Professor of Health Policy & Service Delivery, Faculty of Health & Social Care Sciences, St. George's University of London & Kingston University, London, UK.
J Clin Nurs. 2013 Feb;22(3-4):339-46. doi: 10.1111/j.1365-2702.2012.04125.x. Epub 2012 Jul 13.
To establish whether the problems and issues experienced by people with dementia living at home and their carers were addressed in the clinical guidance for continence management for community nursing services in England.
Internationally, the numbers of people with dementia are rising. Managing incontinence is a significant issue as the presence of incontinence is one of the triggers for people with dementia to move their residence to a care home. People with dementia living at home and their family carers report difficulties in accessing knowledgeable professionals and acceptable continence products.
A review by documentary analysis of clinical policies and guidance from a sample of community nursing services in all Strategic Health Authority regions of England.
A sample of clinical policy and guidance documents for continence assessment and management from up to four community nursing services in each of the ten Strategic Health Authority regions in England was sought. Documentary analysis was undertaken on the relevance of the documents identified for people with dementia living at home.
Ninety-eight documents from 38 local community nursing services spread across ten Strategic Health Authority areas were obtained and analysed. Only in the documents of three services were nurses offered detailed guidance about the management of incontinence for people with dementia at home. In the documentation of only one service were people with dementia identified as a special case which warranted the provision of additional continence products.
Clinical guidance on continence assessment and management for community nurses in many parts of England does not address the specific needs of people with dementia living at home or their carers.
Nurses working in community settings and those providing clinical leadership in continence care should review their clinical guidance and policies to ensure relevance for people with dementia living at home and their family carers.
确定在英国社区护理服务的控尿管理临床指南中，是否涉及居家痴呆症患者及其照顾者所面临的问题。
在国际上，痴呆症患者的数量正在增加。管理失禁是一个重大问题，因为失禁的存在是导致痴呆症患者搬到养老院的一个触发因素。居家痴呆症患者及其家庭照顾者报告难以获得有知识的专业人员和可接受的控尿产品。
通过对英格兰所有战略卫生局地区的社区护理服务的临床政策和指南进行文献分析的审查。
从英格兰十个战略卫生局地区的每个地区最多四个社区护理服务中寻找控尿评估和管理的临床政策和指南文件样本。对确定的与居家痴呆症患者相关的文件进行文献分析。
从 38 个当地社区护理服务中获得了 98 份文件，并对其进行了分析。只有在三个服务的文件中，护士才获得了有关居家痴呆症患者控尿管理的详细指导。只有在一个服务的文件中，痴呆症患者被确定为特殊情况，需要提供额外的控尿产品。
英格兰许多地区的社区护士在控尿评估和管理方面的临床指南并未满足居家痴呆症患者及其照顾者的特殊需求。
在社区环境中工作的护士和提供控尿护理临床领导的护士应审查其临床指南和政策，以确保与居家痴呆症患者及其家庭照顾者相关。
