Brady M C, Jamieson K, Bugge C, Hagen S, McClurg D, Chalmers C, Langhorne P
Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK.
Clin Rehabil. 2016 May;30(5):481-94. doi: 10.1177/0269215515589331. Epub 2015 Jun 4.
Investigate the perspectives of patients and nursing staff on the implementation of an augmented continence care intervention after stroke.
Qualitative data were elicited during semi-structured interviews with patients (n = 15) and staff (14 nurses; nine nursing assistants) and analysed using thematic analysis.
Mixed acute and rehabilitation stroke ward.
Stroke patients and nursing staff that experienced an enhanced continence care intervention.
Four themes emerged from patients' interviews describing: (a) challenges communicating about continence (initiating conversations and information exchange); (b) mixed perceptions of continence care; (c) ambiguity of focus between mobility and continence issues; and (d) inconsistent involvement in continence care decision making. Patients' perceptions reflected the severity of their urinary incontinence. Staff described changes in: (i) knowledge as a consequence of specialist training; (ii) continence interventions (including the development of nurse-led initiatives to reduce the incidence of unnecessary catheterisation among patients admitted to their ward); (iii) changes in attitude towards continence from containment approaches to continence rehabilitation; and (iv) the challenges of providing continence care within a stroke care context including limitations in access to continence care equipment or products, and institutional attitudes towards continence.
Patients (particularly those with severe urinary incontinence) described challenges communicating about and involvement in continence care decisions. In contrast, nurses described improved continence knowledge, attitudes and confidence alongside a shift from containment to rehabilitative approaches. Contextual components including care from point of hospital admission, equipment accessibility and interdisciplinary approaches were perceived as important factors to enhancing continence care.
调查患者和护理人员对中风后实施强化尿失禁护理干预措施的看法。
通过对患者（n = 15）和工作人员（14名护士；9名护理助理）进行半结构化访谈收集定性数据，并采用主题分析法进行分析。
急性和康复中风混合病房。
经历过强化尿失禁护理干预的中风患者和护理人员。
从患者访谈中出现了四个主题，描述了：（a）尿失禁沟通方面的挑战（开启对话和信息交流）；（b）对尿失禁护理的不同看法；（c）行动能力和尿失禁问题之间重点的模糊性；（d）尿失禁护理决策参与的不一致性。患者的看法反映了其尿失禁的严重程度。工作人员描述了以下方面的变化：（i）专业培训带来的知识变化；（ii）尿失禁干预措施（包括制定由护士主导的举措以减少其病房住院患者不必要导尿的发生率）；（iii）对尿失禁的态度从控制方法转向尿失禁康复；（iv）在中风护理背景下提供尿失禁护理的挑战，包括获得尿失禁护理设备或产品的限制以及机构对尿失禁的态度。
患者（尤其是那些严重尿失禁的患者）描述了在尿失禁护理决策沟通和参与方面的挑战。相比之下，护士描述了尿失禁知识、态度和信心的改善，以及从控制方法向康复方法的转变。包括从入院时的护理、设备可及性和跨学科方法在内的背景因素被视为加强尿失禁护理的重要因素。
