Targeting community-dwelling urinary incontinence sufferers: A multi-disciplinary community-based model for conservative continence services

Winsome St John
Associate Professor, Research Centre for Clinical and Community Practice Innovations, School of Nursing and Midwifery, Griffith University, Gold Coast QLD

Marianne Wallis
Clinical Nursing Research, Gold Coast Health Service District; Griffith University, Southport QLD

Heather James
School of Nursing and Midwifery, Flinders University, Adelaide, SA

Shona McKenzie
Continence Nurse Advisor, Gold Coast Health Services District, Gold Coast QLD

Sheridan Guyatt
Griffith University, Gold Coast QLD

PP: 211 - 222

Abstract

This paper presents an argument that there is a need to provide services that target community-dwelling incontinence sufferers, and presents a demonstration case study of a multi-disciplinary, community-based conservative model of service delivery: The Waterworx Model. Rationale for approaches taken, implementation of the model, evaluation and lessons learned are discussed. In this paper community-dwelling sufferers of urinary incontinence are identified as an underserved group, and useful information is provided for those wishing to establish services for them.

The Waterworx Model of continence service delivery incorporates three interrelated approaches. Firstly, client access is achieved by using community-based services via clinic and home visits, creating referral pathways and active promotion of services. Secondly, multi-disciplinary client care is provided by targeting a specific client group, multi-disciplinary assessment, promoting client self-management and developing client knowledge and health literacy. Finally, interdisciplinary collaboration and linkages is facilitated by developing multidisciplinary assessment tools, using interdisciplinary referrals, staff development, multi-disciplinary management and providing professional education.

Implementation of the model achieved greater client access, improvement in urinary incontinence and client satisfaction. Our experiences suggest that those suffering urinary incontinence and living in the community are an underserved group and that continence services should be community-focussed, multi-disciplinary, generalist in nature.

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Keywords

community; community care; continence; female urinary incontinence; incontinence inter agency; inter-professional care; multi-professional care; primary care


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References

Australian Bureau of Statistics (2003) Cat. No. 3218.0. ABS, Canberra.

Borrie MJ, Bawden M, Speechley M, & Kloseck M (2002) Interventions led by nurse continence advisers in the management of urinary incontinence: A randomised controlled trial. Canadian Medical Association Journal, 166 (10): 1267-1273.

Cheater, FM (1992) Nurses' educational preparation and knowledge concerning continence promotion. Journal of Advanced Nursing, 17: 328-338.

Chiarelli P (1998) The efficacy of pelvic floor exercises and electrotherapy in the conservative management of urinary incontinence. Australian Continence Journal, 4(1): 4-6.

Chiarelli P, Bower W, Wilson A, Sibbritt D, & Attia, J, (2002) The prevalence of urinary incontinence with the community: A systematic review. Department of Health and Ageing, National Continence Management Strategy. Retrieved 3-4-03, 2003, from the World Wide Web: http://www.continence.health.gov.au/ncms/ncmseuai.htm

Dugan E, Cohen SJ, Bland DR, Preisser J, Davis CC, Suggs PK, & McGann P (2000) The association of depressive symptoms and urinary incontinence among older adults. JAGS, 48(4): 413-416.

Fultz NH, & Hersog AR (2001) Self-reported social and emotional impact of urinary incontinence. Journal of American Geriatric Society, 49: 892- 899.

Goepel M, Hoffman J, Piro M, Rubben H, & Michel M (2002) Prevalence and physician awareness of symptoms of urinary bladder dysfunction. European Urology, 41: 234-239.

Gold Coast City Council. (2004) Population issues. City Facts, 1. Gold Coast City Council, Evandale.

Jeter K, & Wagner DB (1990) Incontinence in the American home: A survey of 36,500 people. Journal of the American Geriatrics Society, 38: 379-383.

Johnson TM, Kincade JE, Bernard SL, Busby- Whitehead J, Hertz-Picciotto I, & DeFriese GH (1998) The association of urinary incontinence with poor self-rated health. Journal of the American Geriatrics Society, 46: 693-399.

Laycock J (1998) 'Nursing and physiotherapists working in continence care': A consensus meeting at the King's Fund, London on 5th March 1998. Australian Continence Journal, 4(4): 116-118.

Liberman JN, Hunt TL, Stewart WF, Wein A, Zhou Z, Herzog AR, Lipton RB, & Diokno AC (2001) Health-related quality of life among adults with symptoms of overactive bladder: Results from a U.S. community- based survey. Urology, 57(6): 1044-1050.

McDowell BJ, Silverman M, Martin D, Musa D, & Keane C (1994) Identification and intervention for urinary incontinence by community physicians and geriatric assessment teams. Journal of the American Geriatric Society, 42(5): 501-505.

McGhee M, O'Neill K, Major K, & Twaddle S (1997) Evaluation of a nurse-led continence service in the southwest of Glasgow, Scotland. Journal of Advanced Nursing, 26: 723-728.

Meade-D'Alisera P, Merriweather T, Wentland M, Fatal M, & Ghafar M (2001) Depressive symptoms in women with urinary incontinence: A prospective study. Urologic Nursing, 21(6): 397-399.

Moore KN, & Dorey G (1999) Conservative treatment of urinary incontinence in men. Physiotherapy, 85(2): 77-87.

O'Brien BB, Gibb H, & Bradford J (1994) The Julia Farr Centre Model for ongoing nursing management of continence. The National Continence Newsletter, March, 5-8.

O'Brien J, Austin M, Parminder S, & O'Boyle P (1991) Urinary incontinence: Prevalence, need for treatment, and effectiveness of intervention by nurse. British Medical Journal, 303: 1308-1312.

Pomfret I (1996) Comprehensive care to order. Nursing Times, 92(15): 62-64.

Publicover C, & Bear M (1997) The effect of bladder training on urinary incontinence in community-dwelling older women. Journal of Wound Ostomy Continence Nursing, 24(6): 319-324.

Rhodes P, & Parker G (1995) The role of the continence adviser in England and Wales. International Journal of Nursing Studies, 32(5): 423-433.

Roberts RO, Jacobsen SJ, Rhodes T, Reilly TW, Girman CJ, Talley NJ, & Lieber MM (1998) Urinary incontinence in a community-based cohort: Prevalence and healthcare-seeking. Journal of the American Geriatrics Society, 46(4): 467-472.

Roe B, & Doll H (2000) Prevalence of urinary incontinence and its relationship with health status. Journal of Clinical Nursing, 9:, 178-188.

Roe B, Doll H, & Wilson K (1999) Help seeking behaviour and health and social services utilisation by people suffering from urinary incontinence. International Journal of Nursing Studies, 36: 245-253.

Roe B, Wilson K, & Doll H (2000) Health interventions and satisfaction with services: A comparative study of urinary incontinence sufferers living in two health authorities in England. Journal of Clinical Nursing, 9: 792-800.

Rogers J (1997) Cognitive bladder training in the community. Nursing Standard, 16(11): 44-46.

Simons A, Moore K, Louey M, Cragg S, Prashar S, & Foote A J (1998) Nurse continence advisor versus uro-gynaecologist in conservative continence therapy: cost effectiveness, patient motivation and attendance rates. Paper presented at the Pennies well spent? 7th national conference on incontinence.

St John W, James H, & McKenzie S (2001) Health service provision for community-dwelling people suffering urinary incontinence: a case study of neglect. Australian Journal of Primary Health, 7(3): 31-37.

St John W, & McKenzie S (2002) Reflecting on best practice in specialist continence service provision: An Australian survey. Australian Continence Journal, 8(1): 2-11.

St John W, McKenzie S, & James H (1999) Urinary continence services for community-dwelling people in the South East Coast region of Queensland. Faculty of Nursing and Health, Griffith University, Southport.

St John W, McKenzie S, & James H. (2002) 'Oh that's a bit of a nuisance': community-dwelling sufferers' perspectives of continence health service provision. Journal of Wound Ostomy Incontinence Nursing, 29(6): 312-219.

St John W, Wallis M, & James H (2002) Making links: Evaluation of an integrated multi-disciplinary community-focussed model of service delivery for intersectoral transition and community support for people suffering urinary incontinence in the Gold Coast region (Final report to the Department of Health and Ageing). Faculty of Nursing and Health, Griffith University, Southport. Available from the World Wide Web: http://www.continence.health.gov.au/ncms/ncmseuai.htm

Swithinbank LV, & Abrams P (1999) The impact of urinary incontinence on the quality of life of women. World Journal of Urology, 17(4): 225-229.

Walling AD (1998) Exercises reduce incontinence during and after pregnancy. American Family Physician, 58(1): 214.

World Health Organisation & United Nations Children's Fund. (1978) Primary health care: Report of the International Conference on Primary Health Care. World Health Organisation, Geneva.

Wyman JF (1998) Quality of life of older adults with urinary incontinence. Journal of the American Geriatrics Society, 46(6): 778-780.



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