Academic journal article Research and Theory for Nursing Practice

Knowledge, Attitudes, and Perceptions of Advanced Practice Nurses regarding Urinary Incontinence in Older Adult Women

Academic journal article Research and Theory for Nursing Practice

Knowledge, Attitudes, and Perceptions of Advanced Practice Nurses regarding Urinary Incontinence in Older Adult Women

Article excerpt

This study examined the level of knowledge and the attitudes and perceptions of advanced practice nurses (APNs) regarding urinary incontinence (UI) in older adult women. UI is a common health issue for older adult women, and APNs are in a unique position as health care providers to prevent, diagnose, treat, and manage the condition successfully. Little is known about how well APNs were educated regarding UI, especially in older adult women. Purposive sampling was utilized to conduct a cross-sectional, descriptive, and correlational design study. Fifty-four APNs completed a questionnaire developed by the author based on the aging literature, advanced practice nursing competencies, and UI guidelines. Findings suggest that APNs generally have positive attitudes, perceptions, and knowledge of UI in women. However, participants had difficulty in applying this knowledge to the clinical setting: assessing, diagnosing, treating, and managing UI. More emphasis is needed in graduate nursing curriculums and in precepted clinical experiences regarding UI in women.

Keywords: aging; knowledge/attitudes/perceptions; advanced practice nurses; urinary incontinence; older adult women

Urinary incontinence (UI) is the involuntary loss of urine, in any amount, from a few drops to total emptying of the bladder. UI is a potentially burdensome diagnosis that can affect quality of life (QOL), the human spirit, and if not treated, can result in falls, injury, and eventual loss of independence (Broome, 2003; Keilman, 2005; McCarthy, McCormack, Coffey, Wright, & Slater, 2009). Other physical consequences of UI can include skin conditions and urinary tract infections (DuMoulin, Hamers, Ambergen, Janssen, & Halfens, 2008 ). In some studies, UI has been reported as a leading cause of institutionalization (Kinchen et al., 2003) among older adults.

UI is highly prevalent among older women (Anger, Saigal, & Litwin, 2006; DuBeau, 2002; Kang, 2009; Melville, Wagner, Fan, Katon, & Newton, 2008). Prevalence increases with age, with one-third of women older than 65 years of age experiencing some degree of UI and 12% reporting daily urine leakage (Kincade, Dougherty, Carlson, & Wells, 2007). UI is a costly health concern and problem for women in the United States (Kincade et al., 2007). In 1998, the World Health Organization estimated that 200 million people worldwide were affected by bladder leakage conditions (Kalache 1998). Estimated costs are in the billions (Hu et al., 2004) and are continuing to rise (Carson, 2007) causing excessive burdens on patients and the health care system.

Advanced practice nurses (APNs) are in a pivotal role to try and decrease the cost of UI through health promotion, diagnosing, and treating the condition. Many older adult women with UI are cared for in the community and/or health care facilities by APNs who can manage this devastating and costly condition. Thus, the purpose of this study was to examine APNs' knowledge, attitudes, and perceptions regarding UI and aging women. For this study, knowledge was defined as "the sum of what is known; the body of information acquired" (Merriam-Webster, n.d.). Attitudes and perceptions were defined as the feelings or values that may or may not influence the way an individual behaves (Cheater, 1992).


Benner (1984) applied the concept of "novice to expert" to clinical nursing practice based on the 1980 Dreyfus Model of Skill Acquisition. While Benner's research encompasses areas such as nursing domains, functions, and interventions, the skill acquisition stages are the most well known (McEwen & Wills, 2007). The framework is extremely beneficial in understanding incremental learning obtained through experience and education, and originally described nurses who were "experts-byexperience." It is a general assumption that the majority of entry-level masters of nursing students are at the expert level in their current practice roles. …

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