女性尿失禁之復健照護

Rehabilitation Care for Female Urinary Incontinence

女性發生尿失禁的機率比男性高，尿失禁所帶來的身體不舒服、經濟負擔以及心理與社會層面上可能產生之影響，都會造成女性的生活品質降低。本文簡介尿失禁之分類、討論主要之保守性療法種類及其復健治療效果與保守性療法於護理實務中之應用。基於保守性療法之優點與其可降低醫療成本之由，保守性療法實為台灣應積極推展之尿失禁處理方式。尿失禁之保守性療法主要包括三類：生活型態之介入措施、物理治療與訂定排尿計劃。物理治療對於尿失禁之正向療效已被廣泛報導；生活型態介入措施與訂定排尿計劃之療效，則有待後續之臨床實證研究探討。台灣學者已報導尿失禁保守性療法為值得推廣之治療方式；香港地區之護理門診調查發現，排尿控制護理門診個案之症狀改善率位居第二；英國許多已發表文獻亦呈現護理人員主導的社區排尿控制服務具顯著成效。隨著具有豐富臨床經驗、經良好訓練／教育之專業人力的日漸豐富，將使台灣排尿控制護理門診與社區排尿控制服務更易付諸具體施行。

The prevalence rate for urinary incontinence (UI) in women is higher than that in men. Urinary incontinence is a condition that presents considerable psychosocial implications, physical discomfort, and economic burdens; all of which diminish patient quality of life. In this presentation, types of UI, conservative treatments for UI and their effectiveness, and the application of conservative treatments for UI in nursing practice are discussed. Based on their recognized advantages and potential cost savings to Taiwan's health system, conservative treatments should be widely implemented in Taiwan. Conservative treatments of UI cover three main categories, including lifestyle interventions, physical therapies, and scheduled voiding regimens. The positive effects of physical therapy on UI have been reported worldwide. Further clinical evidenced-based studies are needed to explore the effects of lifestyle interventions and scheduled voiding regimens on UI. The value of delivering conservative treatments for UI in Taiwan has already been well established. Patients showed symptom improvement after nurse clinic consultations in Hong Kong, with the second best rate identified at continence clinics. In the United Kingdom, the positive effects of nurse-led continence service have been demonstrated at the community level. In light of increasing numbers of nurses with experience and training in continence care, the implementation of continence nurse clinics and nurse-led continence services in Taiwan is now possible.