Executive Nursing and Midwifery Services, Sydney Local Health District, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia.
J Wound Care. 2024 Aug 1;33(Sup8a):cxcix-ccvii. doi: 10.12968/jowc.2021.0394.
To explore the experience of patients with incontinence and incontinence-associated dermatitis (IAD) in acute care hospitals and their family caregivers, including their perceptions and management, as well as the impact on their wellbeing.
A qualitative exploratory study design was employed in 18 wards across six acute/subacute hospitals in New South Wales, Australia. Patients with incontinence (with or without IAD) were invited to participate. Where interviews were not possible with the patient, their family caregiver was invited to participate. Semi-structured interviews were conducted.
There were 45 interviewees in the study; 41 were patients with incontinence (11 of whom had IAD) and four were family caregivers. The experience of incontinence was captured by three themes: 'incontinence interrupts every aspect of my life'; 'actively concealing and cloaking'; and 'perceived as irreversible'. Incontinence was expected by the patients at their age and did not come as a surprise. It was normalised and approached with stoicism. As such, patients self-managed their incontinence by developing strategies to ensure they avoided episodes of incontinence during their stay. Incontinence left patients feeling anxious, embarrassed and with a sense of shame, and they did not communicate these feelings, or engage with health professionals about their incontinence, nor did health professionals discuss their incontinence with them. There was a strong sense of resignation that incontinence was irreversible and nothing could be done to improve it. All participants displayed little knowledge of IAD. The experience of having IAD was characterised by the theme 'debilitating and desperate for relief' and was experienced as a particularly painful, itching and burning condition that left patients distressed and irritable.
Patients with incontinence in acute settings required further education from health professionals to reduce the stigma of incontinence, and provide further support to manage their incontinence. Health professionals can also play a key role in educating patients about the risks of developing IAD and how it can be prevented.
探索急性护理医院中失禁和失禁相关性皮炎（IAD）患者及其家庭照顾者的体验，包括他们的认知和管理，以及对他们健康的影响。
在澳大利亚新南威尔士州的六家急性/亚急性医院的 18 个病房中采用定性探索性研究设计。邀请患有失禁（伴或不伴 IAD）的患者参与。如果无法与患者进行访谈，则邀请其家庭照顾者参与。进行了半结构化访谈。
研究中有 45 名受访者；41 名是患有失禁（其中 11 名患有 IAD）的患者，4 名是家庭照顾者。失禁的体验包括三个主题：“失禁打断了我生活的方方面面”；“积极隐瞒和掩饰”；以及“被认为是不可逆转的”。患者在他们的年龄预期到失禁，并不感到惊讶。他们将其正常化，并以坚韧的态度对待。因此，患者通过制定策略来避免在住院期间发生失禁事件来自我管理失禁。失禁使患者感到焦虑、尴尬和羞耻感，他们没有与医护人员沟通这些感受，也没有与医护人员讨论他们的失禁问题，医护人员也没有与他们讨论。有一种强烈的不可逆转的感觉，认为失禁是无法改善的。所有参与者对 IAD 的了解都很少。患有 IAD 的体验的特点是“使人衰弱并渴望缓解”，患者感到非常痛苦、瘙痒和灼热，使他们感到痛苦和烦躁。
急性环境中的失禁患者需要从医护人员那里获得进一步的教育，以减少对失禁的污名化，并为他们提供更多的支持来管理失禁。医护人员还可以在教育患者关于发生 IAD 的风险以及如何预防方面发挥关键作用。
