing how to prevent both urinary retention and other voiding issues, by means of bladder monitoring and risk assessments. A detected lack of adherence to such guidelines increases risks for unnecessary suffering among patients but a greater understanding of patients’ experiences can benefit tailored interventions to address quality and safety gaps in orthopaedic nursing and rehabilitation.

Purpose

The aim was to describe patients’ experiences of urinary retention, bladder issues, and bladder care in orthopaedic care due to hip surgery.

Method

This was a qualitative study with a descriptive design: content analysis with an inductive approach was applied to interviews (n = 32) and survey free-text responses (n = 122) across 17 orthopaedic units in Sweden.

Results

The patients had received no or limited details for the recurrent bladder care interventions (such as bladder scans and prompted voiding) while at the hospital. They relied on the staff for safe procedures but were left to themselves to manage and comprehend prevailing bladder issues. Despite the patients’ experiences of bladder issues or the risk of urinary retention postoperatively, the link to hip surgery remained unknown to the patients, leaving them searching for self-management strategies and further care.

Conclusions

Patients’ perspectives on bladder care, urinary retention and bladder issues can serve as a means for increased understanding of procedures and issues, reinforcing improved implementation of guidelines, including person-centred information. Safer bladder procedures imply further patient engagement, highlighted in guidelines.

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患者尿潴留与膀胱护理的经验——骨科护理的定性研究
背景:尿潴留是髋关节手术的常见并发症。有很容易获得的、基于证据的临床实践指南,规定如何通过膀胱监测和风险评估来预防尿潴留和其他排尿问题。如果发现不遵守这些指导方针,会增加患者遭受不必要痛苦的风险,但更好地了解患者的经历有助于采取有针对性的干预措施,以解决骨科护理和康复方面的质量和安全差距。目的描述髋关节手术后患者尿潴留、膀胱问题和膀胱护理的经历。方法这是一项描述性设计的定性研究:采用归纳方法的内容分析应用于瑞典17个骨科单位的访谈(n = 32)和调查自由文本回复(n = 122)。结果患者在住院期间未接受或仅接受过多次膀胱护理干预(如膀胱扫描和提示排尿)。他们依靠工作人员的安全程序,但留给他们自己来管理和理解普遍的膀胱问题。尽管患者经历了膀胱问题或术后尿潴留的风险,但与髋关节手术的联系对患者来说仍然是未知的,这使得他们寻找自我管理策略和进一步的护理。结论患者对膀胱护理、尿潴留和膀胱问题的观点可以作为增加对程序和问题的理解的手段,加强指南的改进实施,包括以人为本的信息。指南中强调,更安全的膀胱手术意味着进一步的患者参与。
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来源期刊
CiteScore
2.60
自引率
14.30%
发文量
34
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