RESUMEN

Parkinson's disease is among the most common neurological diseases. About 4.1 million people are attected worldwide. The course of Parkinson's disease is chronically progressive. With L-Dopa therapy the life expectancy of people being affected by Parkinon's disease is not shortened compared with people who are not affected. Therefore people with Parkinson's disease often suffer from the serious effects for decades which include motor symptoms as well as vegetative disturbance, which concerns bladder function and functions of the gastrointestinal tract. Urinary and fecal incontinence involve severe impairment of quality of life. In this review the occurence of urinary and fecal incontinence should be determined in order to be able to describe its extent. There are different measures for treatment or improvement. These are reviewed based on the following research question: Which effects do interventions have in improving urinary and fecal incontinence in persons with Parkinson's disease compared to usual care? In order to answer the questions a systematic review was conducted. The literature search occured in the electronic databases Cochrane database, PubMed and CINAHL. Three studies investigating the prevalence with a total sample size of n = 1077 and for the evaluation of interventions four studies with a total sample size of n = 48 have been included. 25 percent of the women with Parkinson's disease suffer from urgency incontinence compared to seven percent of the women without Parkinson's disease (p < 0.01). Among men with Parkison's disease 28 percent are affected and six percent among men without Parkinson's disease (p < 0.01). In respect to stress and fecal incontinence there were no significant differences between people affected and people not affected by Parkinson's disease. With pelvic floor muscle exercises and accompanying measures as well as with injections of botulinum toxin A a reduction of urinary incontinence seems to be possible. Due to methodological insufficiency of these studies, no clear recommendations can be given.

Asunto(s)

RESUMEN

AIMS: To determine the effect of psychoeducational interventions on urinary and faecal incontinence and erectile dysfunction in men 50 years and older after prostatectomy for prostate cancer in comparison to usual care. BACKGROUND: Prostate cancer is the second most frequently diagnosed cancer in men worldwide. The major complications of radical prostatectomy are urinary and faecal incontinence as well as sexual dysfunction, associated with significantly reduced quality of life. DESIGN: A systematic review of randomized controlled trials was undertaken to provide a narrative synthesis and critical appraisal of included studies. DATA SOURCES: The electronic databases MEDLINE and CINAHL were searched using a systematic search strategy for studies published between January 2001-December 2012. In addition, reference lists of included papers were checked. The Cochrane Database was screened for whether a review on this topic already exists. REVIEW METHODS: The systematic review included randomized controlled trials in men after prostate cancer treatment and psychoeducational interventions to influence urinary or faecal incontinence and erectile dysfunction. The quality of studies was assessed by the reviewers using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method. RESULTS: Eight trials met the inclusion criteria. Although these studies are heterogeneous and of varied quality, a descriptive synthesis of results suggests that psychoeducational interventions may improve urinary incontinence, bowel bother, sexual function and sexual bother to some extent. CONCLUSION: The results of this systematic review indicate that it would be worthwhile to implement postprostatectomy psychoeducational interventions into nursing discharge planning. Future research is necessary to corroborate these results and define the most favourable time to implement psychoeducational interventions.

Asunto(s)

Asunto(s)

RESUMEN

This article describes a framework model within a selected nursing classification system for the integration of nursing care processes into a clinical information system. The "Electronic Nursing Process Data Model," project was carried out from July 2004 to October 2006 in the Canton of Zurich in Switzerland. The Zurich Electronic Nursing Process Data Model integrates the nursing diagnosis, outcomes, and intervention terminologies in a standardized manner into the nursing care process within the electronic patient record. Findings of the pretest application in clinical nursing practices revealed that (1) functionalities are logically structured, (2) it is difficult to overview many details of the documentation, (3) a specific "to-do list" retrieved from the electronic system is needed, and (4) free-text entries are important to add description of the patient's situation. Furthermore, a consistent assessment terminology needs to be linked to the nursing diagnosis, outcomes, and intervention terminologies and the descriptions of nursing care process within the Electronic Nursing Process Data Model. As the project team, we recommend to implement the developed Electronic Nursing Process Data Model into professional software of clinical information systems and gradually into clinical practice. Therefore, an appropriate utilization strategy includes issues to improve nurses' understanding of the nursing care process and critical-thinking skills: not even the most comprehensive software program can substitute for facilitation.

Asunto(s)