Urinary incontinence is a common problem in the UK, and one often seen by community nurses. While it is often associated with ageing, urinary incontinence can in fact have a number of causes and it is important that the community nurse is aware of the full range of aetiologies and presentations. Community nurses should have a good basic understanding of the causes of incontinence, be able to provide a basic first assessment, become adept at asking the right questions and be able to offer some conventional treatment and problem-solving strategies for immediate relief of symptoms. Most importantly, they should be able to identify when a patient will need referring to a specialist practitioner for more extensive assessment and investigation. This article looks at the assessment of urinary continence in the community, and outlines the common presentations that nurses should look out for.
Interstitial cystitis or painful bladder syndrome (IC/PBS) is a chronic condition presenting with symptoms including pain, urinary urgency and urinary frequency. IC/PBS is often poorly diagnosed and many patients may have seen multiple healthcare professionals over a period of years and undergone a variety of unsuccessful treatments. The lack of a definitive definition of IC/ PBS and diagnosis of its aetiology, cause and successful treatment contributes to a poor quality of life for many patients. This article looks at the main symptoms, diagnostic techniques and treatments for the IC/PBS. The author outlines how comprehensive history taking, physical examination and appropriate clinical tests all help community nurses to arrive at an appropriate and timely diagnosis, which, when combined with individualised treatment plans, can offer patients effective relief of their symptoms.
Constipation is a widespread problem although its subjective nature can mean that diagnosis and treatment can be difficult as there is often a mismatch between patients’ and clinicians’ view of the condition. Constipation is widely believed to include unsatisfactory defecation, infrequent stools and/or difficult stool passage. Thorough patient assessment and promotion of continence issues are imperative to improving services for people with constipation. This article highlights how breaking social taboos around bladder and bowel issues, helping people to acknowledge bowel issues, and referring them to the appropriate specialist nurse-led services will all help to provide a more accurate and timely diagnosis of constipation.
Alison Briant describes the role of community nurses in raising awareness of breast awareness guidelines.
Amira Obeid gives an overview of a case study which involved the management of atopic eczema in a four month old baby
Amira Obeid MSc, ANP, BSc (Hons), RN, RM, RHV, DPS: N (CHS), FETC, CIDC, CHD Dip, ENB 8103, 7310, is a Nurse Practitioner, Lordswood Surgery, Birmingham
Article accepted for publication: January 2004
