Ethical challenges associated with providing continence care in residential aged care facilities : findings from a grounded theory study Ostaszkiewicz,J, O'Connell,B and Dunning, T. 2014, Ethical challenges associated with providing continence care in residential aged care facilities : findings from a grounded theory study, Australian and New Zealand continence journal, vol. 20, no. 4, Summer, pp. 179-186. Attached Files Name Description MIMEType Size Downloads ostaszkiewicz-ethicalchallenges-2014.pdf Published version application/pdf 1.03MB 165 Title Ethical challenges associated with providing continence care in residential aged care facilities : findings from a grounded theory study Author(s) Ostaszkiewicz,J orcid.org/0000-0003-4159-4493 O'Connell,B Dunning, T. orcid.org/0000-0002-0284-1706 Journal name Australian and New Zealand continence journal Volume number 20 Issue number 4 Season Summer Start page 179 End page 186 Total pages 9 Publisher Cambridge Publishing Place of publication Osbourne Park, WA Publication date 2014-12-01 ISSN 1448-0131 Keyword(s) Ethics Urinary incontinence Fecal incontinence Nursing homes Personal autonomy Person-centred care Summary A person-centred approach to care in residential aged care facilities should uphold residents’ rights to independence, choice, decision-making, participation, and control over their lifestyle. Little is known about how nurses and personal care assistants working in these facilities uphold these ideals when assisting residents maintain continence and manage incontinence. The overall aim of the study was to develop a grounded theory to describe and explain how Australian residents of aged care facilities have their continence care needs determined, delivered and communicated. This paper presents and discusses a subset of the findings about the ethical challenges nurses and personal care assistants encountered whilst providing continence care. Grounded theory methodology was used for in-depth interviews with 18 nurses and personal care assistants who had experience of providing, supervising or assessing continence care in any Australian residential aged care facility, and to analyse 88 hours of field observations in two facilities. Data generation and analysis occurred simultaneously using open coding, theoretical coding, and selective coding, until data were saturated. While addressing the day-to-day needs of residents who needed help to maintain continence and/or manage incontinence, nurses and personal care assistants struggled to enable residents to exercise choice and autonomy. The main factor that contributed to this problem was that the fact that nurses and personal care assistants had to respond to multiple, competing, and conflicting expectations about residents’ care needs. This situation was compounded by workforce constraints, inadequate information about residents’ care needs, and an unpredictable work environment. Providing continence care accentuated the ethical tensions associated with caregiving. Nurses’ and personal care assistants’ responses were mainly characterised by highly protective behaviours towards residents. Underlying structural factors that hinder high quality continence care to residents of aged care facilities should be urgently addressed. Language eng Field of Research 111001 Aged Care Nursing Socio Economic Objective 920502 Health Related to Ageing HERDC Research category C1 Refereed article in a scholarly journal ERA Research output type C Journal article Copyright notice ©2014, Australian and New Zealand Continence Journal Free to Read? Yes Persistent URL http://hdl.handle.net/10536/DRO/DU:30069104 Document type: Journal Article Collections: School of Nursing and Midwifery Centre for Quality and Patient Safety Research Open Access Collection Related Links Link Description   Unless expressly stated otherwise, the copyright for items in DRO is owned by the author, with all rights reserved. Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au. Versions Version Filter Type Mon, 19 Jan 2015, 09:10:37 EST Mon, 19 Jan 2015, 09:11:17 EST Tue, 20 Jan 2015, 04:00:26 EST Tue, 20 Jan 2015, 05:06:05 EST Tue, 03 Feb 2015, 07:45:33 EST Tue, 03 Feb 2015, 07:47:06 EST Tue, 03 Feb 2015, 07:49:59 EST Mon, 09 Feb 2015, 09:08:46 EST Mon, 09 Feb 2015, 09:09:47 EST Wed, 18 Mar 2015, 10:48:28 EST Tue, 14 Apr 2015, 14:43:30 EST Wed, 07 Sep 2016, 08:14:38 EST Wed, 06 Dec 2017, 06:12:12 EST Tue, 20 Feb 2018, 11:02:44 EST Fri, 07 Sep 2018, 18:13:41 EST Filtered Full Citation counts:   Cited 0 times in TR Web of Science Cited 0 times in Scopus Search Google Scholar Access Statistics: 754 Abstract Views, 166 File Downloads  -  Detailed Statistics Created: Mon, 19 Jan 2015, 09:11:17 EST

Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.