An Evolutionary Concept Analysis of Urinary Incontinence

Nicole Zhang

Disclosures

Urol Nurs. 2018;38(6):289-295. 

In This Article

An Exemplar Case in the Form of a Personal Vignette

An 85-year-old female has just arrived at her new residence, an extended care facility, upon dismissal from a local hospital. A life-changing medical event occurred, prompting the hospital stay and subsequent decision to place this woman in an extended care facility so she could receive the care needed. A consideration for this change of residence was the presence of UI that developed during her hospital stay; the condition was not present before this hospitalization. The family expressed concerns of managing her UI effectively and preventing complications related to this health condition.

As with any life change, time and patience are needed. The idea of residing in an extended care facility was new and a deviation from the original dismissal plan. Sadness, anger, and even resentment can be part of the grieving process associated with loss. In this case, the patient lost both her independence and control over her body. She was self-conscious and embarrassed about not being able to take care of her own personal care needs. As a result, it was difficult for her to assimilate into the new environment. Friends were not easy to make because there was a fear of being too far from a restroom, which affected her self-concept.

As time went on, the patient was astounded by the lack of privacy and respect the staff had for her toileting needs. She disliked the way staff asked her to go to the bathroom like a child and was embarrassed when UI occurred in public.

The patient chose to remain in her room as her UI became progressively more difficult to manage. It seemed medical professionals did not view her UI as a problem. She was never thoroughly assessed to figure out why UI was getting worse and if there was a modifiable condition at the root.

Skin deterioration began to occur. Now, wearing briefs, there was a feeling of being less attractive. When her husband came to visit, she was distant, especially when her husband offered her compliments. Her husband attempted to broach the topic of the change in their relationship, but he was quickly dismissed.

As a result of UI, many issues developed in her life. These issues were not one isolated incident, but rather, a cyclic course of events that impacted nearly every area of her life in a recurrent manner. From this exemplar, it is clear UI has far-reaching impacts. The way nurses and other medical staff perceive and manage UI greatly affects its progression and the resultant effects on the person.

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