title: Effectiveness of non-pharmacological interventions to promote urinary continence in stroke survivors – a systematic literature review
abstract: Background: Around half of the people who survive a cerebrovascular insult are suffering from urinary incontinence. This is a predictor for functional outcomes and affects the quality of life negatively. Until now, it is not clear, which the optimal method of treatment is. A systematic review of 2008 showed an insufficient data situation and couldn’t make a recommendation. Research question: Which non-pharmacological interventions are effective to promote urinary continence in adult persons who have suffered a cerebrovascular insult? Method: To answer the question a systematic literature review was performed. The literature search was conducted in the databases PubMed, CINAHL, CENTRAL and PsycInfo. The period from March 2007 to May 2015 was taken into account. Results: There were a total of six studies included which examined 732 persons. The following interventions were explored for their effectiveness: transcutaneous electrical nerve stimulation, urodynamic assessment with recommendation of bladder emptying method and interventions that consist of several components (e. g. toilet training). All studies showed a positive effect in at least one outcome. Conclusions: There is limited evidence for interventions to promote urinary continence in people suffering a cerebrovascular insult. An intervention consisting of assessment and individual adapted measures currently appear to be the best treatment method.
authors.affiliation: 1 Institut für Angewandte Pflegewissenschaft, Fachhochschule St. Gallen, Schweiz.|2 Institut für Pflegewissenschaft, Universität Wien, Österreich.|3 Kliniken Valens, Schweiz.
authors.forename: Myrta
authors.initials: M
authors.lastname: Kohler
authors.affiliation: 2 Institut für Pflegewissenschaft, Universität Wien, Österreich.
authors.forename: Hanna
authors.initials: H
authors.lastname: Mayer
authors.affiliation: 1 Institut für Angewandte Pflegewissenschaft, Fachhochschule St. Gallen, Schweiz.
authors.forename: Miriam
authors.initials: M
authors.lastname: Battocletti
authors.affiliation: 3 Kliniken Valens, Schweiz.
authors.forename: Jürg
authors.initials: J
authors.lastname: Kesselring
authors.affiliation: 1 Institut für Angewandte Pflegewissenschaft, Fachhochschule St. Gallen, Schweiz.
authors.forename: Susi
authors.initials: S
authors.lastname: Saxer
mesh_terms: D055318:Evidence-Based Nursing; D006801:Humans; D011379:Prognosis; D011788:Quality of Life / Q000523:psychology; D020521:Stroke / Q000150:complications* / Q000451:nursing* / Q000503:physiopathology / Q000523:psychology; D014039:Toilet Training; D004561:Transcutaneous Electric Nerve Stimulation / Q000451:nursing; D014549:Urinary Incontinence / Q000209:etiology / Q000451:nursing* / Q000503:physiopathology / Q000523:psychology; D014563:Urodynamics / Q000502:physiology
keywords: Pflegeintervention; Urininkontinenz; cerebro-vaskulärer Insult (CVI); nursing interventions; stroke; systematic review; systematische Literaturübersicht; urinary incontinence