Omurilik Hasarlı Bireylerde Mesane Yönetimi: Literatür İncelemesi

Giriş: Omurilik hasarlı (OH) bireylerin yaşadığı tıbbi komplikasyonların en önemlilerinden biri nörojenik mesanedir. Amaç: Nörojenik mesane yönetiminde kullanılan metotları ve etkilerini incelemektir. Yöntem: Çalışma Ocak 2005- Temmuz 2017 yılları arasında CINAHL, EBSCOhost, MEDLINE, ScienceDirect, Ovid, ProQuest, Web of Science ve ULAKBİM Ulusal Veri Tabanları taranarak yürütülmüştür. Çalışmalara ulaşmak için “spinal kord yaralanması”, “mesane yönetimi”, “hemşirelik bakımı”, “kateterizasyon”, “aralıklı üriner kateter” gibi anahtar kelimeler kullanılmıştır. İncelemeye 607 araştırma makalesi alınmış olup araştırmaya dahil edilme kriterlerine uygun 25 araştırma makalesi çalışma kapsamına alınmıştır. Bulgular: Çalışma kapsamında yer alan makalelerin örneklemleri yetişkin yaştaki bireylerden oluşmakta, en düşük yaş ortalaması 29±12 ve en yüksek yaş ortalaması ise 59.5±13.6’dır. İncelenen makalelerde en sık tercih edilen mesane yönetim metodu Temiz Aralıklı Kateterizasyon (TAK)’dur. Bu çalışmalarda TAK’a uyum ile spastisite, maksimum sistometrik kapasite, kateterizasyonu uygulayan kişi arasında anlamlı korelasyon belirlenmiştir. Mesane yönetim metodu değiştirme nedenlerinin başında İdrar Yolu Enfeksiyonları (İYE) gelmektedir. İncelen çalışmaların sonuçları, TAK uygulamasını kendi yapan ve spontan işeyen bireylerde yaşam kalitesi daha yüksek olduğunu göstermektedir. Çalışmaların sonuçları, hastaların yaşı, çalışma durumu ve TAK uygulamasını kendisinin yapıp yapmaması ile depresyon düzeyleri arasında anlamlı bir ilişki olduğunu göstermektedir. Sonuç: Mesane yönetiminde en fazla tercih edilen TAK’ın güvenilir ve etkili bir metot olduğu ve İYE gelişme riskini azalttığı belirtilmektedir. Nörojenik mesaneye sahip bireylerde depresyon belirtileri normal popülasyona göre daha yüksektir

Anahtar Kelimeler:

Omurilik Hasarı, Mesane Yönetimi, Üriner Kateterizasyon, Hemşirelik.

Bladder Management in Individuals with Spinal Cord Injury: Literature Review

Introduction: Neurogenic bladder is one of the most important complications experienced by individuals with spinal cord injury. Aim: To investigate the methods and their effects used in the management of neurogenic bladder. Method: The study was conducted by searching CINAHL, EBSCOhost, MEDLINE, ScienceDirect, Ovid, ProQuest, Web of Science, and ULAKBİM National Databases between January 2005 and July 2017. To identify the studies, keywords such as "spinal cord injury", "bladder management", "nursing care", "catheterization", "intermittent urinary catheter" were used. Out of 607 research articles examined, 25 of them that matched the inclusion criteria were included in the study. Results: The samples of the articles within the scope of the study consist of adults, with the lowest mean age of 29±12, and the highest mean age of 59.5 ± 13.6. The most commonly preferred bladder management method in the investigated articles is Clean Intermittent Catheterization (CIC). In these studies, a significant correlation has been identified among the compliance to CIC and spasticity, maximum cystometric capacity, and the individual applying the catheter. The leading causes of changing the bladder management method are the Urinary Tract Infections (UTI). The results of the studies in the scope of the investigation demonstrate that the quality of life is higher in individuals, who apply CIC themselves, and who urinate spontaneously. The results of the studies demonstrate that there is a significant correlation among the age of the patients, employment status, and whether the individuals apply CIC themselves, and the levels of depression. Conclusion: CIC, which is the most preferred method in the bladder management, is indicated to be effective and safe, and decreases the risk of developing UTI. The symptoms of depression in individuals with neurogenic bladder is more common than those in the normal population

Keywords:

Spinal Cord Injury, Bladder Management, Urinary Catheterization, Nursing,

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