Urinary Incontinence in the Nursing Home Resident: Exploring CNA Caregivers' Attitudes and Beliefs Regarding UI

Sunday, 30 July 2017: 2:30 PM

Roxellen Anntoinette Auletto, DNP
144 Fighter Wing Medical Group, United States Air Force California Air National Guard, Fresno, CA, USA

Purpose: The primary objective of this qualitative study was to elicit the attitudes and beliefs of CNA’s towards UI in a long term care facility. A greater understanding of how CNA’s view UI in this patient population can then position both nursing and CNA’s to effectively identify, prevent, and coordinate plan of care for the reversal of UI.

Methods: Focus group methodology was utilized to answer the research question, “what are the attitudes and beliefs about urinary incontinence among a sample of CNA’s working in a long- term care facility?” Data collection was in the form of semi-structured focus group interviews. Interviews were audio taped and transcribed verbatim. The group facilitator served as note taker capturing observations of the group during the interviews, noting body language, facial expressions and group interactions. The researcher served as the moderator, focusing on group dialogue, dynamics, and participation utilizing the semi-structured interview questions as prompts to facilitate and maintain CNAs engagement in the focus group.

Results: Five themes emerged from the data. 1) "We're stretched too thin"; 2) “No one asks our opinions, but we are the ones who know what’s going on"; 3) "Incontinence: It's just what happens when you get old"; 4) "Some of them do this out of spite,” and 5) "Preventing incontinence: It’s everyone's job.” Although research exists examining differences in attitude and understanding regarding UI among registered nurses, licensed practical nurses, and certified nursing assistants working in skilled nursing homes before and after study interventions, studies focusing solely on CNAs could not be found.

Conclusion: Although the five themes identified during the study may not seem novel or surprising, they represent the feelings of a growing body of healthcare providers whose voices can no longer be ignored. CNAs role in long term care will continue to require more responsibility, education, and leadership. It is unrealistic to think that their involvement can be limited to caregiving alone. If we are to address the issues of understaffing, feelings of unimportance in their role as CNAs, and lack of understanding as to why the elderly become incontinent, active engagement of the primary caregivers is essential.