The Disability Associated Incontinence is a symptom proposed in 2019 by the International Continence Society(1) and this is the first study with the intention of include it in the NANDA International (NANDA-I) Nursing Diagnoses, a very known and used terminology in Nursing. Disability Associated Incontinence is a complaint of urinary incontinence in the presence of a functional inability to reach a toilet/urinal in time because of a physical (eg, orthopedic, neurological) and/or mental impairment (1). This term would replace the nursing diagnosis Functional Incontinence, included in NANDA-I in 1986 and revised in 1998. Therefore, the objective of this study was to constructed conceptual definitions of the components of the proposed nursing diagnosis to improve the diagnostic inference and to differentiate from others nursing diagnoses related to urinary incontinence, beside to stablish better correspondence between both terminologies (ICS and NANDA-I).

We performed an integrative review about the nursing diagnosis Functional Urinary Incontinence from 1996 to 2019, including two years prior the last review and publication of that nursing diagnose. The search was carried out in five databases: EMBASE, MEDLINE (PubMed), Scopus, Cinahl, Virtual Health Library and in the journals Neurourology & Urodynamics and International Journal of Nursing Knowledge. The data were collected using an instrument constructed specifically for this study. We identified 381 papers and, after the exclusions, 14 articles were included in the qualitative synthesis. Based in the literature, the authors constructed the conceptual definitions of the nursing diagnosis components. The conceptual definition represents the abstract or theoretical meaning of the concepts studied. The nursing diagnoses are compounded by four diagnostic indicators, two of them essentials to characterize the phenomenon: Defining Characteristics (the signal and/or symptoms related or showed by the person) and Related Factors (cause or contributing factor, etiological factor). The others two diagnostic indicators, should support the nursing diagnosis and make easier its identification, they are: associated conditions (medical diagnoses, injuries, procedures, medical devices, or pharmaceutical agents, that is, conditions not independently modifiable by nurses, but that may improve the accuracy of the nursing diagnosis) and at risk populations (groups of people who share a characteristic that causes each member to be susceptible to a particular human response, such as, demographics, health/family history, stages of growth/development, or exposure to certain events/experiences)(2).

After the analysis of the 14 articles, was constructed a new definition for the new nursing diagnosis proposed, the Disability Associated Incontinence, and for their six defining characteristics, seven related factors, six associated conditions and three at-risk population. We suggest adopting the ICS title and this definition: Urine leakage caused by external factors to the urinary tract which interfere with the ability to respond in a socially appropriate way to the urge to void, such as getting to the bathroom or using toilets. Conceptual definitions of the components of the proposed nursing diagnosis are showed in Chart 1.

The use of the conceptual definitions of the terms of the standardizing terminologies could facilitate the diagnostic inference and the differentiation between related diagnoses making easier the critical and clinical reasoning.

Through an integrative review based on the specialized literature, it was possible to defining the diagnostics indicators that support the diagnosis inferences for the nursing diagnosis Disability Associated Incontinence.

D’Ancona C, Haylen B, Oelke M, Abranches-Monteiro L, Arnold, E, Goldman H, Hamid R, Homma Y, Marcelissen T, Rademakers K, Schizas A, Singla A, Soto I, Tse V, de Wachter S, Herschorn S. The International Continence Society (ICS) report on the terminology for adult male lower urinary tract and pelvic floor symptoms and dysfunction. Neurourol Urodyn. 2019; 21(2): 1-45. doi: https://doi.org/10.1002/nau.23897.
Herdman TH, Kamitsuru S. Nursing Diagnoses: Definitions and Classification 2018-2020. 11th Edition. New York: Thieme; 2017.