To date, no studies have characterized the impacts of urinary incontinence (UI) at the end of life (EOL) in the home hospice (HH) setting. UI is highly prevalent at the EOL and adversely affects quality of life.
To characterize HH nurses' perspectives on UI in HH patients.
We conducted a qualitative descriptive study of interviews between HH nurses and the study investigator. Thirty-two interviews with HH nurses were transcribed and analyzed. Nurses were mostly female, college-educated, and had several years of experience in HH nursing.
We identified findings in four major themes: 1) HH nurses' definition and identification of UI, 2) the absence of formal guidelines for diagnosing UI in HH patients, 3) UI's adverse effect on HH patients and their families, and 4) the lack of standardized guidelines for the management of UI in the HH setting. We found that there was a general lack of clarity on the subtypes of UI and no standardized guidelines for management of UI in the HH setting. Nurses reported that UI was bothersome to HH patients and their caregivers, citing patient discomfort, loss of dignity, and additional labor burden as reasons for this. Management strategies for UI lacked standardization.
UI is a prevalent and debilitating condition in HH patients. There is a need for studies to further characterize the impacts of UI on HH patients and their caregivers. Formal training on UI subtypes and management is needed to facilitate proper documentation, research, and improve patient outcomes.
Journal of pain and symptom management. 2020 Nov 30 [Epub ahead of print]
Michelina D Stoddard, David Russell, Margaret V McDonald, Ritchell Dignam, Kathryn H Bowles, Holly G Prigerson, Bilal Chughtai
Department of Urology, Weill Cornell Medicine/New York Presbyterian, New York, New York 10065., Center for Home Care Policy & Research, Visiting Nurse Service of New York, New York, New York, 10017; Department of Sociology, Appalachian State University, Boone, North Carolina, 28608., Center for Home Care Policy & Research, Visiting Nurse Service of New York, New York, New York, 10017., Visiting Nurse Service of New York Hospice, New York, New York, 10017., Center for Home Care Policy & Research, Visiting Nurse Service of New York, New York, New York, 10017; Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, PA, 19104., Department of Medicine, Weill Cornell Medicine, New York, New York 10021., Department of Urology, Weill Cornell Medicine/New York Presbyterian, New York, New York 10065. Electronic address: .