"Oh, that's a bit of a nuisance": community-dwelling clients ' perspectives of urinary continence health service provision

Abstract

Objective: This study explored clients' perspectives of urinary continence service provision for community-dwelling people from a primary health care perspective.

Design: For this interpretive study, data were collected from 11 clients via in-depth interviews and a questionnaire eliciting demographic details and written comment. A focus group was also held with 7 people belonging to an existing continence self-help group.

Results: Clients indicated that appropriate and acceptable continence care was accessible, affordable, and based on accurate knowledge. They valued practitioners who were empathetic, interested, had good networks, and could assist in practical ways. They looked for explanation, information, and discussion, often finding this when they accessed continence specialists. However, they often found it difficult to access this type of care, with many clients finding that urinary incontinence was treated as a secondary issue or a nuisance by generalist health practitioners. Clients believed that many health practitioners lacked knowledge and/or interest in urinary incontinence. In particular, there was very poor transitional care between hospital and community. The cost of consulting a health practitioner was seen as secondary to the cost of continence equipment and aids.

Conclusions: This study found that the principles of primary health care were not being realized in generalist continence care. Client- centered services that address individual needs, relationships, psychological factors, emotional needs, financial circumstances, social contexts, and lifestyle factors, particularly in transition between sectors, are needed.