The purpose of this descriptive study was to determine the existence of a relationship between perceptions of global self-esteem and stress incontinence episodes in a group of older women participating in a bladder retraining protocol. A convenience sample of fifteen older women was obtained. The participants constituted a group of well older women who ranged in age from 63 years to 82 years. All participants were living in the community and experiencing urinary incontinence. The University of British Columbia Model for Nursing was the conceptual framework which guided the focus of the study. The model views the individual as a behavioural system composed of nine interrelated and interdependent subsystems. This study focused on the interrelationship of the excretory and ego-valuative subsystems. The theory of self-efficacy, as outlined by Bandura provided the method by which this study was operationalized. Self-efficacy is the product of personal efficacy—an individual's judgement of the effectiveness of an executed course of action in achieving a desired outcome. The enactive, persuasive, and emotive modes of influence were utilized to provide efficacy information. Data were collected on three occasions using four instruments. The first instrument involved collection of selected demographic variables and was completed during the initial interview. A continence assessment and the Rosenberg self-esteem scale were completed during the initial and final interviews. An interview guide was used during a telephone contact. The telephone contact occurred four days following the first interview; the final interview occurred fourteen days after the first. The data were summarized, compared and described using measures of central tendency and frequency distributions. Paired t-tests were performed on selected variables to determine if there was a difference between pre and post intervention interview score. These tests demonstrated no significant differences in scores. Study findings indicated that at the end of the two week trial 53% of the women were able to identify a change in their voiding habits. Four of the participants (26.7%) stated that they were completely continent at the completion of the two week trial and four other participants (26.7%) indicated that $ some type of positive change had occurred. Three women (20%) identified a negative change in their continence status. Global self-esteem scores, as measured by the Rosenberg self-esteem scale, remained relatively stable during the two week trial period. Scores appeared to be unaffected by a change in continence status. This may be due to the many successful normalizing strategies subjects had developed to hide the evidence of the symptom of urinary incontinence. / Applied Science, Faculty of / Nursing, School of / Graduate

The main objective of the present study was to provide an adequately controlled experimental and clinical study to assess the efficacy of hypnotherapy in the treatment of nocturnal enuresis. Hypnotherapy was operationally defined in terms of current research in hypnosis. Subjects were 48 nocturnal enuretic boys, aged 8 to 13. Treatment consisted of six standardised sessions, one hourly session per subject per week. Results indicated that hypnotherapy was significantly more effective in decreasing (a) nocturnal enuresis, compared with both pretreatment base line enuresis frequency and a no treatment control (b) maladjustment. Secondary enuretics were found to be more maladjusted than primary enuretics, responded better to hypnotherapy, yet relapsed more after treatment. Comparisons with other studies indicated that hypnotherapy was a desirable short term clinical alternative to more established psychotherapeutic, psychopharmacological and conditioning methods of treatment.

Urinary bladder marsupialization has been successful in producing acceptable long-term resolution of clinical cases of obstructive urolithiasis in male goats. The purpose of this study was to evaluate the six-month outcome of urinary bladder marsupialization in male goats. The urinary bladders of six male goats free from systemic disease were marsupialized following induced urethral obstruction. Renal ultrasonography, complete blood count, and blood chemistry analysis were evaluated preoperatively (day 0), at 7 postoperative days, and at 30-day intervals until 180 postoperative days. Stomal diameter was recorded at each interval. Necropsy examination was performed on day 180 or when stomal stricture or death occurred. Stomal stricture occurred in one goat at 120 days, and another goat was found dead at 150 days. Necropsy of this goat revealed severe, suppurative cystitis. All goats developed mild urine scald dermatitis. All blood chemistry values remained within normal limits. Significant decreases in white blood cell count, serum creatinine, and stomal diameter were observed from day 0 to day 180. Except for the goat that died at 150 days, all urinary bladders were tubular in shape and the mucosa and serosa of all urinary tract organs appeared grossly normal at necropsy examination. Histologic evidence of chronic suppurative cystitis and chronic, mild, lymphoplasmacytic pyelitis was present in all goats. Culture of renal tissue yielded bacterial growth in three of six goats, and culture of a swab of the urinary bladder mucosa yielded bacterial growth in all animals. Although clinical signs of ascending urinary tract infection were not observed in goats with patent stomata, urinary bladder marsupialization may result in ascending inflammation or infection. Based upon the results of this study, urinary bladder marsupialization should be recommended with caution as the primary procedure in clinical cases. / Master of Science

The placement of an indwelling urinary catheter (IUC) is a commonly performed clinical procedure which may become challenging for the clinician and painful for the patient. In response to urologic complications attributed to repeated failed IUC insertion attempts by nurses, a difficult urinary catheter (DUC) team program was launched in October 2012. The purpose of the doctoral project was to conduct a quality improvement evaluation of the effectiveness of the DUC team program using retrospective data from May 1, 2013 through May 31, 2017. Benner's novice to expert model was chosen as the theoretical framework to guide the additional training, critical thinking, problem-solving, and skill acquisition necessary for team member inclusion. The practice-focused question for the project answered whether DUC team nurses, through advanced training and demonstrated procedural competence, have been effective with DUC insertions. Sources of evidence included primary and secondary articles in peer-reviewed journals, as well as clinical evidence collected from internal sources. During the project time-line, 463 DUC team consultations were recorded with an insertion success rate of 89.6%. Based on the DUC team concept, additional didactic content and simulation training may be developed for other cognitive and skill-based clinical procedures. The implications for positive social change include improved patient safety and comfort, as well as cost savings for the organization and overall healthcare system.

Thesis (Ph. D.)--University of Virginia, 2008. / Includes bibliographical references. Also available online through Digital Dissertations.

Thesis (M.N.)--University of Alberta, 2009. / A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Master of Nursing, Faculty of Nursing. Title from pdf file main screen (viewed on November 8, 2009). Includes bibliographical references.

京都大学 / 新制・課程博士 / 博士(医学) / 甲第23764号 / 医博第4810号 / 新制||医||1056(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 長尾 美紀, 教授 佐藤 俊哉, 教授 永井 洋士 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Stress urinary incontinence is prevalent among women. Pelvic floor muscle exercise has been found to be an effective treatment for management of women with stress urinary incontinence. Women's non-adherence to pelvic floor muscle exercise has been the major obstacle for achieving desirable treatment outcomes. The purpose of this study was to examine the relationships between the severity of stress urinary incontinence, impact of incontinence, self-esteem, and intrinsic motivation among Chinese women with stress urinary incontinence and to examine the implications of these relationships on Chinese women's adherence to pelvic floor muscle exercise. / The model developed from the study explained that Chinese women's adherence to pelvic floor exercise is influenced by the interaction among contextual, intrinsic and extrinsic components. Throughout learning and practicing pelvic floor muscle exercise, women's level of motivation to learn and adhere to exercise can be increased or decreased as these components interacted with each other. Finally, the study also highlights implications for nursing practice including the importance of assessment of women with urinary incontinence, awareness of factors influencing adherence to the exercise, and promoting women's adherence to the exercise by fostering women's exercise competency and commitment to exercise and raising women's awareness of the benefits of exercise. / The phase two findings showed that women's perception of severity of incontinence was influenced by sociocultural factors, self-esteem, and level of knowledge. The findings also indicated that about one-third of women were reluctant to disclose their incontinence problems to their partner. This was partly due to their beliefs of linkage between incontinence and deterioration of sexual function, and their conservative view regarding incontinence as a private matter which should not be discussed with their partner. Furthermore, the findings indicated that women's competency, commitment, perceived benefits of pelvic floor muscle exercise and perceived support from family and health professionals were the factors influencing women's adherence to pelvic floor muscle exercise. Importantly, the study revealed that motivation is dynamic in nature from women's initial learning to maintenance of the exercise. Furthermore, motivation was influenced by beliefs in effectiveness of the exercise, perceived exercise benefits and severity of incontinence. / The study employed a mixed method approach using a quantitative design in phase one and a qualitative design in phase two. The results of phase one of the study showed that the majority of women had low level of severity and impact of incontinence; however, 70% of women had high level of motivation to engage in pelvic floor muscle exercise. The results also demonstrated that women's self-esteem was influenced by the severity of incontinence in terms of consumption of pads, as well as the impact of incontinence on different aspects of life being affected by stress urinary incontinence. In addition, those women who had a higher level of severity in terms of increased wetting in previous year and previous week, as well as increased numbers of activities being affected by incontinence were more likely to have a higher level of motivation to adhere to pelvic floor muscle exercise. Furthermore, women with higher levels of impact of incontinence in terms of being affected on sexual life also demonstrated to have a higher level of motivation to adhere to pelvic floor muscle exercise. / Siu Lai Sheung Katherine. / "August 2006." / Adviser: Sheila Twinn. / Source: Dissertation Abstracts International, Volume: 68-03, Section: B, page: 1562. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 266-300). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

In the United States, many hospitalized patients with indwelling urinary catheters acquire catheter-associated urinary tract infections (CAUTI) during their hospital stay. CAUTI negatively affects peoples' health and quality of life and causes a financial burden to individuals and the nation. The purpose of this quantitative cross-sectional study was to explore the relationship between gender, age, and hospital types and CAUTI incidence in New York and North Carolina over a 3-year period. The theoretical framework of choice was the Donabedian model. Simple logistic regression and hierarchical multivariable logistic regression analysis were performed on archival data that was requested from Healthcare Cost and Utilization Project (HCUP) agency. According to the findings, males (n = 61,040) were at a higher risk of developing CAUTI compared to female (n = 66,792) (p < .001) in New York and North Carolina between 2012 and 2014. The odds of getting CAUTI were much higher among age > = 45 compared to the < 17 years. These findings fit in with previous literature identifying age and gender as having a significant relationship with CAUTI occurrence. The outcomes in this study may guide the formulation of policies that are age-appropriate, gender-specific, and facility-tailored to reduce the incidence of CAUTI.

published_or_final_version / Biochemistry / Doctoral / Doctor of Philosophy