title: Implementing a Systematic Voiding Program for Patients With Urinary Incontinence After Stroke.
abstract: We explored health professionals' views of implementing a systematic voiding program (SVP) in a multi-site qualitative process evaluation in stroke services recruited to the intervention arms of a cluster randomized controlled feasibility trial during 2011-2013. We conducted semi-structured group or individual interviews with 38 purposively selected nursing, managerial, and care staff involved in delivering the SVP. Content analysis of transcripts used normalization process theory (NPT) as a pre-specified organization-level exploratory framework. Barriers to implementing the SVP included perceived lack of suitability for some patient groups, patient fear of extending hospital stay, and difficulties with SVP enactment, scheduling, timing, recording, and monitoring. Enablers included the guidance provided by the SVP, patient and relative involvement, extra staff, improved nursing skill and confidence, and experience of success. Three potential mechanisms of consistency, visibility, and individualization linked the SVP process with improvements in outcome, and should be emphasized in SVP implementation.
authors.affiliation: University of Central Lancashire, Preston, United Kingdom.
authors.forename: Beverley
authors.initials: B
authors.lastname: French
authors.affiliation: University of Central Lancashire, Preston, United Kingdom lhthomas@uclan.ac.uk.
authors.forename: Lois H
authors.initials: LH
authors.lastname: Thomas
authors.affiliation: University of Central Lancashire, Preston, United Kingdom.
authors.forename: Joanna
authors.initials: J
authors.lastname: Harrison
authors.affiliation: Bangor University, Bangor, United Kingdom.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Burton
authors.affiliation: University of Central Lancashire, Preston, United Kingdom.
authors.forename: Denise
authors.initials: D
authors.lastname: Forshaw
authors.affiliation: Glasgow Caledonian University, Glasgow, United Kingdom.
authors.forename: Joanne
authors.initials: J
authors.lastname: Booth
authors.affiliation: University of Liverpool, Liverpool, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Britt
authors.affiliation: University of East Anglia, Norwich, United Kingdom.
authors.forename: Francine M
authors.initials: FM
authors.lastname: Cheater
authors.affiliation: Edge Hill University, Ormskirk, United Kingdom.
authors.forename: Brenda
authors.initials: B
authors.lastname: Roe
authors.affiliation: University of Central Lancashire, Preston, United Kingdom.
authors.forename: Caroline L
authors.initials: CL
authors.lastname: Watkins
mesh_terms: D001291:Attitude of Health Personnel; D006801:Humans; D036301:Qualitative Research; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000150:complications*; D014549:Urinary Incontinence / Q000628:therapy*
keywords: UK; interviews; knowledge transfer; normalization process theory; nursing; program evaluation; qualitative; qualitative analysis; research, clinical; stroke; urinary incontinence