Urinary and Bowel Incontinence Intervention Essay (Literature Review)

Introduction

Urinary and bowel incontinence has been a subject of various studies, ranging from the effectiveness of various methods in its prevention to large-scale analyses of patient records to determine the incidence of such in the ICU and other hospital units. At the same time, there are still gaps present in the existing body of research, in particular towards educational interventions in BUI aimed at nurses and supporting personnel. The lack of such intervention explains, in part, the relatively low knowledge levels of nurses treating patients with BUI, their skills never going far beyond rudimentary practical concerns. Such a situation needs to be rectified in order to improve the conditions for patients, reduce costs, and achieve greater benefits for patients. The purpose of this paper is to analyze and compare the bodies of existing studies and highlight similarities and differences in their various aspects, which would help inform the proposed PICOT intervention.

Comparisons of Research Questions

Research questions of the reviewed studies typically depend on the type of study being performed. For example, studies by Aguiyar and Franco (2018) as well as Danielis et al. (2020) only sought to answer the question of the state of knowledge in regards to BUI and various aspects of its treatment. As such, they only sought to systematize the existing knowledge rather than add something new to the discussion. Intervention-type studies, on the other hand, had a much narrower scope of practice, which informed the choice of research questions. Brown et al. (2019) features one such intervention, with the questions being answered relating directly to the effectiveness of such interventions. Prevalence studies sought to learn about the significance of the problem in the ICU and other areas, or the specifics of certain conditions associated with BUI, such as the perineal dermatitis (Stokes et al., 2016; Kawanabe et al., 2018; Donnelly et al., 2018; Mohammed & Nadr, 2018). Finally, expert recommendations seek to answer the specific questions of how to treat certain diseases. In the chosen literature array, the study by Garcia et al. (2015) seeks to answer the question of how to manage fecal incontinence in the ICU. All of these research questions have different purposes and scopes, but for the purpose of the proposed study it is best to follow the example of Brown et al. (2019) and build research questions around the purpose of the study.

Sample Population Comparison

Sample populations for chosen studies relate to one another, reflecting the research questions and the overall study designs. Sample sizes for systematic literature review vary, but are usually narrowed down to roughly 100-200 entries published in peer-reviewed academic journals in the past decade. The number of participants in cited studies, again, varies, due to a very large scope of the overview. RTSs and interventions, s demonstrated by Brown et al. (2019), typically have between 20 to 200 participants, depending on the purpose, scope, and financial backing of the study. Prevalence and incidence studies, such as those of Stokes et al. (2016), Kawanabe et al. (2016), and Donnely et al. (2018), feature large samples with patient number varying between several hundreds to several thousands, which are much larger than those of other studies reviewed in this paper.

Study Limitations Comparisons

Once more, the limitations of each study are largely attributed by the choice of the framework and methodology for each of the reviewed articles. The primary weakness of the featured literature reviews lies in the fact that they rely on older research and do not provide additional insights beyond what is already known (Stokes et al., 2016). RTSs and interventions typically have a limited scope and not enough representation by race, socio-economic status, and other important factors that might have an effect on the study in question (Brown et al., 2019). Large-scale incidence and prevalence studies typically do not offer any significant insights into the reasons behind said incidence and prevalence, with any connections between the two being correlational, at best (Kawanabe et al., 2016). The proposed study is likely to have issues with representation as well due to the relative small scale of the intervention, being limited only to one ICU.

Conclusions

Most peer-reviewed journals have a relatively high standard of scrutiny, which helps avoid the usual trappings associated with studies of various kinds. The limitations and traits of different studies are, thus, largely motivated by the chosen methodology and the availability of resources. Based on the findings of this paper, it could be concluded that the expected sample size for the intervention would be at about 20 nurses at its highest, with methodological and financial constraints being the primary limitations of the study. Research questions will also be limited to the immediate scope of the effectiveness of the intervention. The results of the paper would add to the available knowledge and help bridge the gap regarding the effectiveness of educational interventions in nurses to reduce the incidence and prevalence of BUI in an ICU setting.

References

1. Aguiar, L. M., & Franco, I. (2018). Bladder bowel dysfunction. Urologic Clinics, 45(4), 633-640.
2. Brown, H. W., Braun, E. J., Wise, M. E., Myers, S., Li, Z., Sampene, E.,… & Rogers, R. G.(2019). Small-Group, community-member intervention for urinary and bowel incontinence: A randomized controlled trial. Obstetrics and Gynecology, 134(3), 600-611.
3. Danielis, M., Palese, A., Terzoni, S., & Destrebecq, A. L. L. (2020). What nursing sensitive outcomes have been studied to-date among patients cared for in intensive care units? Findings from a scoping review. International Journal of Nursing Studies, 102, 103491.
4. Donnelly, D. W., Donnelly, C., Kearney, T., Weller, D., Sharp, L., Downing, A.,… & Cross, W. R. (2018). Urinary, bowel and sexual health in older men from Northern Ireland. BJU International, 122(5), 845-857.
5. García, C. B., Binks, R., De Luca, E., Dierkes, C., Franci, A., Gallart, E.,… & Gibot, S. (2015). Expert recommendations for managing acute faecal incontinence with diarrhoea in the intensive care unit. Journal of the Intensive Care Society, 14(4_suppl), 1-9.
6. Kawanabe, E., Suzuki, M., Tanaka, S., Sasaki, S., & Hamaguchi, T. (2018). Impairment in toileting behavior after a stroke. Geriatrics & Gerontology International, 18(8), 1166-1172.
7. Mohammed, H. M., & Nadr, M. (2018). Perineal dermatitis: A neglected problem in patients at Critical Care Unit. EPH-International Journal of Medical and Health Science (ISSN: 2456-6063), 4(2), 66-71.
8. Stokes, A. L., Crumley, C., Taylor-Thompson, K., & Cheng, A. L. (2016). Prevalence of fecal incontinence in the acute care setting. Journal of Wound, Ostomy and Continence Nursing, 43(5), 517-522.