Do nurses promote urinary continence in hospitalized older people?: An exploratory study.
OBJECTIVE
The aim of this paper is to explore whether nurses working in elderly medicine and in acute medical settings promote urinary continence in older people or in reality use containment strategies.


BACKGROUND
Untreated urinary incontinence in older adults can result in prolonged hospital admission and increased risk of admission to long-term care. Urinary incontinence can also have severe psychosocial effects on older people. Most studies relating to this topic have relied on quantitative approaches to data collection with a seeming lack of qualitative investigation into how nursing staff promote urinary continence in hospitalized older people.


METHODS
Focus groups and one-to-one semi-structured interviews were carried out in two NHS regions in Scotland. Registered and non-Registered Nurses were invited to participate. Five focus groups (n = 17) and four single interviews (n = 4) were conducted. Data generated were analysed thematically using QSR N-VIVO 2.


RESULTS
Some nurses believe that older people accept urinary incontinence as a consequence of ageing. Lack of assessment results in older people being labelled as incontinent of urine. Assessment strategies in medicine for the elderly tend to focus on product identification and management of incontinence. Although nurses from all clinical areas identify the importance of promoting continence, the problem continues to be contained rather than treated. Conflicting clinical priorities, varying staff approaches to urinary continence and deficits in education are cited among the barriers to promoting continence.


CONCLUSIONS
The results suggest that nurses continue to contain urinary incontinence rather than promoting continence in older people.


CONCLUSIONS
Nursing staff need to be aware of the impact of untreated urinary incontinence on older people. Practitioners should promote continence rather than employing containment strategies. A validated assessment tool for older people needs to be developed. Views of older people should be sought regarding their attitudes towards urinary incontinence.
Dingwall
Lindsay
L
SPQ Care of Older People, Assessment and Rehabilitation, School of Nursing and Midwifery, University of Dundee, Dundee, Scotland. l.h.dingwall@dundee.ac.uk
McLafferty
Ella
E
D000367:Age Factors; D000368:Aged / Q000502:physiology / Q000523:psychology; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003220:Conflict, Psychological; D017144:Focus Groups; D015577:Geriatric Assessment; D005851:Geriatric Nursing / Q000193:education / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000458:organization & administration*; D006301:Health Services Needs and Demand; D006801:Humans; D016496:Incontinence Pads; D007297:Inpatients / Q000523:psychology; D024802:Nurse's Role / Q000523:psychology; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology*; D036301:Qualitative Research; D012307:Risk Factors; D012606:Scotland; D017748:Time Management; D014549:Urinary Incontinence / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D016526:Workload