The experience of urinary incontinence in stroke survivors: A follow-up qualitative study

Background.

No previous qualitative exploration of urinary incontinence (UI) or post-stroke urinary incontinence (PSUI) has been undertaken in an Australian population.

Purpose.

The purpose of this study is to explore the experiences of community-dwelling stroke survivors who were living with UI/PSUI and understand how context shaped those experiences.

Methods.

A pragmatic approach using thematic analysis was employed for this study.

Findings.

Four themes emerged from the data: “I’ve got to go”: onset and daily experience of UI; “No one ever mentioned it”: lack of advice and information from the health system; “You can’t enjoy something if you’ve got to go the toilet”: experience of occupational restrictions; and “It’s just a matter of planning”: management strategies.

Implications.

UI continued well beyond discharge and was shaped by limited advice, distress, and role loss. Occupational therapists are encouraged to engage in assessment, management, and treatment of UI, including the provision of education that promotes continence, attenuates negative experiences, and enhances community participation.

Urinary incontinence after stroke: identification, assessment, and intervention by rehabilitation professionals in Canada

BACKGROUND AND PURPOSE

Urinary incontinence (UI) is a common and distressing problem after stroke. Although there is evidence of new, effective UI poststroke rehabilitation intervention, it is unknown whether occupational therapists (OTs)' and physical therapists (PTs)' actual practices reflect best practices. We sought to determine the extent to which OTs and PTs identify, assess, and treat UI after stroke and to identify personal and organizational predictors of UI problem identification, best-practice assessment, and intervention.

METHODS

Six hundred sixty-three OTs (93% participation rate) and 656 PTs (87% participation rate) working in stroke rehabilitation in Canada were randomly selected and interviewed with a telephone-administered questionnaire. Each responded to a series of open-ended questions related to a generated case (vignette) of a typical client with stroke who was experiencing UI.

RESULTS

Only 39% of OTs and 41% of PTs identified UI after stroke as a problem. Fewer than 20% of OTs and 15% of PTs used best-practice assessments, and only 2% of OTs and 3% of PTs used best-practice interventions. Working in Ontario, having allocated learning time, and doing university teaching were among the variables explaining between 6% and 9% of the variability in UI identification and assessment.

CONCLUSIONS

Canadian OTs and PTs do not routinely identify poststroke UI as a problem, and best-practice assessments and interventions are underused.