Rehabilitation nursing strategies for bladder dysfunction in children with spina bifida: A systematic review of best evidence

CONTEXT: Children with spina bifida commonly present with neurogenic bladder dysfunction, which can significantly affect both the renal function and quality of life. OBJECTIVE: This study aimed to systematically synthesize the best available evidence on rehabilitation nursing strategies for managing bladder dysfunction in this population, thereby providing a foundation for evidence-based clinical decision-making. METHODS: A comprehensive literature search was conducted in international and Chinese databases, including BMJ Best Practice, UpToDate, The Cochrane Library, JBI, and CNKI, from database inception to January 2025. The search encompassed clinical guidelines, expert consensus statements, evidence summaries, and systematic reviews. Two reviewers independently assessed methodological quality and extracted data using standardized appraisal tools. RESULTS: Sixteen high-quality publications were included, comprising six clinical guidelines, two expert consensus statements, and eight systematic reviews. A total of 32 best-practice recommendations were identified and categorized into four domains: assessment and screening, rehabilitation treatment, health education, and follow-up care. CONCLUSIONS: Implementing evidence-based rehabilitation strategies that are tailored to both the clinical context and individual patient characteristics can enhance bladder management and improve long-term outcomes in children with spina bifida. This comprehensive summary provides an evidence-informed framework to support nursing practice and facilitate localized clinical application.