Best Evidence Summary for Evidence-Based Nursing Self-Management in Patients with Neurogenic Bladder Following Spinal Cord Injury.

OBJECTIVE

To synthesize available evidence on self-management in patients with neurogenic bladder following spinal cord injury using evidence-based methods, and to provide a reference for evidence-based nursing interventions.

METHODS

We conducted a best evidence summary following the methodological standards of the Fudan University Center for Evidence-based Nursing and the Joanna Briggs Institute (JBI). We searched CNKI, Wanfang, VIP, PubMed, Embase, Web of Science, Cochrane Library, BMJ Best Practice, UpToDate, RNAO, NGC, GIN, and Medlive from inception to October 2025. We included clinical guidelines, expert consensuses, systematic reviews, and evidence summaries. Quality was appraised using AGREE II for guidelines and JBI checklists for other types. Evidence was synthesized thematically and graded using JBI levels (1-5). Recommendation strength (A/B) was determined based on FAME (Feasibility, Appropriateness, Meaningfulness, Effectiveness) attributes. No meta-analysis was performed.

RESULTS

A total of 18 articles were included: 8 clinical guidelines, 2 expert consensuses, 4 systematic reviews, and 4 evidence summaries. The evidence was synthesized into 9 themes: comprehensive assessment, structured education, fluid management, device empowerment, catheter management, assisted voiding, complication monitoring, perineal skin care, and follow-up. A total of 26 pieces of evidence were formulated, with recommendations graded A or B based on the FAME framework.

CONCLUSION

This study systematically synthesizes the available evidence on self-management in patients with neurogenic bladder following spinal cord injury. The 26 evidence items provide a practical, evidence-based framework for clinical nursing decisions, particularly in the areas of intermittent catheterization training, fluid management, complication monitoring, and patient education. The application of evidence should be carefully adapted to the local clinical context, taking into account regional and economic differences, as well as individual patient characteristics such as upper limb function and cognitive status.