An Evolutionary Concept Analysis of Urinary Incontinence

Nicole Zhang


Urol Nurs. 2018;38(6):289-295. 

In This Article

Abstract and Introduction


Urinary incontinence (UI) is a prevalent condition of pertinence for nursing. A concept analysis of UI was conducted using Rodgers' (2000) methods. A novel holistic definition and concept map of UI were developed for use in education and practice.


Urinary incontinence (UI) is a pervasive health condition that has a substantial holistic impact to the person as well as stifling healthcare costs. Rodgers (1989) stated that concept analyses are integral to examining concepts that are often simply seen as a task or a series of tasks. UI is one of those concepts. Management of UI is commonly perceived as a set of tasks to avoid poor outcomes, while the concept, definition, and its usage and application are not widely considered. In light of the importance of UI management to nursing practice, a concept analysis of UI was performed following Rodger's (1989, 2000) evolutionary concept analysis methods. Incontinence was the general term used for much of the literature analysis because it is the most commonly used term. Patients are often labeled "incontinent" without specification as to the form, and unfortunately, the cause or the classification of incontinence. Therefore, examining UI as a concept is critical to understanding the meaning of incontinence.

UI is present in all healthcare settings, but it can be particularly challenging for aging adults residing in extended care facilities. A study by Offermans, Du Moulin, Hamers, Dassen, and Halfens (2009) found the prevalence of UI in these settings to be as high as 77%. In older adults, there are relatively fewer UI management options, even though UI has a significant impact on healthcare outcomes and well-being. However, methods used to manage UI in extended care facilities have progressed very little over time. While there have been advances in drug therapies and surgical procedures, the vast majority of these options are not feasible for the aging adult.

Even with improved assessment and care planning, the prevalence of UI is still staggering. An estimated 200 million people worldwide experience UI (Wood & Anger, 2014). In addition to the increased prevalence among residents of extended care facilities, the development of UI is associated with negative effects that are much more complex than simple skin breakdown. Damian, Pastor-Barriuso, Garcıa Lopez, and de Pedro-Cuesta (2017) found that UI was associated with a 24% increased risk of mortality for older institutionalized adults. Moreover, the risk for mortality increased as the level of severity of UI rose, with a 44% increase in risk of mortality for those with severe UI (Damian et al., 2017).

These statistics make it apparent that UI is a prevalent and serious health issue. Surprisingly, there is little in the literature about the complex nature of UI, a catchall term used to describe various nuances and etiologies of this condition. To gain a better understanding of UI, a concept analysis was undertaken to provide a foundation for further research into this critically important issue.