Will future doctors know enough about stress urinary incontinence to provide proper preventive measures and treatment?

Educating the future: Serbian healthcare students' knowledge and attitudes toward urinary incontinence

INTRODUCTION

Urinary incontinence (UI) is a growing global health problem that affects both women and men of all ages and can seriously negatively impact quality of life. Healthcare professionals' knowledge and attitudes significantly influence UI prevention, diagnosis, and treatment. However, there is a notable lack of research exploring healthcare students' understanding and perceptions of UI. In many countries, they, as future healthcare professionals, must also have continence care competency before graduation. Therefore, the study aimed to assess the knowledge and attitudes of healthcare students toward UI.

METHODS

The study was designed as an observational, analytical, and comparative cross-sectional with 378 healthcare students in Serbia during the winter semester of the 2023/2024 academic year. A general questionnaire for obtaining sociodemographic data, the Urinary Incontinence Knowledge Scale (UIKS) and the Urinary Incontinence Attitude Scale (UIAS) were used as students' report measures. Kuder-Richardson Coefficient (K-R 20) showed high reliability of the UIKS at 0.83, while Cronbach's alpha coefficient was 0.62 for the UIAS.

RESULTS

The UIKS score was 16.6 ± 3.9/30. Healthcare students achieved the highest score in the domain of knowledge about the impact of UI on quality of life and the lowest in the domain of UI control. There is a significant difference in students' knowledge level concerning the study program and whether they had a course focusing on UI. The UIAS score was 45.1 ± 4.6/60, indicating a positive attitude to UI. A statistically significant positive but weak correlation was obtained between knowledge and student attitudes about UI.

CONCLUSIONS

The study findings highlight a concerning gap in understanding UI among healthcare students despite their pivotal role as future healthcare professionals and underscore the urgent need for comprehensive educational strategies to bridge the knowledge gap and foster more positive attitudes toward UI and their implementation in clinical practice to improve patient health outcomes.

Prevalence and severity of urinary incontinence among male and female competitors and recreational CrossFit® practitioners

OBJECTIVE

This study aimed to determine the prevalence, severity and type of urinary incontinence (UI) in female and male CrossFit® practitioners.

STUDY DESIGN

The study design is an online cross-sectional survey distributed to CrossFit® practitioners across all Spanish regions. The questionnaire included categorical questions related to CrossFit® practice, multiple-choice questions to determine the exercises performed during reported UI symptoms, and The International Consultation on Incontinence Questionnaire Short-Form questionnaire items.

RESULTS

Five hundred seventy-one practitioners (34.0 ± 8.37 years, Body Mass Index 24.20 ± 3.34 kg/m²) met inclusion criteria and completed the survey. There were and 316 females and 255 males. Around 45 % of women and 6 % of men reported having UI (p < 0.001). The severity of UI mainly was slight (30.3 % women, 3.5 % men) and moderate (11.7 % women, 2.3 % men) (p < 0.001). Stress and urgent UI were the most prevalent types among women (36 %) and men (5 %) (p < 0.001).

CONCLUSIONS

This study found that UI is relatively common among female CrossFit® practitioners, especially in repetitive jumps. The practitioners' profile (amateur/competitor) does not affect the prevalence or severity of UI. Male athletes can also experience urine leakage while performing CrossFit®, although its prevalence is much lower when compared to female practitioners.

Medical student exposure to women's health concepts and practices: a content analysis of curriculum at Canadian medical schools

BACKGROUND

Women's health (WH) includes a broad array of concerns and challenges that affect health across the lifespan. Considerable research shows that women continue to experience disparities in access to and quality of care. Apart from surveys of medical trainees and faculty, little research and none in Canada examined medical curriculum for WH. This study assessed how Canadian medical schools integrate WH in their curriculum.

METHODS

We used deductive and summative content analysis to describe instances and the nature of WH topics in program and course descriptions that were publicly-available on web sites of Canadian medical schools. We reported results using summary statistics and text examples. We employed a framework, tested in our prior research, that included mention of women's health principles and practices relevant to any health concern or condition including factors (e.g. sex, gender, social determinants) that influence health, and access to or quality of care.

RESULTS

We retrieved 1459 documents from 16 medical schools (median 49.5, range 16 to 301). Few mentioned WH (125, 8.6 %), and the quantity of mentions varied by school (range 0.0-37.5 %). Pre-clerkship course documents more frequently mentioned WH (61/374, 17.3 %, chi square 43.2, p < 0.00001) compared with clerkship course documents (58/1067, 5.4 %). Core course documents more frequently mentioned WH (72/542, 13.3 %, chi square 29.0, p < 0.00001) compared with elective course documents WH (47/899, 5.2 %). Overall, documents more frequently referred to the WH domain of social determinants of health (88, 70.4 %). Few documents addressed women's health (21, 16.8 %), sex or gender (19, 15.2 %), other considerations (15.2 %) or principles/components of women's health (2, 1.6 %). Most documents that mentioned WH provided little detail about what those concepts referred to or how to optimize WH.

CONCLUSIONS

Based on program and course descriptions, WH may not be well-integrated at Canadian medical schools, and future physicians may not be consistently exposed to the full breadth of WH. This reveals opportunities for enhancing WH in the medical curriculum. Future research is needed to engage stakeholders including women in developing, implementing and evaluating competencies and corresponding curriculum that reflect the full range of WH concepts and practices.

Exploring literature on knowledge, attitudes, beliefs and practices towards urinary incontinence management: a scoping review

INTRODUCTION AND HYPOTHESIS

Urinary incontinence affects women of all ages, influencing 8.5% of the world's population in 2018. Effective management of urinary incontinence is influenced by patients help-seeking behaviour and services offered by healthcare professionals within the healthcare system. To facilitate behavioural change, it is important to understand the knowledge(Knowledge: "the comprehension and understanding of acquired facts or information about UI in adults"), attitudes (Attitude: "a predisposed perspective which influences nurses' thoughts, feelings, perceptions and behaviours towards care of adults with UI") and beliefs (Beliefs: "a theoretically conceptualized conviction or expectation regarding UI in general") of healthcare practitioners towards urinary incontinence management. The aim of this review is thus to systematically map the existing literature, reporting on how knowledge, attitude, belief and practices towards urinary incontinence management have been explored.

METHODS

Six databases were systematically searched. Included studies were published between January 2013 to January 2020 in English, investigating urinary incontinence management in women.

RESULTS

The search yielded 39 studies, with data emanating from 16 counties. Quantitative, Qualitative and mixed methodologies were used to explore the four concepts of knowledge, attitudes, beliefs and practices. A wide range of healthcare practitioners were questioned and management was explored in five healthcare settings. All factors explored related to the four concepts are reported and factors reaching consensus in included literature were highlighted.

CONCLUSION

The summarized factors can assist further investigations into the four concepts to change healthcare practitioner's behaviour towards urinary incontinence management.

Simulation-Based Medical Education in Undergraduate Curriculum: Will a Home-Developed Model Suffice?

BACKGROUND

A medical student needs to understand the integral theory of continence, clinically elicit urethral hypermobility and understand the surgical principles of repair. A skill development model was designed for the final year curriculum of medical students to explain the basic knowledge of integral theory of continence along with surgical repair of urinary incontinence.

AIM

The primary objective of the study was to assess the efficacy of simulation-based teaching (SBT) using a home-developed model as compared to video-based teaching (VBT). The secondary objective was to elicit the feedback of students who underwent SBT.

METHODS

One hundred fifty-nine medical students participated in the study. Simulation-based teaching (SBT) (n = 81) was compared with video-based teaching (VBT) (n = 78). Pretest and posttest results were used to assess learning. Feedback was obtained to improve the existing teaching method.

RESULTS

In the VBT group, the posttest values of lowest score, 25th percentile, 75th percentile, and maximum scores were 9, 10, 12, and 15, respectively. In the SBT group, the posttest values of lowest score, 25th percentile, 75th percentile and maximum scores were 11, 12, 14, and 15, respectively. The students were able to comprehend the anatomical landmarks and integral theory of urinary continence better in SBT group. The surgical technique demonstration and hands-on training done on the pelvic model improved their comprehension.

CONCLUSION

A home-developed model is an effective and economic tool in training medical students. This prototype model of education can be employed as a teaching tool in other surgical disciplines as well.