The relationship between cognition and sensation in determining when and where to void: the concept of cognitive voiding
The relationship between cognition and sensation in determining when and where to void: the concept of cognitive voiding
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DOI：
10.1111/j.1464-410x.2012.11078.x
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发表时间：
2012-12-01
影响因子：
4.5
通讯作者：
Gillespie, James
中科院分区：
文献类型：
--
作者：
Harvey, Joan;Finney, Steven;Gillespie, James
目的探讨在确定排尿需求、排尿时间和排尿地点时，意识决策过程和膀胱感觉之间的相互关系。在这项初步研究中，结果主题分析得出6个主题：时间和认知地图、风险问题、习惯化和机会主义行为以及膀胱意识。对于大多数排尿，排尿的决定不是基于感觉，而是由多种因素决定的：个人对上次排尿时间、下次排尿预期时间、厕所距离、风险评估或习惯行为的了解。随着膀胱充满，受试者描述了对膀胱的认识不断提高。这种感觉并没有立即与排泄欲望联系起来。相反，这些感觉被描述为影响考虑何时何地排尿的认知过程。一个小组的受试者报告说，当他们的膀胱充满时，他们几乎没有意识到，只经历了突然的强烈感觉，因为害怕泄漏，需要立即采取行动。结论排尿决定主要是一个受多种因素影响的认知过程，膀胱意识只是其中之一，产生意识的机制可能因病理状态不同而增强或丧失。这些意见的重要性，目前的正常和异常排尿的看法进行了讨论。
OBJECTIVETo investigate the inter-relationship between conscious decision-making processes and bladder sensation in determining the need, time and place to voidSUBJECTS AND METHODSThe approach used interview focus groups and qualitative thematic analysis. In this preliminary study, 25 women were included (aged 2190 years) meeting in groups of one to five on four occasions.RESULTS The thematic analysis yielded six themes: temporal and cognitive maps, risk issues, habituation and opportunistic behaviour and awareness of the bladder.For most voids, the decision to void was not based on sensation but determined by multiple factors: personal knowledge of time of last void, anticipated time to next void, proximity of toilets, a risk assessment or habituated behaviour.As the bladder filled the subjects described an increasing awareness of their bladder. Such sensations were not immediately associated with desire to void. Rather, these sensations were described as influencing the cognitive processes of considering when and where to void.A sub-group of subjects reported little awareness as their bladder filled, experiencing only sudden strong sensations that needed immediate action for fear of leakage. CONCLUSIONSThe decision to void is primarily a cognitive process influenced by multiple elements of which bladder awareness is only one.Mechanisms generating awareness may be intensified or lost reflecting possible different pathological states. The importance of these observations in relation to current views of normal and abnormal voiding is discussed.