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Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Caring for continence in stroke care settings: a qualitative study of patients’ and staff perspectives on the implementation of a new continence care intervention
Authors: Brady, Marion C
Jamieson, Katharine
Bugge, Carol
Hagen, Suzanne
McClurg, Doreen
Chalmers, Campbell
Langhorne, Peter
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Keywords: Incontinence
bladder function
patient-centred care
Issue Date: May-2016
Publisher: SAGE
Citation: Brady MC, Jamieson K, Bugge C, Hagen S, McClurg D, Chalmers C & Langhorne P (2016) Caring for continence in stroke care settings: a qualitative study of patients’ and staff perspectives on the implementation of a new continence care intervention, Clinical Rehabilitation, 30 (5), pp. 481-494.
Abstract: 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.
Type: Journal Article
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Rights: The publisher does not allow this work to be made publicly available in this Repository. Please use the Request a Copy feature at the foot of the Repository record to request a copy directly from the author. You can only request a copy if you wish to use this work for your own research or private study.
Affiliation: Glasgow Caledonian University
Glasgow Caledonian University
HS Research - Stirling
Glasgow Caledonian University
Glasgow Caledonian University
NHS Lanarkshire
Glasgow Royal Infirmary

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