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

TY - JOUR

T1 - 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

AU - Woodward, Susan

AU - Graham, Tanya

AU - Sooriah, Sangeeta

AU - Chatterton, Christopher

AU - Fader, Mandy

AU - Fitzpatrick, Joanne M

AU - Gadd, Hilary

AU - Harris, Ruth

AU - Kausir, Farzana

AU - Norton, Christine

AU - Worsley, Peter

N1 - Publisher Copyright: © 2025 The Authors

PY - 2025/5/1

Y1 - 2025/5/1

N2 - AimsThis 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 methodsUsing 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.ResultsFour 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.ConclusionCare 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.

AB - AimsThis 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 methodsUsing 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.ResultsFour 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.ConclusionCare 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.

KW - Incontinence associated dermatitis (IAD), Social care, Incontinence, Qualitative, Care homes, Home care

UR - http://www.scopus.com/inward/record.url?scp=105005201175&partnerID=8YFLogxK

U2 - 10.1016/j.jtv.2025.100925

DO - 10.1016/j.jtv.2025.100925

M3 - Article

SN - 0965-206X

VL - 34

JO - Journal of Tissue Viability

JF - Journal of Tissue Viability

IS - 3

M1 - 100925

ER -