Ostaszkiewicz Joan, O'Connell Beverly, Dunning Trisha
Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Deakin University, Melbourne, Victoria, Australia.
Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada.
Australas J Ageing. 2016 Jun;35(2):119-26. doi: 10.1111/ajag.12218. Epub 2015 Sep 13.
Most residents in residential aged-care facilities are incontinent. This study explored how continence care was provided in residential aged-care facilities, and describes a subset of data about staffs' beliefs and experiences of the quality framework and the funding model on residents' continence care.
Using grounded theory methodology, 18 residential aged-care staff members were interviewed and 88 hours of field observations conducted in two facilities. Data were analysed using a combination of inductive and deductive analytic procedures.
Staffs' beliefs and experiences about the requirements of the quality framework and the funding model fostered a climate of fear and risk adversity that had multiple unintended effects on residents' continence care, incentivising dependence on continence management, and equating effective continence care with effective pad use.
There is a need to rethink the quality of continence care and its measurement in Australian residential aged-care facilities.
大多数居住在老年护理机构的居民存在失禁问题。本研究探讨了老年护理机构中失禁护理的提供方式，并描述了一组关于工作人员对质量框架和资金模式的信念以及对居民失禁护理的经验的数据。
采用扎根理论方法，对18名老年护理机构工作人员进行了访谈，并在两家机构进行了88小时的实地观察。使用归纳和演绎分析程序相结合的方法对数据进行分析。
工作人员对质量框架和资金模式要求的信念和经验营造了一种恐惧和规避风险的氛围，这对居民的失禁护理产生了多种意想不到的影响，促使人们依赖失禁管理，并将有效的失禁护理等同于有效的尿垫使用。
有必要重新思考澳大利亚老年护理机构中失禁护理的质量及其衡量标准。
