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Understanding Barriers to Continence Care in Institutions*

Published online by Cambridge University Press:  31 March 2010

Cara Tannenbaum ,
Danielle Labrecque  and
Christiane Lepage
Cara Tannenbaum*
Affiliation:
Research Centre, Institut Universitaire de Gériatrie de Montréal Faculty of Medicine and Nursing, Université de Montréal
Danielle Labrecque
Affiliation:
Research Centre, Institut Universitaire de Gériatrie de Montréal Faculty of Medicine and Nursing, Université de Montréal
Christiane Lepage
Affiliation:
Research Centre, Institut Universitaire de Gériatrie de Montréal Faculty of Medicine and Nursing, Université de Montréal
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être addressées à : Cara Tannenbaum, M.D., M.S.C., Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, 4565 Queen Mary Road, Suite 7824, Montreal, QC H3W 1W5. (cara.tannenbaum@umontreal.ca)
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Abstract

This work seeks to identify factors that facilitate or diminish care-providers' propensity to improve continence care in long-term care (LTC) settings. We conducted a cross-sectional qualitative study using focus group methodology in four long-term care institutions in Montreal, QC. Forty-two nurses, nursing assistants, and orderlies caring for incontinent elderly residents were asked how they perceived urinary incontinence (UI), how it was being managed, and what factors enabled or hindered continence care in their institution. Content analysis was used. Facilitating and inhibiting elements of three individual/internal factors (beliefs about UI, attitudes towards the elderly, and knowledge about UI) and five institutional/external factors (workload demands, type of patient, environmental support, co-worker support, and attributes of UI interventions) emerged as important determinants of care-providers' propensity to manage UI. To be successful, continence programs must target multidimensional elements that take into account personal, systems, and organizational level factors.

Résumé

Cette étude vise à identifier les facteurs pouvant faciliter ou réduire la capacité des soignants à améliorer la continence urinaire chez la clientèle âgée hébergée. Nous avons mené une étude qualitative transversale dans quatre établissements de soins de longue durée à Montréal (Québec), utilisant la méthodologie de groupe. Quarante-deux infirmières, assistantes infirmières et préposés prenant soin de résidents âgés incontinents ont été questionnés sur la façon dont ils percevaient l'incontinence urinaire (IU), comment elle était prise en charge dans leur milieu et quels facteurs pouvaient faciliter ou nuire à cette prise en charge. L'analyse de contenu a été utilisée. Trois facteurs individuels/internes (les préjugés sur l'IU, les attitudes vis-à-vis les personnes âgées, et les connaissances sur l'IU), et cinq facteurs institutionnels/externes (la charge de travail, le type de patient, le support du milieu, le support des autres soignants, le caractère des interventions) sont apparus comme d'importants déterminants de la capacité des soignants à prendre en charge l'IU. Pour être couronnés de succès, les programmes de continence en soins de longue durée doivent cibler les interventions prenant en compte ces facteurs et agir auprès des individus, du système et de l'organisation des établissements.

Keywords

urinary incontinencelong-term carebarriersmultidisciplinaryqualitative researchagingincontinence urinairesoins de longue duréeobstaclesmultidisciplinairerecherche qualitative
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 24 , Issue 2 , Summer/Été 2005 , pp. 151 - 159
Copyright
Copyright © Canadian Association on Gerontology 2005

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Footnotes

*

This research was supported by the Incontinence Axis of the Quebec Research Network on Aging in collaboration with the following nursing homes: Maimonides, Montreal Extended Care Centre, Residence Mance Decarie, and Pavillion Alfred Desrochers. The authors wish to thank Francine Ducharme and Howard Bergman for their valuable comments and feedback on the first draft of this manuscript.

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