Urinary incontinence after stroke: identification, assessment, and intervention by rehabilitation professionals in Canada.
OBJECTIVE
Urinary incontinence (UI) is a common and distressing problem after stroke. Although there is evidence of new, effective UI poststroke rehabilitation intervention, it is unknown whether occupational therapists (OTs)' and physical therapists (PTs)' actual practices reflect best practices. We sought to determine the extent to which OTs and PTs identify, assess, and treat UI after stroke and to identify personal and organizational predictors of UI problem identification, best-practice assessment, and intervention.


METHODS
Six hundred sixty-three OTs (93% participation rate) and 656 PTs (87% participation rate) working in stroke rehabilitation in Canada were randomly selected and interviewed with a telephone-administered questionnaire. Each responded to a series of open-ended questions related to a generated case (vignette) of a typical client with stroke who was experiencing UI.


RESULTS
Only 39% of OTs and 41% of PTs identified UI after stroke as a problem. Fewer than 20% of OTs and 15% of PTs used best-practice assessments, and only 2% of OTs and 3% of PTs used best-practice interventions. Working in Ontario, having allocated learning time, and doing university teaching were among the variables explaining between 6% and 9% of the variability in UI identification and assessment.


CONCLUSIONS
Canadian OTs and PTs do not routinely identify poststroke UI as a problem, and best-practice assessments and interventions are underused.
Dumoulin
Chantale
C
Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, 3630 Promenades Sir-William-Osler, Montreal, Quebec, H3G 1Y5, Canada. chantal.dumoulin@mail.mcgill.ca
Korner-Bitensky
Nicol
N
Tannenbaum
Cara
C
D000328:Adult; D019985:Benchmarking; D002170:Canada / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009788:Occupational Therapy / Q000592:standards* / Q000706:statistics & numerical data; D026741:Physical Therapy Modalities / Q000592:standards* / Q000706:statistics & numerical data; D015995:Prevalence; D011364:Professional Practice / Q000592:standards / Q000706:statistics & numerical data; D020521:Stroke / Q000150:complications* / Q000453:epidemiology; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000453:epidemiology / Q000209:etiology* / Q000534:rehabilitation*