Urinary incontinence after stroke - Identification, assessment, and intervention by rehabilitation professionals in Canada

Background and Purpose - Urinary incontinence (UI) is a common and distressing problem after stroke. Although there is evidence of new, effective UI poststroke rehabilitation intervention, it is unknown whether occupational therapists (OTs)' and physical therapists (PTs)' actual practices reflect best practices. We sought to determine the extent to which OTs and PTs identify, assess, and treat UI after stroke and to identify personal and organizational predictors of UI problem identification, best- practice assessment, and intervention. Methods - Six hundred sixty- three OTs (93% participation rate) and 656 PTs (87% participation rate) working in stroke rehabilitation in Canada were randomly selected and interviewed with a telephone- administered questionnaire. Each responded to a series of open- ended questions related to a generated case (vignette) of a typical client with stroke who was experiencing UI. Results - Only 39% of OTs and 41% of PTs identified UI after stroke as a problem. Fewer than 20% of OTs and 15% of PTs used best- practice assessments, and only 2% of OTs and 3% of PTs used best- practice interventions. Working in Ontario, having allocated learning time, and doing university teaching were among the variables explaining between 6% and 9% of the variability in UI identification and assessment. Conclusions - Canadian OTs and PTs do not routinely identify poststroke UI as a problem, and best- practice assessments and interventions are underused.