How to intervene in different degrees of stress urinary incontinence?

On February 1, 2021, the Chinese Nursing Association issued the document [2021] No. 3, which announced the approval of 10 group standards, including Nursing Intervention for Stress Urinary Incontinence in Adult Women, in accordance with the "Management Measures for Group Standards of the Chinese Nursing Association". The 10 group standards will be implemented from May 1, 2021.

Below is an interpretation of the group standard T/CNAS 17-2020 "Nursing Intervention for Stress Urinary Incontinence in Adult Women".

What are the applicable scopes marked in “Nursing Intervention for Stress Urinary Incontinence in Adult Women”?

1. It stipulates the basic requirements, assessment and intervention measures for the care of stress urinary incontinence in adult women.

2. Applicable to qualified nursing staff in various medical institutions, nursing homes, communities and home care at all levels.

What terms and definitions are involved in "Nursing Interventions for Stress Urinary Incontinence in Adult Women"?

1. Stress urinary incontinence: When abdominal pressure increases suddenly, such as when sneezing, coughing or exercising, urine leaks involuntarily from the urethra.

2. Pelvic floor muscle training: Consciously perform autonomous contraction exercises on the pelvic floor muscle groups, mainly the pubococcygeus muscle groups, also known as Kegel exercises.

3. Intermittent urination: Pause urination for 3-5 seconds during urination and then continue to urinate.

What are the basic requirements of “Nursing Intervention for Stress Urinary Incontinence in Adult Women”?

1. Intervention measures should be developed based on individualized principles, based on the assessment and the severity of stress urinary incontinence.

2. Communicate and collaborate with specialists, patients and caregivers to jointly develop and implement nursing measures.

3. Patient privacy should be protected, and a respectful and encouraging attitude should be maintained, and psychological support should be provided.

How is stress urinary incontinence assessed in adult women?

1. When urinary incontinence is suspected, the "Urinary Incontinence Type Assessment Questionnaire" should be used to determine whether stress urinary incontinence is present.

2. It is advisable to use the "Subjective Grading Method for Clinical Symptoms of Stress Urinary Incontinence" to evaluate and record the severity of urinary incontinence.

3. For patients with moderate to severe symptoms, the "1-hour urine pad test" should be used to assess and record the severity of urine leakage.

4. For patients with moderate to severe symptoms, it is advisable to evaluate and record the improvement of urinary incontinence symptoms and urine leakage at least weekly.

What measures can be taken for stress urinary incontinence in adult women?

1. Divide and conquer by risk level

1.1 Mild patients

1.1.1 Patients should be informed to visit the outpatient clinic or receive telephone consultation, and be guided to use urine pads and change their unhealthy lifestyles.

1.1.2 Patients should be taught how to perform pelvic floor muscle training for at least 3 months.

1.2 Moderate patients

1.2.1 In addition to intervention measures for mild patients, they should be advised to seek treatment at a specialist hospital.

1.2.2 The patient should understand the urination pattern and record the interval between urination, activities related to urine leakage, fluid intake, etc.

1.2.3 A toileting plan should be made according to the urination pattern. Urinating can be done every 2 hours to empty the bladder as much as possible.

1.2.4 If there is no urine leakage within 24 hours, the urination interval should be extended by 15 minutes until urination can be completed every 3-4 hours without urinary incontinence.

1.2.5 During and at the end of pelvic floor muscle training, the “Pelvic Floor Muscle Contraction Evaluation Form” should be used to evaluate effectiveness.

1.3 Severely ill patients

1.3.1 Based on the intervention measures for moderate patients, they should be recommended to go to a specialist hospital for surgical treatment.

2. Lifestyle intervention

2.1 For patients with a body mass index greater than 30 kg/m2, a weight loss plan should be developed with them.

2.2 For smokers, smoking cessation intervention strategies should be provided.

2.3 Patients should be guided to increase dietary fiber in their diet and reduce spicy foods and beverages containing alcohol, caffeine, or carbonated drinks.

2.4 Patients with dyspnea should be instructed to have regular bowel movements and advised not to exert excessive force during bowel movements.

2.5 Patients should be instructed to reduce or avoid actions such as lifting heavy objects, laughing, running, jumping, and brisk walking.

2.6 Patients should be instructed to limit fluid intake 4 hours before bedtime.