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Brien H1, Bunting C1, Patman S1
1University of Notre Dame Australia, School of Physiotherapy, Perth, Australia
Background: Chronic respiratory conditions, and associated chronic coughing, are a widely recognised risk factor for urinary incontinence (UI), and various guidelines for management of patients with chronic respiratory conditions state that these patients should be screened for UI and referred to physiotherapy for management and prevention of UI.
Purpose: Within a major metropolitan city of 2.2 million people, anecdotal accounts have indicated that the referral rate of these patients to physiotherapists (PTs), who are able to provide conservative management for UI, is low, and there is little research surrounding the issue. This project aimed to examine the referral rate of chronic respiratory patients to continence PTs and to investigate the barriers to the process of screening for incontinence and referring on.
Methods: Two anonymous online de novo surveys were disseminated; one being sent to 76 continence PTs to explore the anecdotal reports of low referral rates, and the other being sent initially to 11 respiratory physicians, 12 respiratory PTs or physiotherapy head of departments, and 48 general practitioner practices to investigate the potential barriers to the screening and referral processes. Potential participants were identified using publically available information and professional networks of the researchers, as well as utilising the snowball effect. Basic descriptive statistics were obtained via SurveyMonkey, with answers to open questions subsequently collated into themes by the researchers.
Results: The survey to continence PTs received 30 completed responses and affirmed that the referral rate is lower than could be reasonably expected. This suggests that despite recommendations in the chronic respiratory conditions management guidelines, there is a lack of uptake of this knowledge amongst health professionals.
The survey sent to respiratory-based health professionals received 43 completed responses. Nearly one third of these participants [31% (n=12)] stated they 'never' or 'rarely' inquired about incontinence with these patients. Participants reported barriers to the referral that included time constraints [50% (n=16)], a lack of prioritisation of UI amongst other patient needs [53% (n=17)], as well as a lack of service availability and knowledge of referral processes. Participants also reported patient compliance often impeded referral.
Conclusion(s): Findings indicate a need for strategies to ensure clinicians have the time, resources and training to prioritise UI with their patients with chronic respiratory conditions, as well as to provide health professionals with the knowledge of optimal referral pathways and processes for UI prevention and/or management. The lack of patient compliance reported by survey participants suggests that patients with chronic respiratory conditions may not be prioritising UI amongst their other health concerns, which many indicate a variety of factors, including poor health literacy or community stigma surrounding incontinence, that influence this decision.
Implications: The study is one of the first to explore barriers to the referral of patients with chronic respiratory conditions and incontinence, specifically from the health provider perspective. The issue appears to be multifaceted, and as such, future research needs to be directed at exploring the issue further, as well as developing strategies to address the various barriers that have been identified.
Keywords: chronic respiratory, incontinence, referral
Funding acknowledgements: No funding was recieved.
Purpose: Within a major metropolitan city of 2.2 million people, anecdotal accounts have indicated that the referral rate of these patients to physiotherapists (PTs), who are able to provide conservative management for UI, is low, and there is little research surrounding the issue. This project aimed to examine the referral rate of chronic respiratory patients to continence PTs and to investigate the barriers to the process of screening for incontinence and referring on.
Methods: Two anonymous online de novo surveys were disseminated; one being sent to 76 continence PTs to explore the anecdotal reports of low referral rates, and the other being sent initially to 11 respiratory physicians, 12 respiratory PTs or physiotherapy head of departments, and 48 general practitioner practices to investigate the potential barriers to the screening and referral processes. Potential participants were identified using publically available information and professional networks of the researchers, as well as utilising the snowball effect. Basic descriptive statistics were obtained via SurveyMonkey, with answers to open questions subsequently collated into themes by the researchers.
Results: The survey to continence PTs received 30 completed responses and affirmed that the referral rate is lower than could be reasonably expected. This suggests that despite recommendations in the chronic respiratory conditions management guidelines, there is a lack of uptake of this knowledge amongst health professionals.
The survey sent to respiratory-based health professionals received 43 completed responses. Nearly one third of these participants [31% (n=12)] stated they 'never' or 'rarely' inquired about incontinence with these patients. Participants reported barriers to the referral that included time constraints [50% (n=16)], a lack of prioritisation of UI amongst other patient needs [53% (n=17)], as well as a lack of service availability and knowledge of referral processes. Participants also reported patient compliance often impeded referral.
Conclusion(s): Findings indicate a need for strategies to ensure clinicians have the time, resources and training to prioritise UI with their patients with chronic respiratory conditions, as well as to provide health professionals with the knowledge of optimal referral pathways and processes for UI prevention and/or management. The lack of patient compliance reported by survey participants suggests that patients with chronic respiratory conditions may not be prioritising UI amongst their other health concerns, which many indicate a variety of factors, including poor health literacy or community stigma surrounding incontinence, that influence this decision.
Implications: The study is one of the first to explore barriers to the referral of patients with chronic respiratory conditions and incontinence, specifically from the health provider perspective. The issue appears to be multifaceted, and as such, future research needs to be directed at exploring the issue further, as well as developing strategies to address the various barriers that have been identified.
Keywords: chronic respiratory, incontinence, referral
Funding acknowledgements: No funding was recieved.
Topic: Cardiorespiratory; Women's & men's pelvic health
Ethics approval required: Yes
Institution: The University of Notre Dame Australia
Ethics committee: Human Research Ethics Committee
Ethics number: 017190F
All authors, affiliations and abstracts have been published as submitted.
