title: Targeting community-dwelling urinary incontinence sufferers: a multi-disciplinary community based model for conservative continence services.
abstract: This paper presents an argument that there is a need to provide services that target community-dwelling incontinence sufferers, and presents a demonstration case study of a multi-disciplinary, community-based conservative model of service delivery: The Waterworx Model. Rationale for approaches taken, implementation of the model, evaluation and lessons learned are discussed. In this paper community-dwelling sufferers of urinary incontinence are identified as an underserved group, and useful information is provided for those wishing to establish services for them. The Waterworx Model of continence service delivery incorporates three interrelated approaches. Firstly, client access is achieved by using community-based services via clinic and home visits, creating referral pathways and active promotion of services. Secondly, multi-disciplinary client care is provided by targeting a specific client group, multi-disciplinary assessment, promoting client self-management and developing client knowledge and health literacy. Finally, interdisciplinary collaboration and linkages is facilitated by developing multidisciplinary assessment tools, using interdisciplinary referrals, staff development, multi-disciplinary management and providing professional education. Implementation of the model achieved greater client access, improvement in urinary incontinence and client satisfaction. Our experiences suggest that those suffering urinary incontinence and living in the community are an underserved group and that continence services should be community focussed, multi-disciplinary, generalist in nature.
authors.affiliation: Faculty of Nursing and Health, Griffith University, Gold Coast, Australia.
authors.forename: Winsome
authors.initials: W
authors.lastname: St John
authors.forename: Marianne
authors.initials: M
authors.lastname: Wallis
authors.forename: Heather
authors.initials: H
authors.lastname: James
authors.forename: Shona
authors.initials: S
authors.lastname: McKenzie
authors.forename: Sheridan
authors.initials: S
authors.lastname: Guyatt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003152:Community Health Nursing / Q000193:education / Q000458:organization & administration*; D003153:Community Health Services / Q000458:organization & administration*; D003663:Decision Trees; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D008389:Marketing of Health Services / Q000458:organization & administration; D008507:Medically Underserved Area; D008875:Middle Aged; D016294:Models, Nursing; D020380:Needs Assessment; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D010043:Outcome and Process Assessment, Health Care / Q000458:organization & administration; D010348:Patient Care Team / Q000458:organization & administration*; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D016730:Program Development; D015397:Program Evaluation; D012017:Referral and Consultation / Q000458:organization & administration; D012648:Self Care; D014549:Urinary Incontinence / Q000517:prevention & control* / Q000523:psychology