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Analysis of Two Articles

Describe about the Pathological Issue of Lacking the Power.

The relative terms continence and incontinence are indicative of the distinct pathological issue of lacking the power of controlling bladder or bowel movement. The issue of continence and incontinence is a growing issue among the old individuals of the current society of every horizon of the world. Considering this particular issue in the context of pathology, random scientific research works have been paving the way for new technical initiatives to resolve the challenging issue of urinary incontinence that hits the emotional bottom of mind also (Goodman et al. 2013). The purpose of the considered report is to make a brief and in-depth review of two particular research articles those have been created containing significant facts about the technical initiatives taken for the betterment of continence clinic and their ultimate impact. In this respect, it is significant to mention that the entire purpose of the present discourse will be concentrating on the provided case study of Brian Williams who is a chronic sufferer of urinary incontinence.   

Article 1: Measuring the Psychosocial Impact of Continence Management Technologies by Jeffrey W. Jutai, Kenneth Southall, Eleanor A. van den Heuvel

The concerned research article rests on the evaluation of the impact of implementing the management technologies related to the practice of continence. The research showcased under the article is conducted to measure the psychological effect of varied management practices including pharmaceutical practices, surgical methods, behavioural instructions and ATDS (Assistive technology devices). According to the considered article, the issue of Urinary Incontinence is a challenging aspect that harms both the physical and psychological condition of the suffering individual. The article distinctively categorises different forms of interventions with illustrative notes at the initial stage (Jutai et al. 2011). As per the illustration, ATDS is a set of devices that is acknowledged for improvising the functional capabilities of the continence management systems. As per the evaluation and identification of various facets related to ATDS, some of the most reusable and convenient tools, which are used most frequently, are pessaries, insert devices for vagina and continence guard technology. Particularly for the men sufferers, the most commonly used treatment device is artificial sphincter for the urinary system (Grant et al. 2013). However, it can be interpreted from the informative illustration of the article, external aids are compulsory for aptly using the device of sphincter. Some of the most efficient external aids are the reusable underwear and maxi pads controlling the leakage of urine.

The discussion of the ATDS is gently followed by analysing the pivotal challenges of Urinary Incontinence that more cohesively establishes the fact that UI does not only serve as detrimental for the health but also provokes depression and dependence. The review presented in the article therefore suggests that UI patients suffers from social exclusion and makes a suffering individual more vulnerable and less attentive towards personal hygiene (Jutai et al. 2011).

Article 1: Psychological Effects of Management Technologies for Continence

The article thereafter straight goes on to evaluate the findings gained from the research that is being reviewed by the discourse. The interpretations infer that the pathological challenge of UI is found to be associated with diseases like blood pressure, problems in kidneys and specifically Diabetes. On the other side, the reviewed findings concludes that most of the continence suffers are the victim of mental stress due to which most of the time they choose to isolate themselves and do not discuss about their issues with others.

Considering the case study of Brian Williams who seems to be a similar sufferer of Continence as per the account of his wife, it is can be said that the person is one of the most unfortunate victims of UI. Additionally, keeping in mind about the main interpretation of the acknowledged article, which is UI that creates a barrier for the suffering individuals to mingle freely with others. In case of Brian Williams, the situation is found to be worst, as the person has lost his ability to walk and have artery bypass and valve replacement. Therefore, it means that the person’s dependence is not a consequence of his isolation due to having abnormal bladder movement. It is probably his inappropriate medication procedure and a huge number of other physical issues like knee replacement, artery bypass surgery, spondylitis and valve replacement. The case study indicates that the patient consumes warfarin, tramadol and other drugs to stimulate his heart condition and only one for controlling lipid flow. Therefore, it is understandable that Brian should have a balanced medication, which should include a good amount of drugs to control the bladder issue of Mr. William like Mirabegron, alpha-blockers. However, it should not be an appropriate statement to say that the entire medication process is inappropriate though it is clear that the provided medication is not working as per the requirements and condition.  

Hence, two particular premises are appearing in the context of the selected article one of which indicates that there may have not been any scope of using external aids appropriately as per Mr. Williams lacks in having an effective caregiver. Secondly, it can be interpreted that the individual may be in need of the newly innovated management systems like Sensor Technology. Need of an efficient care giver is essential not only to measure and treat Mr. Williams for his incontinence bladder issues but also keeping in mind about the facts like knee replacement, chronic spondylitis and heart surgery. Therefore, 

Article 2: Sensor Technology: A Smart Way to Manage Continence

The article selected regarding managing continence among the older people and patients suffering from dementia. The people that are facing issues regarding emotionally challenging conditions are various times found to be suffering from urinary incontinence (Damián et al. 2016). It is a major concern for both family carers and professional personnel. The article describes about smart ways that can help in managing continence among the suffering people (Fish and Traynor 2013). Technological innovation of wireless tele-monitoring system is been developed in order to manage the urinary continence to the people living in residential complexes suffering from dementia. The telemonitoring system described here is known as sensor technology that will help to promote the care towards urinary incontinence among the patients. In developed countries like United States, older people and people suffering from dementia use to take support from different residence aged care facilities (RACF) (Kaiser et al. 2014). These organizations are focusing on providing more efficient and effective solutions to the people that will focus into the problems caused by the incontinence issue (Shafik 2013). The article focuses on the UC care provided by the organizations using the sensor technologies. Sensor technology is the innovative approach that is adopted by the residential care for aged people gradually (Flanagan et al. 2014). It is seen that the cost of technologies are affordable. There are few facts regarding the incontinence problem are mentioned in the article. It can be said that the older people residential homes requires set up and assistances for controlling urinary incontinences (Westra et al. 2013). The problem is found in most of the older persons. In Australia, it is seen that the aged care statutory standards put stress on the fact that the residential accommodation for older people must have the facilities in controlling urinary incontinency in order to help older people in need (Ouslander 2016). However, the sensor technology is also used for detecting problems in the emotionally challenged people.

However, as per the selected discourse, the innovative plan of UC has been designed keeping mind about the increasing cost of continence care and the lack of efficiency of the existing tools (Fish and Traynor 2013). The approach of UC plan have several opportunities to introduce itself as a convenient management system as the system as per the article includes toileting assistance. Electronic monitoring tools to evaluate voiding patterns have also proved efficient as according to a survey program reviewed in the article has implied that such devices work as sensory mediums for communication. The article is an evident of the fact that palliative care programs like UC care plans works successfully for those old individuals who do not have the ability to express their bladder movement and also for those who have impaired cognitive function (Fish and Traynor 2013).

Conclusion

Another innovative management system that could be implanted by the palliative clinics like continence healthcares is wireless management system for continence patients. It would prove fruitful as per the article’s interpretations that say the wireless system for continence care has the unique monitoring and alerting technology that is directly connected to an intelligent central management system (Makai et al. 2014). The difference between this wireless technology and the electronic tool used in UC management is the wireless one is faster and helps to estimate numerical data (Suskind et al. 2015).

However, among these varied innovative and emerging technical continence management system, the electronic system of telemonitoring seems the most convenient one (Kretschmer et al. 2016). According to another research findings reviewed by the selected piece, telemonitoring system possibly works most conveniently for the UC care plan. Therefore, two major aspects can be deduced from the article, one that says UC care plan is the most applicable and fruitful system to be used to give care to the patients who are chronic sufferers of Urinary Incontinence and the other one is the use of telemonitoring that is found most relevant for the practice of UC. Hence two of the facets are identified linked with each other as a convenient UC care plan requires having less time consuming device for which the system of telemonitoring seems apt. The reason that UC care planning is appropriate for a pathological issue like continence is this particular care planning system is beneficiary for the mobility impaired as well as mentally depressed elder citizens (Van der Aa et al. 2013).

Most importantly, concerning the case of Brian William who is not only challenged by UI issues is found to have dire necessity to be enlisted in a UC care planning immediately. The person is currently suffering with numerous other physical abnormalities like osteoarthritis, spondylitis, valve replacement, coronary artery bypass transplant and walking disabilities along with the issue of UI. Additionally, he requires a strong care giving atmosphere which he lacks due to having an aged wife. It is significant enough to notice that most of his medication elements involve drugs for heartbeat control, blood pressure and heart congestion control and to reduce blood clots. It is understandable that a giant portion of his medication needs to include medicines like Warfarin, Spiractin and amiodorone as most of the pathological disorders of Mr. Brian are related to artery bypass, knee replacement and osteoarthritis. Therefore, it seems that along with simvastatin, the patient is in need of tolterodine, fesoterodine, Topical estrogen and medicines for alpha-blockers, which are some of the effective drugs applied to treat incontinence (Grant et al. 2013).  Care planning programs like UC care planning as per the article review is prepared to give palliative care for those who are dependable upon other by all means (Long et al. 2014). On the same side, Mr. Williams seems to have the requirement of electronic systems like telemonitoring and wireless monitoring. In this context two opinions can be established. One is if the family of the patient from the case study finally finds no convenient place but home to survive, then a well managed and well equipped UC care system will be required. The second one is if the particular continence clinic which is referred by his wife should have a UC care system or an alternative one like this. Most importantly, in that case the clinic should have all kind of modern technical tools as Mr. William is completely beyond the capability to express or communicate about his physical complexities. Considering the elements of the article review, it would be proper if the person is provided with a particular team of UC care giving system to monitor his recovery volume on daily basis.

Conclusion

After diagnosing the review outlines and their importance in the scenario of the given study, it can be drawn that one of the crucial pathological challenge of bladder incontinence is finding multiple technical initiatives in the current era. A little argument can also be noted in this sense that whether all of the depicted technical and behavioural measures are consequently proving fruitful or not. In this respect it can be said based on the conclusive deduction, that among all other continence management care, the possible emerging one is proved to be the UC care planning system. Alongside, the assignment indicates that such a palliative care system will be accompanied relevantly with wireless monitoring and telemonitoring electronic devices.

However, considering the case of Brian Williams, the discourse implicates that the existing continence cares are somewhat proving less effective. Based on which it can be further concluded that UC care planning coupled with the facility of wireless and telemonitoring measurement and control tool are found to be an immediate facet of requirement.  

Based on the drawn conclusion and the review interpretation, for the nursing care that particularly concentrates on serving for the patients suffering with incontinence bladder issue, the following aspects can be suggested –

The nursing care homes should implement the system of UC care planning.

The care clinics should be equipped with telemonitoring and wireless measurement and control devices.

A particular group of care givers should be assigned for patients who have serious continent issues alongside they should be trained in the manner of UC care planning system (Latour et al. 2013).

References

Damián, J., Pastor?Barriuso, R., García López, F.J. and Pedro?Cuesta, J., 2016. Urinary incontinence and mortality among older adults residing in care homes. Journal of Advanced Nursing.

Fish, P. and Traynor, V., 2013. Sensor technology: a smart way to manage continence.

Flanagan, L., Roe, B., Jack, B., Shaw, C., Williams, K.S., Chung, A. and Barrett, J., 2014. Factors with the management of incontinence and promotion of continence in older people in care homes. Journal of advanced nursing, 70(3), pp.476-496.

Goodman, C., Davies, S.L., Norton, C., Fader, M., Morris, J., Wells, M. and Gage, H., 2013. Can district nurses and care home staff improve bowel care for older people using a clinical benchmarking tool. Br J Community Nurs,18, pp.581-587.

Grant, R.L., Drennan, V.M., Rait, G., Petersen, I. and Iliffe, S., 2013. First diagnosis and management of incontinence in older people with and without dementia in primary care: a cohort study using The Health Improvement Network primary care database. PLoS Med, 10(8), p.e1001505.

Jutai, J., Southall, K. and van den Heuvel, E., 2011. Measuring the psychosocial impact of continence management technologies. Generations Rev-Br J Gerontol, pp.1-3.

Kaiser, A.M., Orangio, G.R., Zutshi, M., Alva, S., Hull, T.L., Marcello, P.W., Margolin, D.A., Rafferty, J.F., Buie, W.D. and Wexner, S.D., 2014. Current status: new technologies for the treatment of patients with fecal incontinence. Surgical endoscopy, 28(8), pp.2277-2301.

Kretschmer, A., Grimm, T., Buchner, A., Grimm, J., Grabbert, M., Jokisch, F., Schneevoigt, B.S., Apfelbeck, M., Schulz, G., Bauer, R.M. and Stief, C.G., 2016. Prognostic features for objectively defined urinary continence after radical cystectomy and ileal orthotopic neobladder in a contemporary cohort. The Journal of Urology.

Latour, K., Plüddemann, A., Thompson, M., Catry, B., Price, C.P., Heneghan, C. and Buntinx, F., 2013. Diagnostic technology: alternative sampling methods for collection of urine specimens in older adults. Family Medicine and Community Health, 1(2), pp.43-49.

Long, A., Southall, K., Fowler, S., Cotterill, N., Van Den Heuvel, E. and Jutai, J.W., 2014. Towards the development of the psychosocial impact of assistive devices scale for continence (C-PIADS). Technology and Disability, 26(2, 3), pp.153-160.

Makai, P., Brouwer, W.B., Koopmanschap, M.A., Stolk, E.A. and Nieboer, A.P., 2014. Quality of life instruments for economic evaluations in health and social care for older people: a systematic review. Social Science & Medicine, 102, pp.83-93.

Ouslander, J.G., 2016. Improving Continence Care for Older Adults: From Bedside to Health Policy. Journal of the American Geriatrics Society.

Shafik, A.A., 2013. Autologous Neosphincters and Novel Technologies for Fecal Continence. In Reconstructive Surgery of the Rectum, Anus and Perineum (pp. 367-371). Springer London.

Suskind, A.M. and Clemens, J.Q., 2015. Bladder Filling and Storage:“Continence: Stress Incontinence”. In Rapid and Practical Interpretation of Urodynamics (pp. 209-225). Springer New York.

Van der Aa, F., Drake, M.J., Kasyan, G.R., Petrolekas, A., Cornu, J.N. and Young Academic Urologists Functional Urology Group, 2013. The artificial urinary sphincter after a quarter of a century: a critical systematic review of its use in male non-neurogenic incontinence. European urology, 63(4), pp.681-689.

Westra, B.L., Bliss, D.Z., Savik, K., Hou, Y. and Borchert, A., 2013. Effectiveness of wound, ostomy, and continence nurses on agency-level wound and incontinence outcomes in home care. Journal of Wound Ostomy & Continence Nursing, 40(1), pp.25-53.
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