Incontinence management
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Modules - Incontinence Management
Strategies to Measure Nursing Home Residents' Satisfaction and Preferences Related to Incontinence and Mobility Care: Implications for Evaluating Intervention Effects.
Sandra F. Simmons and John F. Schnelle, 1999, in The Gerontologist, 39(3):1-11.
This study compared four different interview strategies to measure 111 incontinent nursing home residents' "met need" related to incontinence and mobility care. In one method-perhaps the most commonly used strategy in nursing homes-residents were asked direct satisfaction questions (e.g., "Overall, are you satisfied with how often someone helps you to walk?"). A second method asked residents about their preferences for care (e.g., "Would you like for someone to help you walk more often?" "How many times during the day would you like someone to help you to walk?") The last two methods compared resident reports about how often they preferred to receive care to how often they actually did receive care based first on research staff observations (Method 3) and then on their own reports (Method 4). Incontinent residents who passed a simple cognitive screen (residents were asked to state their name or identify two common items) were interviewed.
Results showed that only 25% of the residents provided illogical responses, a finding that dispels the widespread assumption that only a small subset of cognitively intact residents can provide meaningful information about the care they receive. Of the four methods tested, the third method proved superior with respect to response stability. Method 1 yielded the most unstable responses. The third method also revealed comparatively higher levels of "unmet need," but by doing so, is considered more useful for guiding improvement efforts. The authors acknowledge that Method 3 is the most time-consuming to implement because it requires objective, direct observations of the care actually provided to residents. They argue, however, that this type of monitoring should be conducted at least annually in any case.
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