title: Understanding bladder management on a palliative care unit: a grounded theory study.
abstract: BACKGROUND
  Research regarding factors associated with nursing-initiated changes to bladder management at end-of-life is sparse.
  
  
  OBJECTIVE
  To explore the process of Palliative Care Unit (PCU) nurses' approach to bladder management changes.
  
  
  METHODS
  Nursing staff from one PCU in London, Canada were interviewed regarding bladder management care practices. A constructivist grounded theory was generated.
  
  
  RESULTS
  Four interconnected themes emerged: humanity (compassionate support of patients); journey (making the most of a finite timeline); health condition (illness, functional decline); and context (orders, policies, supplies). These overlapping themes must be considered in light of ongoing changes which prompt recycling through the framework. While bladder management necessitates shared decision-making and individualised care, nurses' phronetic experience may serve to detect the presence of change and the need to consider other alternatives.
  
  
  CONCLUSIONS
  End-of-life bladder management requires nurses to continually reconsider the significance of humanity, journey, health condition and context in light of ongoing changes.
authors.affiliation: Associate Scientist, Lawson Health Research Institute in London, ON Canada.
authors.forename: Iris
authors.initials: I
authors.lastname: Gutmanis
authors.affiliation: PhD Candidate, Health and Rehabilitation Sciences, Western University in London, ON Canada.
authors.forename: Melissa
authors.initials: M
authors.lastname: Hay
authors.affiliation: Assistant Professor, Department of Family Medicine, McMaster University, Hamilton, ON in London, ON Canada.
authors.forename: Joshua
authors.initials: J
authors.lastname: Shadd
authors.affiliation: Palliative Pain and Symptom Management Consultation Program, St Joseph's Health Care in London, ON Canada.
authors.forename: Janette
authors.initials: J
authors.lastname: Byrne
authors.affiliation: Forensic Rehabilitation Unit, St Joseph's Health Care in London, ON Canada.
authors.forename: Sarah
authors.initials: S
authors.lastname: McCallum
authors.affiliation: PhD Candidate, Health and Rehabilitation Sciences, Western University in London, ON Canada.
authors.forename: Kristen
authors.initials: K
authors.lastname: Bishop
authors.affiliation: Palliative Pain and Symptom Management Consultation Program, St. Joseph's Health Care in London, ON Canada.
authors.forename: Patricia
authors.initials: P
authors.lastname: Whitfield
authors.affiliation: Family Physician and Practicing in Palliative Care, Adjunct Professor, Department of Family Medicine, Western University in London, ON Canada.
authors.forename: Cathy
authors.initials: C
authors.lastname: Faulds
mesh_terms: D002170:Canada; D003657:Decision Making; D041382:Diapers, Adult; D004645:Empathy; D066296:Grounded Theory; D064946:Hospice and Palliative Care Nursing; D006801:Humans; D051346:Mobility Limitation; D028723:Personhood; D057285:Precision Medicine; D036301:Qualitative Research; D013727:Terminal Care; D014546:Urinary Catheterization; D014549:Urinary Incontinence / Q000451:nursing*
keywords: Bladder management; End-of-life; Nursing