'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. Attached Files Name Description MIMEType Size Downloads 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 orcid.org/0000-0003-4159-4493 O'Connell, Beverly Dunning, Trisha orcid.org/0000-0002-0284-1706 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 Persistent URL http://hdl.handle.net/10536/DRO/DU:30084164 Document type: Journal Article Collections: Faculty of Health School of Nursing and Midwifery Centre for Quality and Patient Safety Research Related Links Link Description Connect to published version Go to link with your DU access privileges     Unless expressly stated otherwise, the copyright for items in DRO is owned by the author, with all rights reserved. Versions Version Filter Type Sat, 11 Jun 2016, 18:47:36 EST Sat, 11 Jun 2016, 18:48:07 EST Sun, 12 Jun 2016, 05:00:07 EST Thu, 16 Jun 2016, 11:37:52 EST Fri, 08 Jul 2016, 06:11:14 EST Mon, 15 Aug 2016, 14:54:13 EST Fri, 19 Aug 2016, 15:39:48 EST Wed, 07 Sep 2016, 11:29:23 EST Wed, 09 Nov 2016, 11:49:04 EST Tue, 29 Nov 2016, 14:50:59 EST Tue, 29 Nov 2016, 14:52:53 EST Wed, 11 Jan 2017, 09:54:37 EST Wed, 01 Mar 2017, 08:06:15 EST Fri, 21 Apr 2017, 13:44:44 EST Sat, 17 Jun 2017, 02:44:58 EST Filtered Full Citation counts:   Cited 14 times in TR Web of Science Cited 0 times in Scopus Search Google Scholar Access Statistics: 433 Abstract Views, 3 File Downloads  -  Detailed Statistics Created: Sat, 11 Jun 2016, 18:48:07 EST

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