Improving continence services for older people from the service-providers’ perspective : a qualitative interview study

Objective: To examine in depth the views and experiences of continence service leads in England on key service and continence management characteristics in order to identify and to improve our understanding of barriers to a good-quality service and potential facilitators to develop and to improve services for older people with urinary incontinence (UI). Design: Qualitative semistructured interviews using a purposive sample recruited across 16 continence services. Setting: 3 acute and 13 primary care National Health Service Trusts in England. Participants: 16 continence service leads in England actively treating and managing older people with UI. Results: In terms of barriers to a good-quality service, participants highlighted a failure on the part of commissioners, managers and other health professionals in recognising the problem of UI and in acknowledging the importance of continence for older people and prevalent negative attitudes towards continence and older people. Patient assessment and continence promotion regardless of age, rather than pad provision, were identified as important steps for a good-quality service for older people with UI. More rapid and appropriate patient referral pathways, investment in service capacity, for example, more trained staff and strengthened interservice collaborations and a higher profile within medical and nurse training were specified as being important facilitators for delivering an equitable and highquality continence service. There is a need, however, to consider the accounts given by our participants as perhaps serving the interests of their professional group within the context of interprofessional work. Conclusions: Our data point to important barriers and facilitators of a good-quality service for older people with UI, from the perspective of continence service leads. Further research should address the views of other stakeholders, and explore options for the empirical evaluation of the effectiveness of identified service facilitators.

Att leva och sälja sin dröm : Livsstilsföretagaren mellan familjeliv, marknadoch politisk retorik

Living and selling a dream: Lifestyle entrepreneurship in the intersection between family, market and political rhetoric The article focuses on lifestyle entrepreneurship, characterised by a balancing work between personal lifestyle motives and economic motives. It builds on a qualitative study of business owners who have realized a life dream of starting a countryside business in the tourism and hospitality industry in Sweden. Through the notion of ”balancing work”, the analysis focuses on the tension between a personal life sphere and a market. In particular, the analysis highlights how the notion of ”the life dream” emerges as a narrative practice of self-realization, simultaneously as it is offered as an experience product. The analysis demonstrates how the entrepreneurs balance between personal stories of togetherness and marketing practices, between images of right and wrong commodification, and between constraining working conditions and a popular image of the successful entrepreneur, reinforced by a political discourse on rural entrepreneurship. It is concluded that balancing work between personal identities and economic practices is a practice of valuation, offering new insights into working conditions and markets situated in the intersection between markets and personal life spheres.