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Table 3 Characteristics of included descriptive studies

From: Understanding how to facilitate continence for people with dementia in acute hospital settings: a mixed methods systematic review and thematic synthesis

Author/s, year, country
Demographic details for PLWD Data collection
Outcome measures
MMAT score
Cross sectional surveys
Study 7: Wilkinson et al. 1995 [67]
To evaluate the comparative suitability of a range of words or symbols to label a toilet for people with dementia
Phase 1: Hostel care for ambulant people with dementia (n = 24/28, rr 86%)
Phase 2: Aged care complex with hostel and nursing home facilities (n = 28) and an acute hospital ward (n = 20)
Phase 1: n = 24 institutions
Phase 2: n = 24 patients
No details provided
Age (years)
80.4 (95% CI 77.1–83.1)
Mental status
Folstein MSE
Normal cognition (n = 21)
Mild dementia (n = 11)
Moderate dementia (n = 16)
Severe dementia excluded
The study comprised two phases and questionnaires were used in both
Data collection
Phase 1: questions posed to hostel management on what word and/or symbols were already in use in that institution to label toilet and/or bathroom facilities
Phase 2: questions asking preference for toilet door labelling
Outcome measures
Preferred symbol according to cognitive state
Preferred word according to cognitive state
MMAT score: 100%
Study 12: Shih et al. 2015 [68]
To understand and compare the behavioural characteristics of bowel movement and urination needs in patients with dementia
Long-term care facilities (n = 8)
Day centre (n = 1)
Residents (n = 187)
Gender: female (59%)
Age (mean + SD) years
80.1 + 9.6/range 70 to 90
Mental status
AD 38.5%
Unspecified dementia 32.6%
Vascular dementia 18.7%
Other dementia 10.2%
Data collection
Behaviour checklist for bowel and urination developed for the study
Outcomes measures
Symptom’s and signs of bowel movement and urination expressed by the patient
MMAT score: 100%
An adapted three-stage Delphi consultation study
Study 13: Iliffe et al. 2015 [69]
Phase 4
The aim of this study was to develop and test a continence assessment tool and supporting resources for people with dementia, to be used by primary care professionals, primarily community nurses (p. 95)
Stage 1
Carers and professionals (n = 10)
Stage 2
Carers and professionals (n = 10)
Specialist continence professionals (n = 10)
Stage 3
Carers (n = 8)
General Practitioner (n = 2),
Geriatrician/psychogeriatrician (n = 1)
Continence nurse specialist (n = 3)
District nurse/community nurse (n = 7)
Occupational therapist (n = 2)
Other (n = 3)
(rr = 26/50)
Not applicable
Mental status
Data Collection
Stage 1: Face to face consultations were facilitated to describe a broad range of principles and issues that would underpin an assessment tool designed to address the needs of people with dementia
Stage 2: A prototype dementia-focused continence assessment tool was developed using the data generated in stage 1, asking for agreement or disagreement to items plus suggestions for further items. This was used to consult, in writing, both the expert group in stage 1 and also a further group of carers and specialist continence professionals. The prototype was further adapted.
Stage 3: A different, wider group of experts (carers and professionals) was consulted in writing. They were sent the draft dementia-focused assessment tool together with a questionnaire to test its face and content validity.
Outcome measures
Recipients were asked (1) whether or not the tool would improve recognition of the problems (face validity) and (b) to rate each item for importance and identify missing or unnecessary items (content validity)
MMAT score: 75%
  1. Key: AD Alzheimer’s disease, CI confidence intervals, MMAT Mixed Methods Appraisal Tool, MSE Mental State Examination, PLWD people living with dementia, SD standard deviation