Urinary Incontinence: United States and British Nursing Perspectives

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Abstract
The articles prior to January 2008 are part of the back file collection and are not available with a current paid subscription. To access the article, you may purchase it or purchase the complete back file collection here Karin Dufault It is conceivable that nurses practicing in different countries approach similar nursing care problems from their own unique perspective. The perspective may be dictated in part by distinct educational preparation, national values and priorities, and other cultural and demographic variables. It is generally recognized that Great Britain has provided leadership in the medical and nursing care of geriatric patients in hospitals, nursing homes, and in the community. The purpose of this paper is to examine one geriatric nursing care problem as it is discussed in recent British nursing journals and to compare and contrast the approaches with those found in recent journals from the United States. The nursing care problem chosen for comparison is that of urinary incontinence. Study Approach The journal articles reviewed for this study were selected from among those listed in the Cumulative Index to Nursing Literature, Vol. 20 (1975) and Vol. 21 (1976), under the heading "Urinary Incontinence." The articles listed in these two volumes represented 18 articles from Great Britain, 10 from the United States, and one from both Canada and Australia. The topics of the articles as suggested by the titles varied widely in both United States and British journals. They included: (a) specific target groups, such as the elderly, spinal cord injured patients, and stroke patients; (b) specific treatments, such as physiotherapy, electrical stimulation, artificial urinary sphincters, and behavioral therapy bladder retraining; and (c) collecting devices, such as portable urinals and external catheters. For purposes of this paper, articles were selected for comparison that addressed the problem of incontinence in the elderly and chronically ill. The titles and authors of the selected articles are listed in Table I according to the country of publication. These articles were compared and contrasted by the following characteristics: (a) descriptiveness of title; (b) general content overview; (c) basic assumptions about incontinence, nursing attitudes and responsibilities, and rewards of continence; (d) approaches to intervention; and (e) supporting literature. Titles In general, the titles of both British and United States articles were descriptive of the article's major content. However, it would have been helpful to the reader for information retrieval if the target population of the article had been identified in the title when a specific group of patients was used. Wells did provide such a descriptive title as did Wilson. As indicated by the titles, the British articles examined incontinence in a more global manner than did the United States articles. British authors discussed the promotion of continence to prevent incontinence as well as provided a comprehensive approach to the understanding and treatment of incontinence. The sixpart series on incontinence contributed greatly to the multifaceted understanding of the incontinence problem. In contrast, the United States article titles indicated concern for specific bladder training programs with the exception of one article which only demonstrated use of male external collection devices. Content Overview To gain a clearer understanding of the varied approaches to the problem of incontinence found in this survey, an overview of the British and United States articles will be provided. The articles will be examined by authors beginning with the British journals. Willington. In his articles, Wellington (1975) stated his attempt to relate the problems of incontinence to the totality of health in the individual. He established incontinence as a major problem to the incontinent person, to families, to nursing staff, and to society. The complexities of incontinence with its physical, psychological, and social variables were discussed. The range of causative factors were explored and the psychological and psychogenic aspects were described. In articles related to nursing care, Willington purposed to demonstrate that nursing staff contribution to… 10.3928/0098-9134-19780301-07

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