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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.

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Title Ethical challenges associated with providing continence care in residential aged care facilities : findings from a grounded theory study
Author(s) Ostaszkiewicz,JORCID iD for Ostaszkiewicz,J orcid.org/0000-0003-4159-4493
O'Connell,B
Dunning, T.ORCID iD for 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

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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.