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Reducing and managing faecal incontinence in people with advanced dementia who are resident in care homes: protocol for a realist synthesis.

Goodman, C; Rycroft Malone, J; Norton, C; Harari, D; Harwood, R; Roe, B; Russell, B; Fader, M; Buswell, M; Drennan, VM; et al. Goodman, C; Rycroft Malone, J; Norton, C; Harari, D; Harwood, R; Roe, B; Russell, B; Fader, M; Buswell, M; Drennan, VM; Bunn, F (2015) Reducing and managing faecal incontinence in people with advanced dementia who are resident in care homes: protocol for a realist synthesis. BMJ Open, 5 (7). e007728. ISSN 2044-6055 https://doi.org/10.1136/bmjopen-2015-007728
SGUL Authors: Drennan, Vari MacDougal

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Abstract

INTRODUCTION: Faecal incontinence (FI) is the involuntary loss of liquid or solid stool that is a social or hygienic problem. The prevalence of FI in residents of care homes is high, but it is not an inevitable consequence of old age or dementia. There is good evidence on risk factors, but few studies provide evidence about effective interventions. There is a need to understand how, why, and in what circumstances particular programmes to reduce and manage FI are effective (or not) for people with dementia. The purpose of this review is to identify which (elements of the) interventions could potentially be effective, and examine the barriers and facilitators to the acceptability, uptake and implementation of interventions designed to address FI in people with dementia who are resident in care homes. METHODS AND ANALYSIS: A realist synthesis approach to review the evidence will be used which will include studies on continence, person-centred care, implementation research in care homes, workforce and research on care home culture. An iterative four-stage approach is planned. Phase 1: development of an initial programme theory or theories that will be 'tested' through a first scoping of the literature and consultation with five stakeholder groups (care home providers, user representatives, academics and practice educators, clinicians with a special interest in FI and continence specialists). Phase 2: a systematic search and analysis of published and unpublished evidence to test and develop the programme theories identified in phase 1. Phase 3: validation of programme theory/ies with a purposive sample of participants from phase 1. ETHICS AND DISSEMINATION: The overall protocol does not require ethical review. The University research ethics committee will review interviews conducted as part of phase 1 and 3. The final fourth phase will synthesise and develop recommendations for practice and develop testable hypotheses for further research.

Item Type: Article
Additional Information: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
Keywords: GERIATRIC MEDICINE, Aged, 80 and over, Clinical Protocols, Dementia, Evidence-Based Medicine, Fecal Incontinence, Female, Homes for the Aged, Humans, Institutionalization, Male, Nursing Homes, Humans, Fecal Incontinence, Dementia, Clinical Protocols, Institutionalization, Evidence-Based Medicine, Aged, 80 and over, Homes for the Aged, Nursing Homes, Female, Male
Journal or Publication Title: BMJ Open
ISSN: 2044-6055
Language: eng
Dates:
DateEvent
10 July 2015Published Online
1 July 2015Published
23 April 2015Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
HTA/13/75/01Department of HealthUNSPECIFIED
PubMed ID: 26163032
Web of Science ID: WOS:000363482000040
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/109438
Publisher's version: https://doi.org/10.1136/bmjopen-2015-007728

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