Caring for continence in stroke care settings –a qualitative study of patients’ and staff’ perspectives on the implementation of a new continence care intervention in a stroke ward setting

MC Brady, K Jamieson, C Bugge, S Hagen, D McClurg, C Chalmers, P Langhorne

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Abstract

Objectives: To investigate the dual perspectives of patients and nursing staff on the implementation of an augmented continence care intervention in a stroke ward.

Design: Qualitative data were elicited during semi structured interviews with stroke patients (n=15) and staff (14 nurses; 9 nursing assistants) and analysed using thematic analysis.

Setting: Mixed acute and rehabilitation stroke ward.

Participants: Stroke patients able to participate in an interview and nursing staff that experienced an enhanced continence care intervention.

Results: Four themes emerged from the stroke patients’ interviews (a) communication about continence (b) continence care provision, (c) functional abilities and (d) personal choice and decision making in continence care. Patients’ perceptions of continence care reflected the severity of their urinary incontinence. Staff described changes in (i) knowledge as a consequence of specialist training, (ii) continence interventions (including the development of nurse-led initiatives to reduce the incidence of unnecessary catheterisation amongst patients admitted to their ward) and (iii) changes in attitude towards continence from containment approaches to continence rehabilitation and (iv) the challenges of providing continence care within a stroke care context including limitations in access to continence care equipment or products and institutional attitudes towards continence.
Conclusion: Continence care is a complex issue involving patients, the nursing team and the wider multidisciplinary stroke rehabilitation team. The enhanced continence care intervention may facilitate a shift in nursing approaches to continence care. Patients face significant challenges in communicating about continence issues and involvement in their own continence care.
Original languageEnglish
Pages (from-to) 481-494
Number of pages15
JournalClinical Rehabilitation
Volume30
Issue number5
Early online date4 Jun 2015
DOIs
Publication statusPublished - May 2016

Keywords

  • incontinence
  • rehabilitation
  • nursing
  • bladder function
  • patient-centred care

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