Continence - your experience

We want to hear people's experiences of accessing services to support them with continence issues (wee and poo) to help us understand and improve services.

The survey is anonymous and should only take you a few minutes to complete.

Thank you for your time and help.

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* 1. Have you ever experienced any continence – wee and poo – issues?

Yes urinary incontinence (wee)

Yes faecal incontinence (poo)

Yes, both

Other (please specify)

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* 2. Are you still experiencing the issue?

Yes

Other (please specify)

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* 3. What type of issue is it? (select all that apply)

Urgency – desperate need to wee/poo that comes on quickly

Stress – stress makes you more likely to wee/poo

Constipation – can’t poo or doesn’t happen very often

Find it difficult to wee

Not emptying your bladder when you wee, so you still feel you need to wee after you have just been to the toilet

Overflow – leaks and weeing or pooing when you didn’t realise you had

Weak bladder or bowels – likely to wee or poo when you cough, laugh etc

Have a catheter

Have a stoma (wee or poo)

Other (please specify)

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* 4. Is it a stand alone issue or part of another condition eg dementia, MS etc?

Stand alone

Part of a long term condition

Other (please specify)

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* 5. If part of a long-term condition, what is the condition?

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* 6. What did you do when the issue first happened?

Talked to friends or family

Looked online for information

Contacted my GP practice

Rang NHS 111

Contacted a specialist continence service

Spoke to a specialist nurse/consultant/other who supports my long term condition

Ignored it and hoped it would go away

Other (please specify)

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* 7. Have you received any treatment/support for the issue?

Yes

Other (please specify)

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* 8. What support have you received?

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* 9. How would you rate the treatment/support you have had from:

	Poor	OK	Average	Good	Excellent
Your GP practice	Your GP practice Poor	Your GP practice OK	Your GP practice Average	Your GP practice Good	Your GP practice Excellent
Specialist services in the community	Specialist services in the community Poor	Specialist services in the community OK	Specialist services in the community Average	Specialist services in the community Good	Specialist services in the community Excellent
Specialist services at the hospital	Specialist services at the hospital Poor	Specialist services at the hospital OK	Specialist services at the hospital Average	Specialist services at the hospital Good	Specialist services at the hospital Excellent
Support from the people who support you with your long term condition if appropriate	Support from the people who support you with your long term condition if appropriate Poor	Support from the people who support you with your long term condition if appropriate OK	Support from the people who support you with your long term condition if appropriate Average	Support from the people who support you with your long term condition if appropriate Good	Support from the people who support you with your long term condition if appropriate Excellent

Other (please specify)

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* 10. What was good about the treatment/support?

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* 11. What could have been better?

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* 12. Is there anything missing / what else could help?

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* 13. If you are involved in any peer support (from other people with a similar condition/issue) how helpful has it been? (five stars is very helpful).

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* 14. If you haven't accessed any peer support, do you think this would be helpful?

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* 15. What impact does your issue have on your life? (tick as many as appropriate)

No impact at all

It limits some of the things I do inside the house

It limits some of the things I do outside the house

It limits a lot of the things I do inside the house

It limits a lot of the things I do outside the house

It stops me going out of the house most of the time

I don’t ever leave the house

I only go out to places close by

I only go out when I know they have toilets nearby

Other (please specify)

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* 16. Does your issue affect your family?

Yes – I can’t do as many things with my family

Yes – I can’t visit my family

Yes – someone has to care for me / help me

Other

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* 17. Any other comments on the impact on you, your family or friends?

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* 18. What has helped you the most if anything?

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* 19. Is there anything else you feel could help you?

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* 20. Is there anything else you want to tell us?

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* 21. Which district do you live in?

Craven

Hambleton

Harrogate

Richmondshire

Ryedale

Scarborough

Selby

York

Other (please specify)

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* 22. Which gender do you identify with?

Woman

Man

Non binary

Intersex

Prefer to use my own term

Prefer not to say

Other (please specify)

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* 23. What is your age?

0 – 12

13 – 15

16 - 17

18 – 24

25 – 49

50 – 64

65 – 79

80+

Prefer not to say

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* 24. What is your ethnicity?

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* 25. Sexual orientation

Asexual

Bisexual

Gay Man

Heterosexual / straight

Lesbian / gay woman

Pansexual

Prefer not to say

Prefer to use my own term

Other (please specify)

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* 26. Do you consider yourself to have a disability?

Yes

Prefer not to say

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* 27. Do you consider yourself to have a long term condition?

Yes

Prefer not to say