School of Health Sciences, University of Southampton, Southampton General Hospital, Tremona Road, Shirley, SO16 6YD, UK.
NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King's College London, Virginia Woolf Building, 22 Kingsway, London, WC2B 6LE, UK.
BMC Geriatr. 2024 Feb 29;24(1):213. doi: 10.1186/s12877-024-04830-8.
People living with dementia at home and their family carers often feel unsupported by healthcare professionals in managing continence problems. In turn, primary and community-based healthcare professionals have reported lacking specific knowledge on dementia-continence. This study aimed to understand more about healthcare professionals' experiences and views of supporting people living with dementia experiencing continence problems, as part of developing acceptable resources. Having a nuanced understanding of unmet need would facilitate the design of engaging resources that enable healthcare professionals to provide more effective continence support to people living with dementia at home.
Semi-structured interviews were conducted with a range of healthcare professionals (n = 31) working in primary and community care in the South of England in 2023. Transcribed interviews were uploaded to NVivo 12, then analysed inductively and deductively using a thematic framework.
Continence-related conversations were avoided by many healthcare professionals due to lack of dementia-continence specific knowledge. Many considered that continence problems of people living with dementia were largely outside their remit once a physical cause had been ruled out. This contributed to a lack of priority and proactivity in raising the subject of continence in their consultations. Challenges to providing support included limited consultation time and lack of access to specialist services with availability to support individuals.
There is substantial scope to support primary and community-based healthcare professionals in their provision of continence-related support and advice to people living at home with dementia. This includes addressing knowledge deficits, enhancing confidence and instilling a sense of accomplishment.
居家患有痴呆症的患者及其家庭照顾者在管理失禁问题时，常常感到得不到医疗保健专业人员的支持。反过来，初级和社区医疗保健专业人员报告称，他们缺乏有关痴呆症-失禁的特定知识。本研究旨在更深入地了解医疗保健专业人员在支持患有痴呆症且出现失禁问题的患者方面的经验和观点，这是开发可接受资源的一部分。深入了解未满足的需求将有助于设计吸引人的资源，使医疗保健专业人员能够为居家患有痴呆症的患者提供更有效的失禁支持。
2023 年，在英格兰南部的初级和社区护理中，对从事各种医疗保健工作的专业人员（n=31）进行了半结构化访谈。将转录的访谈上传到 NVivo 12 后，使用主题框架进行了归纳和演绎分析。
由于缺乏痴呆症-失禁特定知识，许多医疗保健专业人员避免进行与失禁相关的对话。许多人认为，一旦排除了身体原因，患有痴呆症的患者的失禁问题在很大程度上超出了他们的职责范围。这导致他们在咨询中很少主动提出或优先考虑失禁问题。提供支持的挑战包括咨询时间有限，以及缺乏专门服务来支持个人。
在为居家患有痴呆症的患者提供与失禁相关的支持和建议方面，有很大的空间可以支持初级和社区医疗保健专业人员。这包括解决知识缺陷、增强信心和培养成就感。
