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Continence research in the JWOCN: A report card
ED TORIAL Continence Research in the JWOCN A Report Card n the January issue, I reviewed ostomy nursing research over the past 4 years and the Journal's role as a resource for these reports. A l t h o u g h I was pleased to note that the JWOCN published most of the ostomy nursing research, I was concerned with the meager volume of all nursing research pertinent to this important c o m p o n e n t of our specialty practice. This review of published research led to a discussion of the Journal's role as a resource for clinical and research articles in w o u n d , ostomy, and continence nursing at our Annual Editorial Board meeting held in December 1997. Although we remain dedicated to our role as a resource for review articles covering clinical and professional practice issues, we are also dedicated to publishing original data in the Journal, including case reports, u n c o n t r o l l e d clinical series, randomized, controlled clinical trials, and mechanistic research articles. This Editorial serves as a direct follow-up to the January "report card" on ostomy research in the Journal (J W O C N 1998;25:2-4.); a similar review of w o u n d care research will be published in the July issue.
URINARY INCONTINENCE Unlike ostomy nursing research, the volume of continence nursing research has g r o w n significantly over the past decade. To quantify continence nursing research and the Journal's contribution to this aspect of our practice, a MEDLINE search using the key words "Urinary Incontinence" and "Nursing" was completed. When the years 1993 to 1997 were searched, 245 articles were found, including 49 research reports. For the purposes of this evaluation, the phrase researchreport includes all original research articles and case studies. A variety of nursing journals accounted for these research reports, including Nursing Research, the Japanese Journal of Nursing Research, and a variety of specialty practice nursing journals.
Articles also appeared in several medical journals such as JAMA, Journal of the American Geriatric Society, and the British MedicalJournal. Within this time frame, the JWOCN published 11 manuscripts containing original data on urinary incontinence, comprising 22% of the articles identified by a MEDLINE search using the k e y w o r d s outlined earlier. These articles included investigations of the impact of urinary incontinence on skin integrity, the comfort provided by containment devices, and the efficacy of behavioral interventions for urinary incontinence.
FECAL INCONTINENCE When evaluating continence care from the perspective of WOC nursing, it is also necessary to examine our track record in publishing original data pertaining to fecal incontinence. In 1996, the WOCN released a position statement that supported a scope of continence nursing including urinary incontinence, fecal incontinence, and perineal skin care. In contrast to the large number of articles pertaining to urinary incontinence, a MEDLINE search using the words "Fecal Incontinence" and "Nursing" revealed 49 published manuscripts, including 12 reports of original research. During this period of time, the Journal published two articles providing original data on the nursing management of fecal incontinence in the intact gastrointestinal system (fecal incontinence in the patient with an ostomy was considered in the January 1998 Editorial). One of these reports considered the impact of both fecal and urinary incontinence on skin integrity and is listed under both urinary and fecal incontinence discussions; the other report is a case study using biofeedback to strengthen the anal sphincter after trauma and surgical reconstruction. No uncontrolled clinical series, randomized, controlled clinical trial, or mechanistic research on fecal incontinence was published in our Journal during this period.
Mikel Gray, PhD, CUNP, CCCN, FAAN
J WOCN 1998;25:61-2.
Copyright © 1998by the Wound, Ostomy and Continence Nurses Society, 1071-5754/98/$5.00 + 0 21/9/89240
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JWOCN March 1998
Gray
DISCUSSION From m y perspective, the JWOCN has made significant progress in our publication record with respect to continence nursing research. When examining both urinary and fecal incontinence research, I observed that most original research reports have been published in the past 2 to 3 years, reflecting the increasing attention to this important aspect of WOC nursing practice and the growing impact of continence specialty certification and the continence coalition. In addition, we have published controlled research detailing the wet comfort provided by various pad designs, directly reflecting the global influence of our Continence Section Editor, Dr. Mary H. Palmer. Nonetheless, our record of continence nursing research articles remains unbalanced. Specifically, we lack a record of publishing the randomized, controlled clinical trials needed to answer some of the persistent and topical questions in continence nursing such as the necessity of including biofeedback in
pelvic muscle reeducation. In addition, we lack sufficient research on the impact of urinary incontinence on the integrity of the perineal skin. However, our most obvious deficit pertains to fecal incontinence. As with ostomy research, I remain concerned that we assume this important aspect of continence n u r s i n g will be handled by "someone else." Clearly, the lessons learned from our research on urinary incontinence demonstrates that ignoring problems of fecal elimination frustrates our patients' needs and encourages the "don't ask, don't tell" policy that inhibited urinary incontinence research and clinical m a n a g e m e n t for so long. The Editorial Board of the JWOCN urgently seeks manuscripts containing original data on urinary and fecal incontinence and its impact on the perineal skin. This call for papers includes, but is not limited to, case studies, uncontrolled clinical series, randomized, controlled clinical reports, and mechanistic research designed to advance the practice of continence nursing.
AVAILABLITYOF JOURNAL BACK ISSUES As a service to our subscribers, copies of b a c k issues of Journal of WOCN for the preceding 5 years are maintained and are available for purchase from Mosby until inventory is d e p l e t e d at a cost of $12.00 per issue. The following quantity discounts are available: 25% off on quantities of 12 to 23, and one third off on quantities of 24 or more. Please write to Mosby, Inc., Subscription Services, 11830 Westline Industrial Dr,, St. Louis, MO 63146-3318, or call 800-453-4351 or 314-453-4351 for information on availability of particular issues. If unavailable from the publisher, photocopies of c o m p l e t e issues m a y b e purchased from UMI, 300 N. Zeeb Rd., Ann Arbor, MI 48106, phone 313-761-4700.
URINARY INCONTINENCE Unlike ostomy nursing research, the volume of continence nursing research has g r o w n significantly over the past decade. To quantify continence nursing research and the Journal's contribution to this aspect of our practice, a MEDLINE search using the key words "Urinary Incontinence" and "Nursing" was completed. When the years 1993 to 1997 were searched, 245 articles were found, including 49 research reports. For the purposes of this evaluation, the phrase researchreport includes all original research articles and case studies. A variety of nursing journals accounted for these research reports, including Nursing Research, the Japanese Journal of Nursing Research, and a variety of specialty practice nursing journals.
Articles also appeared in several medical journals such as JAMA, Journal of the American Geriatric Society, and the British MedicalJournal. Within this time frame, the JWOCN published 11 manuscripts containing original data on urinary incontinence, comprising 22% of the articles identified by a MEDLINE search using the k e y w o r d s outlined earlier. These articles included investigations of the impact of urinary incontinence on skin integrity, the comfort provided by containment devices, and the efficacy of behavioral interventions for urinary incontinence.
FECAL INCONTINENCE When evaluating continence care from the perspective of WOC nursing, it is also necessary to examine our track record in publishing original data pertaining to fecal incontinence. In 1996, the WOCN released a position statement that supported a scope of continence nursing including urinary incontinence, fecal incontinence, and perineal skin care. In contrast to the large number of articles pertaining to urinary incontinence, a MEDLINE search using the words "Fecal Incontinence" and "Nursing" revealed 49 published manuscripts, including 12 reports of original research. During this period of time, the Journal published two articles providing original data on the nursing management of fecal incontinence in the intact gastrointestinal system (fecal incontinence in the patient with an ostomy was considered in the January 1998 Editorial). One of these reports considered the impact of both fecal and urinary incontinence on skin integrity and is listed under both urinary and fecal incontinence discussions; the other report is a case study using biofeedback to strengthen the anal sphincter after trauma and surgical reconstruction. No uncontrolled clinical series, randomized, controlled clinical trial, or mechanistic research on fecal incontinence was published in our Journal during this period.
Mikel Gray, PhD, CUNP, CCCN, FAAN
J WOCN 1998;25:61-2.
Copyright © 1998by the Wound, Ostomy and Continence Nurses Society, 1071-5754/98/$5.00 + 0 21/9/89240
61
62
JWOCN March 1998
Gray
DISCUSSION From m y perspective, the JWOCN has made significant progress in our publication record with respect to continence nursing research. When examining both urinary and fecal incontinence research, I observed that most original research reports have been published in the past 2 to 3 years, reflecting the increasing attention to this important aspect of WOC nursing practice and the growing impact of continence specialty certification and the continence coalition. In addition, we have published controlled research detailing the wet comfort provided by various pad designs, directly reflecting the global influence of our Continence Section Editor, Dr. Mary H. Palmer. Nonetheless, our record of continence nursing research articles remains unbalanced. Specifically, we lack a record of publishing the randomized, controlled clinical trials needed to answer some of the persistent and topical questions in continence nursing such as the necessity of including biofeedback in
pelvic muscle reeducation. In addition, we lack sufficient research on the impact of urinary incontinence on the integrity of the perineal skin. However, our most obvious deficit pertains to fecal incontinence. As with ostomy research, I remain concerned that we assume this important aspect of continence n u r s i n g will be handled by "someone else." Clearly, the lessons learned from our research on urinary incontinence demonstrates that ignoring problems of fecal elimination frustrates our patients' needs and encourages the "don't ask, don't tell" policy that inhibited urinary incontinence research and clinical m a n a g e m e n t for so long. The Editorial Board of the JWOCN urgently seeks manuscripts containing original data on urinary and fecal incontinence and its impact on the perineal skin. This call for papers includes, but is not limited to, case studies, uncontrolled clinical series, randomized, controlled clinical reports, and mechanistic research designed to advance the practice of continence nursing.
AVAILABLITYOF JOURNAL BACK ISSUES As a service to our subscribers, copies of b a c k issues of Journal of WOCN for the preceding 5 years are maintained and are available for purchase from Mosby until inventory is d e p l e t e d at a cost of $12.00 per issue. The following quantity discounts are available: 25% off on quantities of 12 to 23, and one third off on quantities of 24 or more. Please write to Mosby, Inc., Subscription Services, 11830 Westline Industrial Dr,, St. Louis, MO 63146-3318, or call 800-453-4351 or 314-453-4351 for information on availability of particular issues. If unavailable from the publisher, photocopies of c o m p l e t e issues m a y b e purchased from UMI, 300 N. Zeeb Rd., Ann Arbor, MI 48106, phone 313-761-4700.