Authors (including presenting author) :
Poon A (1), Law YS (1), Leung WY (1), Hui N (1), Wong KK (1)
Affiliation :
(1) Occupational Therapy Department, United Christian Hospital
Introduction :
Urinary Incontinence (UI) is highly prevalent in older adults, which impacts all areas of occupation, including activities of daily living, instrumental activities of daily living, rest and sleep, leisure tasks, and social participation (AOTA, 2014). Effective treatment for UI depends on the expertise, knowledge and multidisciplinary approach to continence care. Although emerging evidence in literature supports the role of Occupational Therapist in UI management, current service provision and its efficacy are not well established in local hospital settings.
Objectives :
To increase the knowledge and confidence of occupational therapy practitioners working with older adults who have urinary incontinence. To develop occupational therapy UI program and clinical pathway for older adults who have urinary incontinence.
Methodology :
The development of comprehensive approach to urinary incontinence in occupational therapy for older adults consists of three parts 1) UI program content development Established occupational therapy clinical pathway in UI management and standardized related assessment, documentation and intervention in May 2021 2)Staff training and engagement The knowledge translation model of education (3 sessions) was used to educate occupational therapist to improve integration of UI information and the reflective questioning framework for coaching (4 sessions) was used to increase knowledge and confidence of occupational therapist from June to July 2021 3)Clinical application Implemented the clinical pathway and occupational therapy program of urinary incontinence for older adults in Yung Fung Shee Geriatric Day Hospital (GDH)and a pilot trial from July to December 2021
Result & Outcome :
16 Occupational Therapist of medical & geriatric team were trained of UI knowledge. Overall the occupational therapists reported an increase in knowledge and confidence and reported competent and mastery level skills after the educational program and coaching session. Increased in knowledge and confidence include use of standardized / non-standardized screening / assessment instruments (207%), understanding roles and contributions (181%) and determining intervention strategies & approaches (164%). 62 patients in GDH (mean age 77.1, female 46.7%, male 53.3%) with 48.3% urge UI,37% functional UI,8 % stress UI were gone through occupational therapy pathway and intervention in UI. Intervention include provision of functional and physical training (100%), lifestyle redesign and empowerment program (53.2%) provision of advice on environmental modification (51.9%), carer education and training (50%), prescription of aids and appliances (33.8%) and provision of clothing design & modification (20.9%). 32.6% score enhancement in pre and post evaluation of International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ - UI SF). Conclusion: A UI educational program and coaching sessions can improve knowledge and confidence for occupational therapist working with older adults. Occupational Therapist would enhance older adults who have urinary incontinence’s quality of life and patient care by Occupational Therapy UI program and clinical pathway.
