{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T19:31:34Z","timestamp":1765827094397},"reference-count":55,"publisher":"BMJ","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2013,6,16]]},"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine in depth the views and experiences of continence service leads in England on key service and continence management characteristics in order to identify and to improve our understanding of barriers to a good-quality service and potential facilitators to develop and to improve services for older people with urinary incontinence (UI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Qualitative semistructured interviews using a purposive sample recruited across 16 continence services.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>3 acute and 13 primary care National Health Service Trusts in England.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>16 continence service leads in England actively treating and managing older people with UI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In terms of barriers to a good-quality service, participants highlighted a failure on the part of commissioners, managers and other health professionals in recognising the problem of UI and in acknowledging the importance of continence for older people and prevalent negative attitudes towards continence and older people. Patient assessment and continence promotion regardless of age, rather than pad provision, were identified as important steps for a good-quality service for older people with UI. More rapid and appropriate patient referral pathways, investment in service capacity, for example, more trained staff and strengthened interservice collaborations and a higher profile within medical and nurse training were specified as being important facilitators for delivering an equitable and high-quality continence service. There is a need, however, to consider the accounts given by our participants as perhaps serving the interests of their professional group within the context of interprofessional work.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our data point to important barriers and facilitators of a good-quality service for older people with UI, from the perspective of continence service leads. Further research should address the views of other stakeholders, and explore options for the empirical evaluation of the effectiveness of identified service facilitators.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2013-002926","type":"journal-article","created":{"date-parts":[[2013,7,31]],"date-time":"2013-07-31T00:54:52Z","timestamp":1375232092000},"page":"e002926","source":"Crossref","is-referenced-by-count":21,"title":["Improving continence services for older people from the service-providers\u2019 perspective: a qualitative interview study"],"prefix":"10.1136","volume":"3","author":[{"given":"Alison","family":"Orrell","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"McKee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lena","family":"Dahlberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Gilhooly","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stuart","family":"Parker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2013,7,30]]},"reference":[{"key":"2024051504440378000_3.7.e002926.1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.10052"},{"key":"2024051504440378000_3.7.e002926.2","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/22.3.427"},{"key":"2024051504440378000_3.7.e002926.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2003.04721.x"},{"key":"2024051504440378000_3.7.e002926.4","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1002\/nau.20842","article-title":"Incontinence in the frail elderly: report from the 4th International Consultation on Incontinence","volume":"29","author":"DuBeau","year":"2010","journal-title":"Neurourol Urodyn"},{"key":"2024051504440378000_3.7.e002926.5","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1002\/nau.22333","article-title":"The prevalence of incontinence in people with cognitive impairment or dementia living at home: a systematic review","volume":"32","author":"Drennan","year":"2013","journal-title":"Neurourol Urodyn"},{"key":"2024051504440378000_3.7.e002926.6","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.urology.2003.12.001","article-title":"Clinical and socioeconomic relevance of overactive bladder","volume":"63","author":"Debruyne","year":"2004","journal-title":"Urol"},{"key":"2024051504440378000_3.7.e002926.7","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1007\/s001920070021","article-title":"Epidemiology and natural history of urinary incontinence","volume":"11","author":"Hunskaar","year":"2000","journal-title":"Int Urogynecol J Pelvic Floor Dysfuncy"},{"key":"2024051504440378000_3.7.e002926.8","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1111\/j.1464-410X.2003.04609.x","article-title":"The prevalence of urinary incontinence in women in four European countries","volume":"93","author":"Hunskaar","year":"2004","journal-title":"BJU"},{"key":"2024051504440378000_3.7.e002926.9","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1016\/j.urology.2009.07.1325","article-title":"Impact on quality of life of urinary incontinence and overactive bladder: a systematic literature review","volume":"745","author":"Bartoli","year":"2010","journal-title":"Urol"},{"key":"2024051504440378000_3.7.e002926.10","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/26.5.367"},{"key":"2024051504440378000_3.7.e002926.11","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-410X.2003.04463.x"},{"key":"2024051504440378000_3.7.e002926.12","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1136\/bmj.b4914","article-title":"Retrospective analysis of attitudes to ageing in the Economist: apocalyptic demography for opinion formers?","volume":"339","author":"Martin","year":"2009","journal-title":"BMJ"},{"key":"2024051504440378000_3.7.e002926.13","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.urology.2009.11.078","article-title":"Prevalence of urinary incontinence in men, women and children\u2014current evidence: findings of the fourth international consultation on incontinence","volume":"76","author":"Buckley","year":"2010","journal-title":"Urol"},{"key":"2024051504440378000_3.7.e002926.14","unstructured":"Wagg A . 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