Improving continence services for older people from the service-providers' perspective: a qualitative interview study

Area of Science:

• Gerontology
• Healthcare Management
• Public Health

Background:

• Urinary incontinence (UI) significantly impacts the quality of life for older adults.
• Effective continence management services are crucial for this demographic.
• Understanding service delivery challenges is essential for improving care.

Purpose of the Study:

• To explore the perspectives of continence service leads in England regarding barriers and facilitators to high-quality urinary incontinence services for older adults.
• To identify key characteristics of effective continence care.
• To inform strategies for service improvement.

Main Methods:

• Qualitative study employing semistructured interviews.
• Purposive sampling of 16 continence service leads across 3 acute and 13 primary care NHS Trusts in England.
• Focus on participants actively managing older adults with UI.

Main Results:

• Barriers include lack of recognition of UI, underestimation of its importance, and negative attitudes among commissioners, managers, and health professionals.
• Facilitators include prioritizing patient assessment and continence promotion over pad provision, establishing rapid referral pathways, increasing service capacity (staffing), and enhancing interprofessional collaboration.
• Higher visibility of continence care in medical and nursing training is crucial.

Conclusions:

• Continence service leads' views highlight significant barriers and facilitators for improving UI services for older adults.
• Further research should incorporate perspectives from other stakeholders.
• Empirical evaluation of identified service improvement strategies is recommended.