International Journal of Urological Nursing最新文献

The aim of this study was to analyse the experience of users of indwelling bladder catheters and evaluate the anticipated usability of a prototype of the T-Control® urinary catheter (without being inserted) by patients who were able to compare the differences between the T-Control® prototype and other urinary catheters and urinary catheter accessories. A qualitative study was conducted with people who had lived with an indwelling urinary catheter for at least 1 week. Two user-centred design techniques were applied: patient experience trajectory map and Think Aloud, a method where the participants were able to express their previous experiences, expectations and preferences while manipulating the devices. The experiential trajectory was collected based on a semi-structured following interviews. Participants were able to manipulate the new T-Control® and, based on their previous experiences, compare the potential usability of T-control® with Foley-type catheter and its accessories All the participants stated that they had experienced negative emotions concerning bladder catheterisation during the trajectory of use, from the initial prescription and adaptation to the follow-up, and the forced life changes that a permanent catheterisation implies. The most frequent emotions were rejection and sadness. The new T-Control® device could potentially improve the patient experience, as all participants perceived advantages related to the closure system, ease of use, safety and discretion. Participants also noted its closure system as an advantage and highlighted its ease of use, although one-handed operation required some learning. Catheters currently on the market are functional, but some patients do not always have a satisfactory experience. This might negatively affect their quality of life, so there is a wide market opportunity for new devices that improve clinical and psychological care. Based on patient evaluation, the new T-Control® device with a built-in valve could provide benefits for patients.

This article aims to present updates and review current practise on the main imaging modalities used in diagnosis of bladder and prostate cancer and provide this to readers. Patients diagnosed with or having treatment for a urological cancer are a huge part of any urological nurses' rota or clinical responsibilities, particularly now in an era of ever changing and improving diagnosis and management options. In this manuscript a practical overview of imaging is given to influence a fuller understanding of therapeutic management in prostate and bladder malignancies. For the purpose of this article there is only a focus on imaging in terms of diagnosis and staging purposes. It is hoped that detailed use of imaging in radiotherapy and brachytherapy for planning and treatment verification will be the subject of a separate paper but, for now, it is briefly mentioned for readers that may be less familiar with radiation oncology. Discussion and overview of imaging modalities used in the diagnosis of prostate and bladder cancer will improve understanding for urology nurses, especially junior career nurses.

Catheter associated urinary tract infection (CAUTI) is the most prevalent healthcare-associated infection worldwide, and the use of care bundles such as CAUTI bundles has been identified as the most effective ways of preventing it. This cross sectional descriptive study thus, evaluated the application and barriers to application of CAUTI bundles in patients' care among nurses in a tertiary government hospitals. Census method was used to recruit into the study all 446 registered nurses and midwives who met the inclusion criteria in the institution; thus, no sampling was done to select the participants from the study area. Data were collected by means of researchers' developed and validated semi-structured self-administered questionnaire delivered through Google drive. Univariate and bivariate data analyses were conducted with the aid of SPSS version 24. Results of the study revealed that only 7 (1.9%) of the nurses claimed they always use written guidelines during catheter insertion, whilst majority 57.4% do not follow any written protocol or guidelines when inserting catheter. The use of aseptic non-touch technique was always done by 80% of the respondents. In general, score on compliance with the bundles was poor, as only 46.4% of the respondents correctly apply the bundles to patients' care. Barriers to application of the bundles as revealed by the results include; lack of written policy/guideline documents on CAUTI bundles in the facility (100%), lack of existing monitoring and feedback tools (98.9%), Supervisors/staff do not feel empowered to challenge suboptimal practices in a safe way (52.4%), lack of team meeting/ward round routinely addressing patients with indwelling urinary catheter (78.6%). It is thus, imperative to conclude that although the nurses in this study have some knowledge about the catheter associated urinary tract infections' bundles, their application of the bundles to patients' care is very poor, and was found to be due to some modifiable barriers. These barriers are some of the areas nurse educators and hospital policy-makers should focus in their bid to curbing healthcare acquired infections.

We sought to evaluate the effectiveness and acceptability by patients of transcutaneous sacral roots neuromodulation (TSRN) by paravertebral placement of surface electrodes to treat pelvic pain and pelvic muscle stiffness. Pelvic pain is a disabling condition, often related to non-relaxing pelvic muscles. Causes for the onset are often unclear; noninvasive treatment targeted at maintenance factors can be administered by nurses in some countries. previous studies have investigated the role of invasive stimulation for pelvic pain; TSRN has proved successful in other pelvic disorders. We conducted a pilot study on a sample of consecutive patients of both genders, reporting pelvic pain (chronic or not). Weekly sessions of TSRN with surface electrodes were performed; pain was recorded with the numeric rating scale (NRS) at baseline and after the end of the rehabilitation plan. Therapeutic success was defined as a reduction of 50% in pain scores. Twenty patients were enrolled, most complaining multiple symptoms apart from pain. Seven males had primary prostate pain syndrome, one had history of orthopaedic surgery, and eight had muscle stiffness (Median = 3 out of 4, IQR = [3;3], range [2;4]). Sixteen patients (12 males and 4 females) had chronic pelvic pain. The median NRS values in the sample at baseline was 4[5.5–7.5] with no significant differences between genders (p = 0.144) and decreased significantly (Me = 0.5, IQR[0.0–1.0], p < 0.001) after a median of 20 weekly sessions (range [10–30]). The results indicated clinically relevant benefit for all patients (ω² = 0.689, 95%IC[0.505–0.793]) Decrease in pelvic muscle stiffness was significant (from Me = 3, IQR [3] to Me = 0, IQR[0–1], p < 0.0001) without differences between the genders (p = 0.711). No significant difference was found in the number of sessions required by males and females to achieve therapeutic success (p = 0.282). TSRN seems a promising treatment for pelvic pain and can be performed in outpatients' clinics with low costs and no invasivity. Further studies on larger, randomized samples are required to confirm these results.

How can nurses assess the self-management of lower urinary tract symptoms (LUTS) in patients with cancer after radical prostatectomy (RP)? Patients with prostate cancer who have undergone RP experience multiple LUTS. This study aimed to develop a self-management scale for LUTS in patients with cancer following RP (SMS-LUTS-RP), as well as to verify its reliability and validity. LUTS has physical, social, and psychological consequences for patients. As a result, patients are forced to self-manage their LUTS and LUTS-related issues. However, no indicators exist to assess self-management of LUTS. A total of 246 individuals were surveyed. A 49-item scale draft, whose content validity and face validity were confirmed, was used to develop a questionnaire for patients with LUTS after RP. The reliability and validity were determined using by item analysis, exploratory factor analysis, confirmatory factor analysis, and Cronbach's α coefficient. The exploratory factor analysis produced the following 18 items on five extracted factors: ‘monitoring of urinary status,’ ‘coping with daily life difficulties due to LUTS,’ ‘collaboration with medical professionals,’ ‘continued training to improve LUTS,’ and ‘living with LUTS.’ The goodness-of-fit-index (GFI) for confirmatory factor analysis was 0.876, and the root mean square error of approximation was 0.075. Cronbach's α coefficient was 0.754–0.820. SMS-LUTS-RP has desirable psychometric properties and can assess the cognitive and behavioural aspects of self-management of LUTS in patients with cancer who have undergone a RP. This scale can be used to provide individualized self-management support according to living conditions.

Leuprolide acetate (LA) is a gonadotropin-releasing hormone agonist used as androgen deprivation therapy for advanced prostate cancer. LA is available in formulations intended for intramuscular (IM-LA) or subcutaneous (SC-LA) administration. Post-marketing reports have noted handling errors associated with the preparation and administration of SC-LA. This study gathered real-world evidence on administration and management of IM-LA and SC-LA in large, urology- or oncology-based practices. Over 200 staff were invited; 151 participated in an online survey. Main outcomes were time for each step of the ordering, inventory, mixing and administration processes. Mean values and standard errors are reported for continuous variables, and frequency and percentage are reported for categorical variables. Comparisons between groups were made with t tests and chi-square tests as appropriate. For IM-LA and SC-LA, ease of ordering and time to place an order (10.8 ± 1.3 vs. 10.6 ± 1.4 min, respectively) were similar. IM-LA was associated with a shorter time to complete preparation (2.5 ± 0.2 vs. 6.1 ± 0.6 min, P < 0.001) compared with SC-LA. This difference of 3.6 min per preparation could result in substantial time savings annually ranging from 120 h per year to 240 h per year in clinical practices administering 2000 injections per year or 4000 injections per year, respectively. For IM-LA vs. SC-LA, greater ease of preparation was reported by 64% vs. 43% of respondents, respectively. Over 15% of respondents used injection sites inconsistent with prescribing information, regardless of the type of injection. This study found that it takes a significantly shorter time to prepare and administer IM-LA than SC-LA in large urology- and oncology-based practices. The time saved could be utilized for other tasks such as seeing additional patients. Use of injection sites inconsistent with prescribing information suggests a need for more training of nursing staff in the proper administration of these drugs to ensure adequate testosterone suppression and patient safety.