A Study Of Post-Surgery Home Care In Adolescents With Urinary Incontinence

Objectives:In order to fully know and explore the situation of home care among adolescents after urinary incontinence surgery, to carry out "heath instruction manual for adolescents with urinary incontinence" and have a clinical trial to evaluate the manual, to recognize the health problems timely among adolescents after urinary incontinence surgery, so as to provide better continuing nursing care after discharge.Subjects and MethodsSubjects:Adolescents with urinary incontinence, who were in hospital from2007.7to2014.1from one top tertiary hospitals in Jinan were selected, the inclusion criteria was:①age between10to19when admitted into the hospital;②including diagnosis of urinary incontinence, and could not be cured through surgery;③be conscious, be able to read, have no problem when communicating with researchers;④be able to participate in telephone interview independently; exclusion criteria:①serious cognitive disorder;②have mental illness;③comprise with other serious chronic illness and cannot be cured.Methods:Quantitative research combined with qualitative research was applied. Frist, interviewed was carried out to explore the problems and needs of adolescents with urinary incontinence refereeing to home care, and literature analysis was combined to carry out "heath instruction manual for adolescents with urinary incontinence". After evaluation by experts and clinical trial, telephone interview was adopted after discharge, once a month and third time for one subject in all, and the "heath instruction manual for adolescents with urinary incontinence" was revised according to the result of clinical trial. Telephone interview contained primary illness of the subject, surgery, health need, the illness’s affection to heath development, and the need of instruction. Questionnaires included the short version of "Testing of the Incontinence Impact Questionnaire"(Incontinence Impact Questionnaire, IIQ-7), WHO Disability Assessment Schedule2.0Ⅱ (World Health Organization Disability Assessment Schedule2.0, WHODAS) were used to to evaluate quality of life and health related functions. Using the method of text analysis to analyze the interview, quantitative data used descriptive statistics and repeated measurement of single factor analysis by SPSS13.0Results:34patients attended in the first interview, including20boys and14girls, the average age was11.9years when they were in hostital (s=1.99years), and the average age was14.4years when the interview(s=2.47years). Total of27patients had a clinical trial to try health guide, including10boys and17girls, the average age was12.4years old when they were in hostital (s=3.08years). With a total of five experts to participate in the validity evaluation and manual modifications, of which3doctors and2nurses,2men and3women, the average age was39.2years (s=8.17years).1. In the preliminary interview, we found that the problems of home care among adolescents with urinary incontinence including:genera#1. shortage of illness and information, such as, surgical complications and treatment, the key medical treatment and outcome; genera#2. lack of self-care, specifically, poor compliance, poor care of incontinence and activity limitation; genera#3. poor emotional reaction, such as negative emotional reaction, lack of positive reaction, and lack of psychological counseling; genera#4. restraint of social development, such as, social alienation, challenge in study, and shortage of support system.2. To hand out heath instruction manual one or two days before leaving hospital, and telephone once a month, the total scores were, IIQ-7:7.4±4.20,5.2±4.24,4.0±3.60, WHODAS Ⅱ:72.7±13.88,58.3±12.82,49.5±10.65. The overall scores had significant difference in1month interview,2month interview,3month interview, IIQ-7:F=39.661, P<0.001; WHODAS Ⅱ:F=166.513, P<0.001. Specifically, the dimension scores of IIQ-7in activity, travel, social relation and emotion had significant difference.(activity, F=19.690,P<0.001; travel, F=14.203, P<0.001; social relation, F=11.607, P<0.001; emotion, F=19.887, P<0.001)。The overall score of WHODAS Ⅱ were significantly different in1month interview,2month interview,3month interview,(Understanding and communication, F=26.614, P<0.001; going around, F=63.616, P<0.001; self-care, F=49.122, P<0.001; getting along with others, F=43.376, P<0.001; life and activities, F=59.520, P<0.001; Social participation, F=140.254, P<0.001. The problems of telephone interview were negative emotional reaction, activity restriction and study challenge.Conclusion:Adolescents with urinary incontinence may face many mental and physical illness, and chronic suffer may turn into psychological disorder. In this research, we hand out "heath instruction manual for adolescents with urinary incontinence" and interviews, we find out the quality of life and functional status had been greatly improved. This shows that clinical nursing and intervention after discharge should be taken to promote the study, growth and positive development. Also, the results could be used to push the development in nursing practice, research and education, so as to enhance the capacity of nurses in area of adolescents with urinary incontinence.