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'We just do the dirty work': dealing with incontinence, courtesy stigma and the low occupational status of carework in long-term aged care facilities.

Ostaszkiewicz, Joan, O'Connell, Beverly and Dunning, Trisha 2016, 'We just do the dirty work': dealing with incontinence, courtesy stigma and the low occupational status of carework in long-term aged care facilities., Journal of clinical nursing, vol. 25, no. 17-18, pp. 2528-2541, doi: 10.1111/jocn.13292.

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Title 'We just do the dirty work': dealing with incontinence, courtesy stigma and the low occupational status of carework in long-term aged care facilities.
Author(s) Ostaszkiewicz, Joan
O'Connell, Beverly
Dunning, Trisha
Journal name Journal of clinical nursing
Volume number 25
Issue number 17-18
Start page 2528
End page 2541
Total pages 14
Publisher Wiley
Place of publication London, Eng.
Publication date 2016-09
ISSN 1365-2702
Keyword(s) carework
dignity
incontinence
long-term aged care
role status
stigma
Summary AIMS AND OBJECTIVES: To systematically examine, describe and explain how continence care was determined, delivered and communicated in Australian long aged care facilities. BACKGROUND: Incontinence is a highly stigmatising condition that affects a disproportionally large number of people living in long-term aged care facilities. Its day-to-day management is mainly undertaken by careworkers. We conducted a Grounded theory study to explore how continence care was determined, delivered and communicated in long-term aged care facilities. This paper presents one finding, i.e. how careworkers in long-term aged care facilities deal with the stigma, devaluation and the aesthetically unpleasant aspects of their work. DESIGN: Grounded theory. METHODS: Eighty-eight hours of field observations in two long-term aged care facilities in Australia. In addition, in-depth interviews with 18 nurses and careworkers who had experience of providing, supervising or assessment of continence care in any long-term aged care facility in Australia. RESULTS: Occupational exposure to incontinence contributes to the low occupational status of carework in long-term aged care facilities, and continence care is a symbolic marker for inequalities within the facility, the nursing profession and society at large. Careworkers' affective and behavioural responses are characterised by: (1) accommodating the context; (2) dissociating oneself; (3) distancing oneself and (4) attempting to elevate one's role status. CONCLUSION: The theory extends current understandings about the links between incontinence, continence care, courtesy stigma, emotional labour and the low occupational status of carework in long-term aged care facilities. RELEVANCE TO CLINICAL PRACTICE: This study provides insights into the ways in which tacit beliefs and values about incontinence, cleanliness and contamination may affect the social organisation and delivery of care in long-term aged care facilities. Nurse leaders should challenge the stigma and devaluation of carework and careworkers, and reframe carework as 'dignity work'.
Language eng
DOI 10.1111/jocn.13292
Field of Research 111004 Clinical Nursing: Tertiary (Rehabilitative)
1110 Nursing
1701 Psychology
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Wiley
Free to Read? No
Persistent URL http://hdl.handle.net/10536/DRO/DU:30084164

Document type: Journal Article
Collection: School of Nursing and Midwifery
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