Association of a continuous continence self-management program with independence in voiding behavior among stroke patients: A retrospective cohort study.

Abstract

Many stroke patients cannot urinate independently due to motor and cognitive dysfunctions. This study examined whether a continuous continence self-management program during acute and convalescent phases is associated with independence in voiding behavior. A retrospective cohort study was conducted among stroke patients registered in the Council of Kaga Local Stroke Network, Japan, from 2015 to 2019. In the intervention group (n = 941), a multidisciplinary continence care team and ward nurses provided continence care in the acute phase and shared the information with the staff in the convalescent ward. The control group (n = 579) received traditional voiding care from ward nurses. The primary and secondary outcomes were independence in voiding behavior at discharge from the convalescent ward and length of hospital stay, respectively. At discharge from the convalescent wards, the proportion of patients who voided at the toilet or bedside commode was higher in the intervention group than in the control group (76.3% vs. 62.4%, p < 0.001). The continuous continence self-management program was associated with independence in voiding behavior (adjusted odds ratio: 1.801, 95% confidence interval[CI]: [1.102, 2.942]; p = 0.019) and length of hospital stay (β: -0.178, 95% CI: [-14.320, -7.607]; p < 0.001) after adjusting for other variables. The program was associated with increasing independent voiding behavior and shortened the length of hospital stay, suggesting the importance of promoting treatments for lower urinary tract symptoms and rehabilitation by a multidisciplinary continence care team for stroke patients.