Exploration of current practice and context for the prevention and treatment of incontinence associated dermatitis for adults living in care homes and community settings: a qualitative study
Exploration of current practice and context for the prevention and treatment of incontinence associated dermatitis for adults living in care homes and community settings: a qualitative study
AIMS: This study aimed to explore current practice and context for the prevention and treatment of incontinence associated dermatitis (IAD), identify challenges and solutions, current prevention and treatment strategies, and products used.
MATERIALS AND METHODS: Using a qualitative cross-sectional approach online focus groups were conducted with stakeholders including experts by experience of IAD (n = 5) and health/care professionals (n = 16). Verbatim transcripts were coded independently by two researchers and analysed using framework analysis.
RESULTS: Four themes and two sub-themes were identified: (1) Impact of IAD: "significant" damage could occur in a short space of time; (2) Uncertainty, is it IAD? Correct diagnosis of IAD was challenging, especially in people with black skin. Uncertainty was underpinned by a lack of education and clear guidance on skin inspection. (3) Lack of resources (sub-themes human resources and product resources): Lack of human resources related to the number of staff available, deficiency of knowledgeable and skilled staff, and limited leadership. Lack of availability of pads was a challenge and carers reduced the number of pad changes to "conserve pads"; (4) Variation in practice, both for cleansing skin and applying a leave-on 'barrier' product.
CONCLUSION: Care for adults with incontinence to prevent and/or treat IAD is challenging in the social care sector. Wide variation in practice exists and there is a need for educational interventions in the sector, targeting an international and transient workforce.
Care homes, Home care, Incontinence, Incontinence associated dermatitis (IAD), Qualitative, Social care
Woodward, Sue
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Graham, Tanya
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Sooriah, Sangeeta
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Chatterton, Christopher
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Fader, Mandy
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Fitzpatrick, Joanne M.
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Gadd, Hilary
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Harris, Ruth
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Kausir, Farzana
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Norton, Christine
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Worsley, Peter R.
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August 2025
Woodward, Sue
fcf00367-04c2-4e26-adee-c86d30f96035
Graham, Tanya
8d1f961d-d8d9-48cb-83f3-ddeb8cf1746d
Sooriah, Sangeeta
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Chatterton, Christopher
af7d3ec9-bc58-4efe-a2ed-229b73913469
Fader, Mandy
c318f942-2ddb-462a-9183-8b678faf7277
Fitzpatrick, Joanne M.
b356ea3e-95de-49dc-96c0-45fbabd51d03
Gadd, Hilary
696b45f8-57da-4079-80f2-76dcf0a7a516
Harris, Ruth
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Kausir, Farzana
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Norton, Christine
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Worsley, Peter R.
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Woodward, Sue, Graham, Tanya, Sooriah, Sangeeta, Chatterton, Christopher, Fader, Mandy, Fitzpatrick, Joanne M., Gadd, Hilary, Harris, Ruth, Kausir, Farzana, Norton, Christine and Worsley, Peter R.
(2025)
Exploration of current practice and context for the prevention and treatment of incontinence associated dermatitis for adults living in care homes and community settings: a qualitative study.
Journal of Tissue Viability, 34 (3), [100925].
(doi:10.1016/j.jtv.2025.100925).
Abstract
AIMS: This study aimed to explore current practice and context for the prevention and treatment of incontinence associated dermatitis (IAD), identify challenges and solutions, current prevention and treatment strategies, and products used.
MATERIALS AND METHODS: Using a qualitative cross-sectional approach online focus groups were conducted with stakeholders including experts by experience of IAD (n = 5) and health/care professionals (n = 16). Verbatim transcripts were coded independently by two researchers and analysed using framework analysis.
RESULTS: Four themes and two sub-themes were identified: (1) Impact of IAD: "significant" damage could occur in a short space of time; (2) Uncertainty, is it IAD? Correct diagnosis of IAD was challenging, especially in people with black skin. Uncertainty was underpinned by a lack of education and clear guidance on skin inspection. (3) Lack of resources (sub-themes human resources and product resources): Lack of human resources related to the number of staff available, deficiency of knowledgeable and skilled staff, and limited leadership. Lack of availability of pads was a challenge and carers reduced the number of pad changes to "conserve pads"; (4) Variation in practice, both for cleansing skin and applying a leave-on 'barrier' product.
CONCLUSION: Care for adults with incontinence to prevent and/or treat IAD is challenging in the social care sector. Wide variation in practice exists and there is a need for educational interventions in the sector, targeting an international and transient workforce.
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Accepted/In Press date: 30 April 2025
e-pub ahead of print date: 30 April 2025
Published date: August 2025
Additional Information:
Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.
Keywords:
Care homes, Home care, Incontinence, Incontinence associated dermatitis (IAD), Qualitative, Social care
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Local EPrints ID: 501840
URI: http://eprints.soton.ac.uk/id/eprint/501840
ISSN: 0965-206X
PURE UUID: 5df7dcab-cdf7-41a0-9003-0520c2bcba5d
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Date deposited: 10 Jun 2025 18:29
Last modified: 01 Oct 2025 01:44
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Contributors
Author:
Sue Woodward
Author:
Tanya Graham
Author:
Sangeeta Sooriah
Author:
Christopher Chatterton
Author:
Joanne M. Fitzpatrick
Author:
Hilary Gadd
Author:
Ruth Harris
Author:
Farzana Kausir
Author:
Christine Norton
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