Deakin University, School of Nursing and Midwifery, Centre for Quality and Patient Safety Research - Barwon Health, Deakin University, Geelong, Vic., Australia.
Deakin University, School of Nursing and Midwifery, Geelong, Vic., Australia.
J Clin Nurs. 2018 Jun;27(11-12):2425-2437. doi: 10.1111/jocn.14293. Epub 2018 Apr 6.
To explore nursing home staff members' beliefs and expectations about what constitutes "quality continence care" for people living in nursing homes.
Most nursing home residents require assistance to maintain continence or manage incontinence. Best practice guidelines promote active investigation of incontinence, treatment of underlying potentially reversible causes, and initial conservative interventions to prevent, minimise and/or treat incontinence. Despite research showing the positive benefits of implementing active interventions, translating the findings of research into practice in nursing homes has been modest. Understanding the perspectives of individuals who provide continence care may help bridge the gap between evidence and practice.
A qualitative exploratory descriptive design.
Qualitative interviews were conducted with 19 nursing home staff: eight registered nurses, four enrolled nurses and seven personal care workers working in a nursing home in Australia between 2014-2015. Data were analysed inductively to identify themes and subthemes that described and explained staff beliefs about quality continence care in nursing homes.
Participants' understanding and expectations about quality continence care were linked to beliefs about incontinence being an intractable and undignified condition in nursing homes. The key theme to emerge was "protecting residents' dignity" which was supported by the following six subthemes: (i) using pads, ii) providing privacy, (iii) knowing how to "manage" incontinence, (iv) providing timely continence care, (v) considering residents' continence care preferences and (vi) communicating sensitively.
The findings provide new insight into the basis for continence care practices in nursing homes. Education about continence care should challenge beliefs that limit continence care practice to cleaning, containing and concealing incontinence. There is a need for a multidimensional framework that is informed by social, psychological and biomedical research about incontinence, research about the fundamental elements of care, care-dependent individuals' expectations about care, and values about dignity and care.
The in-depth exploration led to an understanding of the basis for continence care practices that centre on cleaning, containing and concealing residents' incontinence in some nursing homes. There is a need to review the quality of education for the aged care workforce about incontinence to ensure it equips them with a broad understanding of the fundamentals of care and how to enact dignity in continence care through a resident-centred approach.
探讨养老院工作人员对养老院居民“优质控尿护理”的信念和期望。
大多数养老院居民需要帮助来保持控尿或管理失禁。最佳实践指南提倡积极调查失禁，治疗潜在可逆转的原因，并采取初始保守干预措施来预防、最小化和/或治疗失禁。尽管研究表明实施积极干预的积极益处，但将研究结果转化为养老院的实践进展甚微。了解提供控尿护理的个人的观点可能有助于缩小证据与实践之间的差距。
定性探索性描述性设计。
2014-2015 年，在澳大利亚的一家养老院，对 19 名养老院工作人员（8 名注册护士、4 名注册护士和 7 名个人护理人员）进行了定性访谈。使用归纳法分析数据，以确定描述和解释工作人员对养老院优质控尿护理的信念的主题和子主题。
参与者对优质控尿护理的理解和期望与他们对失禁在养老院中是一种棘手和不体面的状况的信念有关。出现的主要主题是“保护居民的尊严”，以下六个子主题支持了这一主题：（一）使用尿垫，（二）提供隐私，（三）了解如何“管理”失禁，（四）及时提供控尿护理，（五）考虑居民的控尿护理偏好，（六）敏感沟通。
研究结果为养老院控尿护理实践的基础提供了新的见解。关于控尿护理的教育应该挑战那些将控尿护理实践限制在清洁、容纳和掩盖失禁的信念。需要一个多维框架，该框架以关于失禁的社会、心理和生物医学研究、关于护理的基本要素的研究、依赖护理的人对护理的期望以及关于尊严和护理的价值观为依据。
深入探讨导致了对一些养老院以清洁、容纳和掩盖居民失禁为中心的控尿护理实践基础的理解。需要审查老年护理人员关于失禁的教育质量，以确保他们对护理的基本知识有广泛的了解，并通过以居民为中心的方法来实施控尿护理中的尊严。
