Management of Fecal Incontinence in Older People With Dementia Resident in Care Homes: A Realist Synthesis—The FINCH Study

Roe, Brenda; Goodman, Claire; Russell, Bridget; Buswell, Marina; Norton, Christine; Harari, Danielle; Harwood, Rowan H.; Malone, Jo Rycroft; Drennan, Vari; Fader, Mandy; Maden, Michelle; Bunn, Frances

doi:10.1016/j.jamda.2017.06.001

Cited by 1 publication

(10 citation statements)

References 15 publications

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“…After title and abstract screening, and removal of duplicates, 55 articles were reviewed at full-text level. From these, 18 articles [21,23,30,32,33,[68][69][70][71][72][73][74][75][76][77][78][79][80] (see Fig. 1 for the PRISMA flow chart) were included.…”

Section: Resultsmentioning

confidence: 99%

“…Among the eligible articles were three studies that were reported in two or more papers. Specifically, the ‘FINCH’ study was reported in three papers [ 69 , 70 , 77 ]. Similarly, Ostaszkiewicz reported on different aspects of the same Grounded theory study about providing continence care in Australian residential aged care homes (RACH) in three papers [ 32 , 72 , 73 ].…”

Section: Resultsmentioning

confidence: 99%

“…Whilst incontinence itself is not a life threatening illness, it has been viewed by some as a state worse than death [89]. It is difficult to ascertain if it is the incontinence or Vulnerability and threats to social integrity [33] Feeling like a child [21,74] Feeling like a burden or a nuisance [21] Feeling degraded [78] Feeling unclean/dirty [21,32,72,73] Being embarrassed [21,23,68,74,75,78] Feeling ashamed and humiliated, leading to loss of personhood [21,23,32,68,72,73,75] Being anxious, afraid, distressed, agitated [30,32,33,69,70,72,73,75,77,79] Feeling stigmatised [69,70,77] Low self-esteem [71,74] Self-imposed isolation [80] Resistance to care [30,33,74] Concerns about odour [78] Being ethically compromised & morally distressed [33,71,72] Feeling ...…”

Section: Discussionmentioning

confidence: 99%

“…Coupled with this, the sector faces severe constraints on budgets, staffing, time and resources, all of which affect the provision of dignified care [26]. By clarifying the concept dignity, and exploring how it is manifested in continence care, the findings of this concept analysis can support reflection on the identified antecedents and attributes as part of appropriate staff education and training [76,77].…”

Section: Discussionmentioning

confidence: 99%

“…A further 9 attributes that related to the social environmental were identified. These included; time to deliver care and flexible work practices [32,69,70,72,73,77,79], staff knowledge and beliefs about incontinence [23,32,69,70,72,73,77], an adequate number of staff as well as staff who are trained [23,30,32,33,69,70,72,73,77,79], managerial support and leadership [68][69][70]77], a predictable work environment [32,72,73] and regulation that does not constrain caring practices [69,70,77].…”

Section: Antecedents and Key Attributesmentioning

confidence: 99%

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A concept analysis of dignity-protective continence care for care dependent older people in long-term care settings

et al. 2020

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Background: Although codes of conduct, guidelines and standards call for healthcare practitioners to protect patients' dignity, there are widespread concerns about a lack of attention to the dignity of older people who need assistance with toileting, incontinence or bladder or bowel care in health or social care settings that provide longterm care. Incontinence and care dependence threatens patient dignity. The aim of this research was to explore, describe and explain the concept of dignity as it relates to continence care for older people requiring long-term care. Methods: The first four steps of Rodgers evolutionary method of concept analysis were followed. First, a comprehensive and systematic search of databases and key guidelines about continence care was undertaken to identify empirical research about dignity and continence care in older people in facilities that provide permanent residential or inpatient care of older people for day-today living. Data were extracted on the authors, date, sample, country of origin, and key definitions, attributes, contexts and consequences from each included record. Findings were inductively analysed and grouped according to whether they were the key attributes and antecedents of dignity in relation to continence care or the consequences of undignified continence care. Results: Of 625 articles identified, 18 were included in the final analysis. Fifty individual attributes were identified that were categorised in 6 domains (respect, empathy, trust, privacy, autonomy and communication). A further 15 were identified that related to the environment (6 physical and 9 social). Key consequences of undignified continence care were also identified and categorised into 3 levels of impact (resident/family member, staff or organisation). Conclusions: This research resulted in a conceptual understanding of dignity that can be used as a value or guiding principle in an ethic of care for older people who need assistance with toileting, incontinence or bladder or bowel care in long-term care settings.

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