Article

OBJECTIVES: Investigate the perspectives of patients and nursing staff on the
implementation of an augmented continence care intervention after stroke. DESIGN:
Qualitative data were elicited during semi-structured interviews with patients (n
= 15) and staff (14 nurses; nine nursing assistants) and analysed using thematic
analysis. SETTING: Mixed acute and rehabilitation stroke ward. PARTICIPANTS:
Stroke patients and nursing staff that experienced an enhanced continence care
intervention. RESULTS: Four themes emerged from patients' interviews describing:
(a) challenges communicating about continence (initiating conversations and
information exchange); (b) mixed perceptions of continence care; (c) ambiguity of
focus between mobility and continence issues; and (d) inconsistent involvement in
continence care decision making. Patients' perceptions 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 among patients admitted to their ward); (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: Patients (particularly
those with severe urinary incontinence) described challenges communicating about
and involvement in continence care decisions. In contrast, nurses described
improved continence knowledge, attitudes and confidence alongside a shift from
containment to rehabilitative approaches. Contextual components including care
from point of hospital admission, equipment accessibility and interdisciplinary
approaches were perceived as important factors to enhancing continence care.
CI - (c) The Author(s) 2015.

Langue : ANGLAIS