title: Healthcare providers' perspectives on communicating incontinence and skin damage information with patients with dementia and their family caregivers: a descriptive study.
abstract: Communication between healthcare providers and patients/family caregivers about incontinence and associated skin damage is wanting, and information about healthcare providers perspectives on improving this communication is limited. A descriptive study was conducted using semi-structured, tape-recorded interviews with 11 healthcare providers with clinical expertise in geriatrics and dementia working in a large integrated healthcare system. The survey was developed by the authors based on a review of the relevant literature with guidance from a three-member Advisory Committee and consisted of nine open-ended questions related to communication with patients and families about incontinence and skin damage. Specifically, information was obtained about providers' perspectives on the timing of inquiring about these problems, how best to tailor language and approach the topic, barriers and facilitators to discussion of incontinence, and recommendations for educational and supportive resources. Responses were analyzed using a content analysis approach. Using a purposeful sampling technique, 11 experienced healthcare professionals agreed to participate in the study. Main themes observed included: 1) incontinence issues are not routinely or voluntarily addressed by all providers, 2) caregivers are receptive to discussion if the topic is broached by patient/caregiver, and 3) main barriers to providing information include limited clinician time and patient/family caregiver embarrassment. Participant clinicians expressed interest in readily available, single-topic, printed patient/caregiver-focused educational materials to enhance patient-provider communication and serve as a resource. These materials were subsequently developed. Further research is warranted to test the effectiveness of the recommendations and the materials developed as a result of the study.
authors.affiliation: HealthPartners Institute of Education and Research, Bloomington, MN, USA. cheri.j.rolnick@healthpartners.com
authors.forename: Sharon
authors.initials: S
authors.lastname: Rolnick
authors.forename: Donna Z
authors.initials: DZ
authors.lastname: Bliss
authors.forename: Jody M
authors.initials: JM
authors.lastname: Jackson
authors.forename: Casey
authors.initials: C
authors.lastname: Arntson
authors.forename: Jean
authors.initials: J
authors.lastname: Mullins
authors.forename: Kenneth
authors.initials: K
authors.lastname: Hepburn
mesh_terms: D000328:Adult; D017028:Caregivers; D003704:Dementia / Q000451:nursing*; D005190:Family; D006282:Health Personnel; D006801:Humans; D008875:Middle Aged; D012871:Skin Diseases / Q000150:complications*; D014549:Urinary Incontinence / Q000150:complications / Q000503:physiopathology*
references.citation: Can J Urol. 2004 Dec;11(6):2430-7
references.pmid: 15636668
references.citation: J Wound Ostomy Continence Nurs. 2011 Jul-Aug;38(4):433-45
references.pmid: 21747261
references.citation: Psychol Aging. 2009 Jun;24(2):385-96
references.pmid: 19485656
references.citation: J Am Geriatr Soc. 1990 Mar;38(3):374-8
references.pmid: 2179382
references.citation: J Adv Nurs. 1993 Sep;18(9):1415-23
references.pmid: 8258600
references.citation: Nurs Outlook. 2004 Sep-Oct;52(5):241-7
references.pmid: 15499313
references.citation: West J Nurs Res. 2008 Nov;30(7):817-35
references.pmid: 18270314
references.citation: Am J Gastroenterol. 1996 Jan;91(1):33-6
references.pmid: 8561140
references.citation: Neurourol Urodyn. 1999;18(3):199-204
references.pmid: 10338440
references.citation: J Wound Ostomy Continence Nurs. 2005 Mar-Apr;32(2):101-11
references.pmid: 15867700
references.citation: J Wound Ostomy Continence Nurs. 2004 Mar-Apr;31(2):85-94
references.pmid: 15209431
references.citation: Neurourol Urodyn. 2010 Apr;29(4):540-4
references.pmid: 19693950
references.citation: J Wound Ostomy Continence Nurs. 2010 Jan-Feb;37(1):73-9
references.pmid: 20075695
references.citation: Scand J Urol Nephrol. 2008;42(6):534-8
references.pmid: 18615365
references.citation: Prim Care. 2005 Sep;32(3):699-722
references.pmid: 16140124
references.citation: Nurse Pract. 2009 Dec;34(12):33-45
references.pmid: 19952586
references.citation: J Gerontol Nurs. 2001 Mar;27(3):19-28
references.pmid: 11915254
references.citation: Med Clin North Am. 2011 May;95(3):539-54, x-xi
references.pmid: 21549877
references.citation: Ostomy Wound Manage. 2003 Dec;49(12):46-52
references.pmid: 14712010
references.citation: J Gerontol Nurs. 2003 Jan;29(1):37-44; quiz 55-6
references.pmid: 12596336
references.citation: Nurs Stand. 2004 May 5-11;18(34):33-40
references.pmid: 15151022
references.citation: J Am Geriatr Soc. 1994 Feb;42(2):208-12
references.pmid: 8126338
references.citation: Gerontologist. 2003 Dec;43(6):908-15
references.pmid: 14704391
references.citation: Br J Community Nurs. 2004 Dec;9(12):520-3
references.pmid: 15655485
references.citation: Am J Nurs. 2010 Sep;110(9):30-8; quiz 39-40
references.pmid: 20736708
references.citation: Nurs Res. 2011 May-Jun;60(3 Suppl):S58-67
references.pmid: 21543963
references.citation: Res Nurs Health. 2006 Jun;29(3):233-43
references.pmid: 16676338
references.citation: BJU Int. 2001 Oct;88(6):532-5
references.pmid: 11678745
references.citation: J Gerontol A Biol Sci Med Sci. 1999 Jan;54(1):M34-7
references.pmid: 10026660
references.citation: Res Nurs Health. 2004 Jun;27(3):162-73
references.pmid: 15141369
references.citation: J Womens Health (Larchmt). 2005 Dec;14(10):906-16
references.pmid: 16372892
references.citation: J Wound Ostomy Continence Nurs. 2011 May-Jun;38(3):289-97
references.pmid: 21464770
references.citation: J Wound Ostomy Continence Nurs. 2006 Jul-Aug;33(4):389-95
references.pmid: 16932121
references.citation: Gerontologist. 1999 Jun;39(3):299-309
references.pmid: 10396888
references.citation: J Wound Ostomy Continence Nurs. 2005 Jan-Feb;32(1):38-52
references.pmid: 15718956
references.citation: J Am Geriatr Soc. 2001 Apr;49(4):450-7
references.pmid: 11347790
references.citation: Hosp Med. 2001 Sep;62(9):538-41
references.pmid: 11584611
references.citation: Med J Aust. 2002 Jan 21;176(2):54-7
references.pmid: 11936284
references.citation: J Wound Ostomy Continence Nurs. 2013 Sep-Oct;40(5):515-23
references.pmid: 24448620