Perceptions and barriers that influence the ability to provide appropiate incontinence care in nursing home residents : Statements from nursing staff

among nursing home residents. Urinary incontinence in older people has a multifactorial etiology and is therefore more difficult to assess and treat than uri- nary incontinence in younger people. Previous re- search has shown that incontinence care in nursing home residents often is inadequate and little systema- tized. The aim of this study was to identify percep- tions and barriers that influence the ability of the nursing staff to provide appropriate incontinence care. This was a qualitative study using focus-group meth- odology. Data were collected from three focus-group interviews with 15 members of the nursing staff from six different units in a nursing home. The focus-group interviews were recorded on tape, transcribed verba- tim and analyzed according to qualitative content analysis. Three topics and eight categories were iden- tified. The first topic, Perceptions and barriers associ- ated with residents, consisted of one category: "phy- sical and cognitive problems". The second topic, Per- ceptions and barriers associated with nursing staff, consisted of three categories: "lack of knowledge", "attitudes and beliefs" and "lack of accessibility". The third topic, Perceptions and barriers associated with organizational culture, consisted of four cate- gories: "rigid routines", "lack of resource", "lack of documentation" and "lack of leadership". The find- ings from this study show that there are many barri- ers that might influence the possibilities of nursing staff to provide appropriate incontinence care to re- sidents in nursing homes. However, it can neverthe- less seem like opinions and the attitude of nursing staff, together with a lack of knowledge about UI, are the most important barriers to provide appropriate incontinence care.