261 - What is “toiletting”? Defining toiletting and toiletting-related terms as a basis for bladder and bowel conversations: a literature scan

Hypothesis / aims of study “When I use a word,” Humpty Dumpty said, in rather a scornful tone, “it means just what I choose it to mean – neither more nor less.” In both research and clinical contexts, it is essential for terminology to have concise and agreed definitions of terms that can be referenced by other researchers and used in the same context throughout the medical community. The ICS Standardisation committee notes [1] that “[the] precise use of agreed terminology ensures clear understanding for collaborating centres and readers of publications.” The term “toiletting” (toileting in US/Canadian English) is used in general parlance to refer to a range of activities relating to personal hygiene, in particular to the process of urinating or defecating, and the process of assisting another person to achieve this. The term toiletting is commonly used by researchers and health care professionals in academic, research, and clinical contexts, yet no consensus definition exists and the term does not feature in the ICS Glossary [2] . The aim of this study was to survey the published literature using “toiletting” as a term and establish how this was defined and used in the literature. Study design, materials and methods A broad search strategy was developed with a research librarian using key terms to find all articles relating to bladder and bowel toiletting for three databases, PubMed, CINAHL, and Scopus. Studies which used the term “toiletting” in humans relating to bladder or bowel function were included. Papers that were not in English were excluded, as the aim was to synthesise the definition of the term in English. Records that did not have the full text available were excluded. No limitations on date or publication type, study design, population, or method were used. The reference lists of each paper were reviewed for additional potential papers. Each paper was read in full and the definition of toiletting used in each paper was extracted. The definitions were then consolidated into themes. These definitions were then analysed to identify the most common definitions among the authors’ definitions. A definition was proposed for each term based on this analysis. Definitions were extracted by a single author and discussed with the other authors to reach a consensus on the definition given. Results The initial searches returned 390 results, of which 191 were unique papers. 123 did not define the term toiletting, and 5 related to other meanings of toiletting, such as aural toilet, or were in animals. 78 papers were included in the analysis. 61 papers were in adults and 17 in children. Toiletting was used as a stand-alone term by 29 papers, and was used with three broad meanings; “the planning and performance of elimination of human waste such as menstruation, defecation, or urination, as well as cleaning oneself afterwards”, “the process of finding, getting to, and using a lavatory for elimination, cleaning, and then returning to other activity”, and “the process of assisting another person to get to and use a lavatory, commode, or bedpan for elimination and cleaning” Toiletting was also used with other terms, including toiletting behaviours, assisted toiletting, toiletting programs, and toiletting disability. The definitions from the papers included are summarised in Table. Interpretation of results No clear, consensus definition of “toiletting” exists in the current literature base, limiting the ability of researchers to accurately interpret research and plan future studies. Toiletting is used in combination with other terms to modify the meaning, and there is again a range of terms and meaning used with no agreement across researchers. Concluding message A consensus definition of toiletting and its associated terms should be agreed. Download: Download high-res image (135KB) Download: Download full-size image Figure 1 . Table 1: Definitions Funding Alberta Innovates High School Youth Researcher Summer Program (HYRS) Clinical Trial No Subjects None

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