Nurse perspectives on the psychosocial care of patients with urinary incontinence in home hospice: A qualitative study

Background: Urinary incontinence is prevalent among patients receiving home hospice and presents multiple care management challenges for nurses and family caregivers. Aim: This study sought to understand how urinary incontinence influences the psychosocial care of patients receiving home hospice and...

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Published in:Palliative medicine 2022-01, Vol.36 (1), p.135-141
Main Authors: Russell, David, Stoddard, Michelina D, Morgan, Natalie, McDonald, Margaret V, Dignam, Ritchell, Bowles, Kathryn H, Prigerson, Holly G, Chughtai, Bilal
Format: Article
Language:English
Subjects:
Caregiver burden
Caregivers
Caregivers - psychology
Caregiving
Comfort
Diapers
Embarrassment
Health care management
Hospice care
Hospice Care - psychology
Hospices
Humans
Incontinence
Interviews
Nonprofit organizations
Normalization
Nurses
Patients
Private sector
Psychiatric Rehabilitation
Psychosocial factors
Qualitative Research
Relatives
Urinary incontinence
Urinary Incontinence - psychology
Urinary Incontinence - therapy
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Summary:Background: Urinary incontinence is prevalent among patients receiving home hospice and presents multiple care management challenges for nurses and family caregivers. Aim: This study sought to understand how urinary incontinence influences the psychosocial care of patients receiving home hospice and the strategies that nurses employ to maximize patient and family comfort. Design: Qualitative descriptive study using semi-structured interviews. Setting/participants: Nurses employed at a large not-for-profit hospice agency in New York City. Results: Analyses of 32 interviews revealed three primary themes. First, nurses considered urinary incontinence to be associated with multiple psychosocial issues including embarrassment for patients and caregiver burden. Second, nurses described urinary incontinence as a threat to patient dignity and took steps to preserve their continence function. Third, nurses assisted patients and their families to cope with urinary incontinence through normalization, reframing incontinence as part of the disease process, mobilizing caregiving assistance, and encouraging use of continence supplies such as diapers and liners. Conclusion: Urinary incontinence influences the psychosocial care of patients receiving home hospice and nurses employ strategies to maximize patient and family comfort. Additional research is needed to examine the psychosocial benefits of facilitated discussions with patients and family members about incontinence, provision of caregiving support, and distribution of comprehensive incontinence supplies to patients with fewer resources.
ISSN:0269-2163
1477-030X
DOI:10.1177/02692163211043378