Effect Of Urinary Control Management On Neurogenic Bladder Symptoms And Stigma

Objective:To explore the effect of urine control management on neurogenic bladder symptoms and stigma.Methods:49 patients with neurogenic bladder of spinal cord injury who were admitted to the rehabilitation medicine from January to October in 2018 and met the inclusion criteria.They were implemented“time-type” combined with“capacity”intermittent catheterization and other comprehensive urinary management measures.At admission,discharge,one month after discharge and three months after discharge,we would dynamically evaluate neurogenic bladder symptoms and stigma of patients from different time points and analyze the factors affecting the recovery of neurogenic bladder.Results:1.A total of 49 patients with neurogenic bladder injury were included in this study,including 43 males(age: 44.05±13.78),6 females(age: 46.67±12.69);course of disease(40.04±35.67)and time from illness to complete removal of indwelling catheter(40.59±34.95).2.There were significant differences in the urination methods between patients at four time points(P<0.01).Comparisons were made between two nodes at different time points,it is considered that P<0.05/6?0.008 is statistically significant according to the number of comparisons.There were significant differences in urination methods between admission and discharge for 1 month,admission and discharge for 3 months,discharge and discharge for 3 months(P<0.008),while there were no significant differences in urination methods between admission and discharge,discharge and discharge for 1 month,discharge for 1 month and 3 months(P>0.008).3.The total score of neurogenic bladder symptoms,incontinence,storage and emptying,urinary tract complications,quality of life by single factor repetitive measurement,the difference was significant(P<0.01).Through pairwise comparison: the total score of neurogenic bladder symptoms,incontinence,storage,and emptying between discharge for 3 months and discharge,discharge for 1 month were statistically significant(P<0.01).Urinary tract complications and quality of life between discharge for 3 months and admission,discharge,discharge for 1 month were statistically significant(P<0.01).4.There were significant differences in total score and external stigma of chronic diseases by single factor repetitive measurement(P<0.05),but no significant differences in internal stigma(P>0.05).Through pairwise comparison: the total score of chronic disease stigma between discharge for 3 months and admission,discharge for 1 month were statistically significant(P<0.05).The score of external stigma between discharge for 3 months and admission were statistically significant(P<0.05).5.Gender,course of disease and duration of indwelling urinary catheter had an effect on neurogenic bladder symptoms,the difference was statistically significant(P<0.05).In additional,gender and the duration of indwelling urinary catheter were the main factor affecting neurogenic bladder symptoms.General data of patients had no effect on stigma,and there was no significant difference(P>0.05).Conclusion:1.Intermittent catheterization is the main method of urination after admission.Three months after discharge,urination is mainly performed by catheter/pad and toilet-free urination.The gradual recovery of bladder function reduces the physical and mental burden of patients.2.Neurogenic bladder symptoms dynamically changed with time.After discharge,the total score of neurogenic bladder symptoms showed a downward trend and the clinical symptoms improved significantly.At the same time,satisfaction and quality of life improved.3.The scoring score of chronic diseases was double-peaked,which scores of patients admitted to hospital and discharged for one month were relatively high and the discharge and discharge for 3 months were relatively low.The management of urinary control has positive significance that paid attention to patients' stigma while restored their bladder.4.The patient's gender,duration of disease and urinary catheter indwelling time have an effect on neurogenic bladder symptoms,among which gender and time of indwelling urinary catheter is the main factor affecting neurogenic bladder symptoms.Although general data of patients have no effect on stigma,patients have different degrees of stigma at different stages.Affective disorders caused by stigma are also a focus of attention in future clinical work.