Art of connectedness: Value‐creating care for older persons provided with toileting assistance and containment strategies—A critical interpretive synthesis

Abstract

Aims and objectives The aim was to conduct a synthesis of the literature on value‐creating care for older persons with incontinence provided with toileting assistance and containment strategies, from the perspectives of older persons and healthcare professionals. Background Incontinence is a health problem for many persons worldwide and the problem will increase as the global population ages. It can have a profound impact on a person's wellbeing, and assistance with toileting and containment strategies is common in home care settings and nursing homes. Design The design was a literature review with an iterative, reflexive and critical approach. Methods A critical interpretive synthesis was conducted. Ten papers published between 2011 and 2019 were analysed. The PRISMA ‐ScR Checklist was used in this review. Results Based on the findings, the conceptual construct ‘The art of connectedness’ was developed, built on co‐created care, personalised care and reflective care between the older person and healthcare professionals. Co‐created care is based on establishing a relationship, building trust and respecting preferences. Personalised care consists of meeting the person's needs, promoting comfort and maintaining self‐determination. Reflective care entails showing empathy, upholding the person's dignity and developing professional competence. Conclusions Value‐creating care consists conceptually of a connectedness that starts with co‐creating the care together with the older person in a close relationship. Assistance is given and received based on the older person's individual needs and is highly valued by the older person as it helps them maintain self‐determination. Reflective care is of importance for healthcare professionals. Relevance for practice The findings are hoped to enhance healthcare professionals’ understanding of how to improve the clinical encounter in nursing when providing assistance. They may also stimulate critical reflection among healthcare professionals on how to improve assistance to meet the older person's values.

Effectiveness of non-pharmacological interventions delivered at home for urinary and faecal incontinence with homebound older people: systematic review of randomised controlled trials

“…This review’s focus on randomised trials of interventions delivered at home adds to learning from previous reviews of interventions for incontinence among older people, which included non-randomised studies or programmes in institutional settings [ 17 , 30 , 31 , 54 , 56 , 58 , 59 ]. Its strengths include its inclusion of multiple databases using comprehensive search strategies and extensive lateral searches.…”