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Burgio KL, Cunningham SD, Newman DK, Low LK, Nodora J, Lipman TH, Klusaritz H, James AS, Rickey L, Gahagan S, Hebert-Beirne J, Kenton KS, Williams BR. Preferences for Public Health Messaging Related to Bladder Health in Adolescent and Adult Women. J Womens Health (Larchmt) 2023; 32:1120-1135. [PMID: 37610853 PMCID: PMC10541935 DOI: 10.1089/jwh.2022.0463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023] Open
Abstract
Objective: The purpose of this analysis was to explore adolescent and adult women's preferences for the content and delivery of public health messaging around bladder health. Materials and Methods: This was a directed content analysis of focus group data from the Study of Habits, Attitudes, Realities, and Experiences, which explored adolescent and adult women's experiences, perceptions, beliefs, knowledge, and behaviors related to bladder health and function across the life course. This article reports an analysis of the "Public Health Messaging" code, which includes participants' views on what information is needed about bladder health, attributes of messaging, and preferred locations and delivery methods. Results: Forty-four focus groups were conducted with 360 participants (ages 11-93 years) organized into six age groups. Across age groups, participants wanted messaging on maintaining bladder health and preventing bladder problems. They offered suggestions for a wide variety of methods to deliver bladder health information. Ideas for delivery methods fell into three broad categories: (1) traditional in-person modes of delivery, which included individual communication with providers in clinical settings and group-based methods in schools and other community settings where adolescent and adult women naturally gather; (2) internet-based website and social media delivery methods; and (3) static (noninteractive) modes of delivery such as pamphlets. Participants recommended the development of multiple delivery methods to be tailored for specific audiences. Conclusions: These findings can inform development of broad ranging public health messaging tailored to audiences of all ages with a goal of engaging adolescent and adult women across the bladder health risk spectrum.
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Affiliation(s)
- Kathryn L Burgio
- Department of Medicine, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA
- Department of Veterans Affairs, Geriatric Research, Education, and Clinical Center, Birmingham, Alabama, USA
| | - Shayna D Cunningham
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Diane K Newman
- Department of Surgery, Division of Urology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lisa Kane Low
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Jesse Nodora
- Behavioral Medicine, Herbert Wertheim School of Public Health, University of California-San Diego, La Jolla, California, USA
| | - Terri H Lipman
- Department of Surgery, Division of Urology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Heather Klusaritz
- Department of Surgery, Division of Urology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Aimee S James
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Leslie Rickey
- Departments of Urology and Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Shelia Gahagan
- Department of Pediatrics, University of California, San Diego, La Jolla, California, USA
| | - Jeni Hebert-Beirne
- Division of Community Health Services, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA
| | - Kimberly S Kenton
- Department of Obstetrics and Gynecology, Northwestern University, Evanston, Illinois, USA
| | - Beverly Rosa Williams
- Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA
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Burgio KL, Cunningham SD, Newman DK, Low LK, Nodora J, Lipman TH, Gahagan S, Klusaritz H, James AS, Rickey L, Kenton KS, Hebert-Beirne J, Williams BR. Need for Public Health Messaging Related to Bladder Health from Adolescence to Advanced Age. J Womens Health (Larchmt) 2023; 32:224-238. [PMID: 36454206 PMCID: PMC9940805 DOI: 10.1089/jwh.2022.0185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective: The purpose of this analysis was to explore adolescent and adult women's interest in public health messaging around bladder health and perceptions of its usefulness. Materials and Methods: Directed content analysis of focus group data from the Study of Habits, Attitudes, Realities, and Experiences, which explored adolescent and adult women's experiences, perceptions, beliefs, knowledge, and behaviors related to bladder health across the life course. This article reports an analysis of the "Public Health Messaging" code, which included participants' desire or need for information about bladder health and recommendations for appropriate priority audiences. Results: Forty-four focus groups were conducted with 360 participants organized into six age groups (11-93 years). There was consensus across age groups that more information about the bladder is wanted and needed throughout the life course, as there is currently a lack of reliable educational resources. Information on bladder health was seen as useful and important because it enables people to anticipate negative changes in bladder health and act to prevent these. Several priority audiences were identified based on their risk of developing symptoms, but participants also saw value in educating the general public regardless of risk status. They also recommended education for parents and teachers who are in positions to control bathroom access. Conclusions: Results indicate a uniform desire for information on women's bladder health and a need for more research to develop individual prevention strategies and public health messaging for women of all ages, as well as guidance for organizations with a role in supporting bladder health.
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Affiliation(s)
- Kathryn L. Burgio
- Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA
- Department of Veterans Affairs, Geriatric Research, Education, and Clinical Center (GRECC), Birmingham, Alabama, USA
| | - Shayna D. Cunningham
- Department of Public Health Services, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Diane K. Newman
- Department of Surgery, Division of Urology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lisa Kane Low
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | - Jesse Nodora
- Behavioral Medicine, Herbert Wertheim School of Public Health & Human Longevity Science, School of Public Health, University of California—San Diego, La Jolla, California, USA
| | - Terri H. Lipman
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Shelia Gahagan
- Department of Pediatrics, University of California, San Diego, California, USA
| | - Heather Klusaritz
- Department of Surgery, Division of Urology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Aimee S. James
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Leslie Rickey
- Department of Urology and Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Kimberly S. Kenton
- Department of Obstetrics and Gynecology, Northwestern University, Evanston, Illinois, USA
| | - Jeni Hebert-Beirne
- Division of Community Health Services, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Beverly Rosa Williams
- Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA
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Goodridge SD, Chisholm LP, Heft J, Hartigan S, Kaufman M, Dmochowski RR, Stewart T, Reynolds WS. Association of Knowledge and Presence of Pelvic Floor Disorders and Participation in Pelvic Floor Exercises: A Cross-sectional Study. Female Pelvic Med Reconstr Surg 2021; 27:310-314. [PMID: 32217913 PMCID: PMC7381369 DOI: 10.1097/spv.0000000000000813] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Women's baseline knowledge of pelvic floor exercises (PFEs) and pelvic floor disorders (PFDs) is not well established, as is their knowledge regarding PFE and participation in such exercise. The aim of our study was to assess baseline PFD and PFE knowledge and to determine if knowledge in any way influenced participation in PFEs. METHODS This was an institutional review board-approved, cross-sectional survey administered to women 18 years or older. We included all women who completed the survey, of which 3733 met the criteria. A survey-based questionnaire was used to query lower urinary tract symptoms, PFD, knowledge, and frequency of participation in PFEs. RESULTS Of those who responded, the mean incontinence knowledge score was 9.2 ± 2.6, whereas the mean score for pelvic organ prolapse (POP) knowledge was 6.8 ± 3.6. Of the respondents, 92.5% reported being familiar with Kegel exercises. The majority of respondents reported that they did not participate in PFEs (57.4%). Those with POP were more likely to do daily PFEs than those without POP, 34.8% versus 16.4% (P < 0.001). Stress urinary incontinence did not influence frequency of performing PFEs. CONCLUSIONS Our study demonstrated that while baseline knowledge of POP and incontinence knowledge were high in this patient population, the majority of participants did not participate in PFE. Participants with POP were more likely to partake in daily PFE. A gap exists between knowledge and willingness to participate in PFE. Bridging this gap may be significantly impactful for women's health.
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Affiliation(s)
| | | | - Jessica Heft
- Department of Obstetrics and Gynecology, Vanderbilt University, Nashville, TN
| | - Siobhan Hartigan
- Department of Urology, Vanderbilt University Medical Center, Nashville, TN
| | - Melissa Kaufman
- Department of Urology, Vanderbilt University Medical Center, Nashville, TN
| | | | - Thomas Stewart
- Department of Biostatistics, Vanderbilt University, Nashville, TN
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Beddar SAM, Holden-Bennett L, Mccormick AM. Development and Evaluation of a Protocol to Manage Fecal Incontinence in the Patient with Cancer. J Palliat Care 2019. [DOI: 10.1177/082585979701300206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Fecal incontinence is an important yet often overlooked clinical problem in the care of patients with cancer. This paper presents a protocol for the assessment and management of this distressing symptom. The objective of the protocol is to regulate bowel motion, thereby minimizing fecal incontinence and improving patients’ physical functioning, self-esteem, dignity, and quality of life. A comprehensive assessment addressing the patient's physical status, previous elimination routines, dietary habits, and medications provides the foundation for successful management. Components of the intervention include dietary modification, Pharmacotherapy with laxatives and suppositories, and attention to routines that capitalize on the normal, involuntary gastrointestinal reflexes. Promotion of normal bowel elimination patterns, positioning, and comprehensive patient teaching and support are also critical components of the intervention. Our experience with this protocol and the outcomes achieved in a small series of patients are discussed.
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Affiliation(s)
- Sandra A. Mitchell Beddar
- Oncology Nurse Practitioner, Albany, New York
- Ontario Cancer Institute/Princess Margaret Hospital and Assistant Professor, Faculty of Nursing, University of Toronto
| | - Lynn Holden-Bennett
- Department of Nursing, Ontario Cancer Institute/Princess Margaret Hospital, Toronto, Ontario, Canada
| | - Anne Marie Mccormick
- Department of Nursing, Ontario Cancer Institute/Princess Margaret Hospital, Toronto, Ontario, Canada
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Factors associated with reasons incontinent midlife women report for not seeking urinary incontinence treatment over 9 years across the menopausal transition. Menopause 2018; 25:29-37. [PMID: 28763399 DOI: 10.1097/gme.0000000000000943] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We explored factors associated with reasons that women with urinary incontinence (UI) reported for not seeking treatment for their UI from a healthcare professional and whether reasons differed by race/ethnicity, socioeconomic status, or education. METHODS We analyzed questionnaire data collected from 1995 to 2005 in the Study of Women's Health Across the Nation. In visits 7 to 9, we elicited reasons that women with UI reported for not seeking treatment and condensed them into: UI not bad enough, beliefs about UI causes (UI is a normal consequence of aging or childbirth), and motivational barriers (such as feeling too embarrassed). We used Generalized Estimating Equations and ordinal logistic regression to evaluate factors associated with these reported reasons and number of reasons. RESULTS Of the 1,339 women reporting UI, 814 (61.0%) reported they did not seek treatment for UI. The most frequently reported reasons were as follows: "UI not bad enough" (73%), "UI is a normal part of aging" (53%), and "healthcare provider never asked" (55%). Women reporting daily UI had higher odds of reporting beliefs about UI causes (adjusted odds ratio UI 3.16, 95% CI 1.64-6.11) or motivational barriers (adjusted odds ratio UI 2.36, 95% CI 1.21-4.63) compared with women reporting less than monthly UI. We found no interactions by race/ethnicity, socioeconomic status, or education and UI characteristics in reasons that women reported for not seeking UI treatment. CONCLUSIONS Over half of women who did not seek treatment for their UI reported reasons that could be addressed by public health and clinical efforts to make UI a discussion point during midlife well-women visits.
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Hodgson LG, Cutler SJ. Help Seeking for Personal Concerns About Developing Alzheimer’s Disease. J Appl Gerontol 2016. [DOI: 10.1177/0733464804270587] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study examined the patterns and predictors of help-seeking behavior for personal concerns about developing Alzheimer’s disease (AD) among middle-aged persons. Data were obtained from a survey of two subsamples of 40- to 60-year-old adults with concerns about AD: (a) 99 adult children with a living parent with a diagnosis of probable AD and(b)70 adults in a matched group with no parental history of AD. Descriptive analyses of the types and levels of help seeking show that respondents who are concerned about developing AD take their fears mainly to their informal rather than formal networks. Bivariate and multivariate analyses identified significant correlates of help seeking within three clusters: memory assessment, AD experience, and sociodemographics. The most robust predictors were aspects of AD experience. Understanding the patterns and correlates of help seeking for AD concerns can help health care professionals to develop more effective models of early intervention with implications for early detection of the disease.
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Xu D, Liu N, Qu H, Chen L, Wang K. Relationships among symptom severity, coping styles, and quality of life in community-dwelling women with urinary incontinence: a multiple mediator model. Qual Life Res 2015. [PMID: 26198664 DOI: 10.1007/s11136-015-1070-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE To investigate the relationships among symptom severity, coping styles, and quality of life (QOL) in community-dwelling women with urinary incontinence (UI). METHODS A total of 592 women with UI participated in this cross-sectional study. Bivariate Pearson's correlation was used to examine the correlations between symptom severity, coping styles, and QOL. Multivariate regression models and Sobel tests were used to test the mediating effect of coping styles. Additionally, a multiple mediator model was used to examine the mediating role of coping styles collectively. All regression models were adjusted for age, education, marital status, income, duration of UI, and type of UI. RESULTS Participants tended to use avoidant and palliative coping styles and not use instrumental coping style. Avoidant and palliative coping styles were associated with poor QOL, and partially mediated the association between symptom severity and QOL. Nearly 73% of the adverse effect of symptom severity on QOL was mediated by avoidant and palliative coping styles. CONCLUSIONS The use of avoidant and palliative coping styles was higher with more severe urine leakage, and QOL tended to be poorer. Coping styles should be addressed in UI management. It may be of particular value to look closely at negative coping styles and implement education and training of patients in improving their coping skills related to managing UI, which will in turn improve their QOL.
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Affiliation(s)
- Dongjuan Xu
- School of Nursing, Shandong University, No. 44, Wenhua Xi Road, Jinan, Shandong, China.,School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Nana Liu
- School of Nursing, Shandong University, No. 44, Wenhua Xi Road, Jinan, Shandong, China
| | - Haili Qu
- Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Liqin Chen
- School of Nursing, Shandong University, No. 44, Wenhua Xi Road, Jinan, Shandong, China
| | - Kefang Wang
- School of Nursing, Shandong University, No. 44, Wenhua Xi Road, Jinan, Shandong, China.
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Beadnall HN, Kuppanda KE, O'Connell A, Hardy TA, Reddel SW, Barnett MH. Tablet-based screening improves continence management in multiple sclerosis. Ann Clin Transl Neurol 2015; 2:679-87. [PMID: 26125042 PMCID: PMC4479527 DOI: 10.1002/acn3.205] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 03/17/2015] [Indexed: 11/12/2022] Open
Abstract
Objective To investigate whether electronic continence questionnaires aid early identification and optimizes management of sphincter dysfunction in a multiple sclerosis clinic. Methods A custom designed, tablet-based cross-platform software tool was designed to capture validated multiple sclerosis (MS) patient-reported outcomes. An unselected cohort of MS patients from a tertiary referral clinic completed electronic tablet-based versions of the Bladder Control Scale (BLCS) and the Bowel Control Scale in the waiting room. Data were captured wirelessly “on-the-fly” and stored in a deidentified, secure database; and individual questionnaire results were immediately available to the treating neurologist in the electronic medical record. Scores of ≥2 on either questionnaire generated an automated electronic referral to the clinic MS continence nurse (MS CN). Results One hundred and fifty-seven MS patients completed a total of 184 electronic continence test sets and on two occasions only the BLCS was completed. An automatic electronic referral for formal continence review was generated 128 times in 108 patients. Fifty-seven formal continence assessments were undertaken by the MS CN following automated referral. All reviews resulted in at least one clinical intervention being made. Interpretation Tablet-based data capture and automated continence referral using this software tool is an efficient, sensitive, and feasible method of screening MS patients for bladder and bowel dysfunction. Concordance with the results of formal continence assessment in this pilot study validates the use of this technology as a screening tool.
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Affiliation(s)
- Heidi N Beadnall
- Brain and Mind Research Institute, University of Sydney Sydney, New South Wales, Australia ; Multiple Sclerosis Clinic, Brain and Mind Research Institute, University of Sydney Sydney, New South Wales, Australia ; Department of Neurology, Royal Prince Alfred Hospital Sydney, New South Wales, Australia
| | - Kushi E Kuppanda
- Multiple Sclerosis Clinic, Brain and Mind Research Institute, University of Sydney Sydney, New South Wales, Australia ; Multiple Sclerosis Australia Sydney, New South Wales, Australia
| | - Annmaree O'Connell
- Multiple Sclerosis Clinic, Brain and Mind Research Institute, University of Sydney Sydney, New South Wales, Australia ; Multiple Sclerosis Australia Sydney, New South Wales, Australia
| | - Todd A Hardy
- Multiple Sclerosis Clinic, Brain and Mind Research Institute, University of Sydney Sydney, New South Wales, Australia ; Neuroimmunology Clinic, Concord Hospital and University of Sydney Sydney, New South Wales, Australia
| | - Stephen W Reddel
- Brain and Mind Research Institute, University of Sydney Sydney, New South Wales, Australia ; Department of Neurology, Concord Repatriation General Hospital Sydney, New South Wales, Australia ; Concord Clinical School, University of Sydney Sydney, New South Wales, Australia
| | - Michael H Barnett
- Brain and Mind Research Institute, University of Sydney Sydney, New South Wales, Australia ; Multiple Sclerosis Clinic, Brain and Mind Research Institute, University of Sydney Sydney, New South Wales, Australia ; Department of Neurology, Royal Prince Alfred Hospital Sydney, New South Wales, Australia
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Browne C, Salmon N, Kehoe M. Bladder dysfunction and quality of life for people with multiple sclerosis. Disabil Rehabil 2015; 37:2350-8. [PMID: 25801920 DOI: 10.3109/09638288.2015.1027007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Bladder dysfunction affects 75% of people with multiple sclerosis (MS). People with MS are reluctant to seek treatment for this distressing symptom. This is the first-known study to explore in depth how bladder dysfunction interferes with quality of life for people with MS. METHODS Nineteen individual semi-structured interviews were conducted (M = 8, F = 11). Participants had a definite diagnosis of MS, aged between 37 and 64 years and had at least one bladder dysfunction symptom. The audio-recorded interviews lasted up to 90 min and were transcribed verbatim. RESULTS Thematic analysis within NVivo10 yielded two key themes: (1) Disruptions and loss and (2) ways of knowing. "Disruptions and Loss" explores how bladder dysfunction interrupted daily living activities and how this contributed to experiencing loss. "Ways of knowing" portrays the types of knowledge that existed around bladder dysfunction. Participants described using their experiential knowledge to self-manage bladder symptoms without advice from healthcare providers. CONCLUSIONS Bladder dysfunction imposes major disruptions on daily life. People with MS attempt to self-manage their bladder symptoms, despite current barriers to navigating existing healthcare infrastructure. Understanding these barriers and the individual strategies employed by people with MS are the first steps in facilitating independent management of bladder dysfunction. Implications for Rehabilitation Each individual's experience of bladder dysfunction is unique. Healthcare professionals must be prepared to discuss all disruptions and losses associated with bladder dysfunction for people with MS. People with MS have a vast range of knowledge in relation to their own bladder symptoms and healthcare professionals need to explore their existing self-management strategies during assessment. People with MS and healthcare professionals need to be educated on the wider health implications relating to bladder dysfunction.
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Affiliation(s)
- Catherine Browne
- a Department of Clinical Therapies , University of Limerick , Limerick , Ireland and
| | - Nancy Salmon
- a Department of Clinical Therapies , University of Limerick , Limerick , Ireland and
| | - Maria Kehoe
- b Community Physiotherapy Department , Kildare/West Wicklow, Co. Kildare , Ireland
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Improving resident screening and workup of urinary incontinence in an OB/GYN residency program: a randomized controlled study. Female Pelvic Med Reconstr Surg 2013; 17:242-5. [PMID: 22453108 DOI: 10.1097/spv.0b013e31823122f2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES : With an aging US population, an increased prevalence of urinary incontinence, rising health care costs, and a disease that remains largely unidentified, there is an immediate need to train physicians to screen for and treat incontinence. We aim to evaluate resident physician screening of urinary incontinence with a chart-based review. METHODS : This study entailed 2 parts: a retrospective chart review (part 1) and a prospective randomized trial (part 2). Charts of 200 patients were retrospectively evaluated for documentation of bladder symptoms and incontinence for part 1. In part 2, patients' charts were prospectively randomized to receive a chart-alert sticker ("Do you leak urine?") that reminded resident physicians to ask about urinary incontinence in their general gynecology clinics. The primary outcome was documentation of urinary incontinence. Secondary outcomes were initiation of workup, diagnoses made, and treatment plans. Overall, 200 charts were needed for the prospective study to provide 80% power. RESULTS : Residents documented any type of bladder symptom (incontinence, urgency, frequency, dysuria, nocturia) in 32 (16.3%) of 196 charts in part 1 and 45 (23.7%) of the 190 randomized charts in part 2 (P = 0.154). In the prospective study, 88 included charts were randomized to receive the "Do you leak urine?" chart-alert sticker and 102 were randomized to no sticker. Residents documented that they asked about incontinence in 30 (34.1%) of the charts with stickers versus 4 (3.9%) of the charts without (P = 0.001). CONCLUSIONS Overall, the rate that resident physicians inquired about incontinence increased with the alert-sticker from 4% to 34%. Directed education will likely further this improvement.
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Predictors of Help Seeking Among Korean American Women With Urinary Incontinence. J Wound Ostomy Continence Nurs 2011; 38:663-72. [DOI: 10.1097/won.0b013e31822fc655] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Berger MB, Patel DA, Miller JM, Delancey JO, Fenner DE. Racial differences in self-reported healthcare seeking and treatment for urinary incontinence in community-dwelling women from the EPI Study. Neurourol Urodyn 2011; 30:1442-7. [PMID: 21717504 PMCID: PMC3184333 DOI: 10.1002/nau.21145] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Accepted: 03/28/2011] [Indexed: 11/07/2022]
Abstract
AIMS Objectives of this study are: (1) to examine the prevalence of healthcare seeking among black and white women with self-reported urinary incontinence (UI), (2) to investigate barriers to treatment for incontinence, and (3) To investigate commonly used therapeutic modalities for UI. METHODS This is a planned secondary analysis of responses from 2,812 black and white community-dwelling women living in southeastern Michigan, aged 35-64 years, who completed a telephone interview concerning UI, healthcare-seeking behaviors and management strategies. The study population was 571 subjects (278 black, 293 white) who self-identified as having urinary incontinence. RESULTS Of these women with UI, 51% sought healthcare with no statistically significant difference between the two races (53% black, 50.6% white, P = 0.64). In multivariate logistic regression analysis, a higher likelihood of seeking healthcare was associated with increased age, body mass index lower than 30 kg/m(2) , prior surgery for UI, having regular pelvic exams, having a doctor, and worsening severity of UI. There was no significant association between hypothesized barriers to care seeking and race. Almost 95% of the subjects identified lack of knowledge of available treatments as one barrier. Black and white women were similar in percentage use of medications and some self-care strategies, for example, pad wearing and bathroom mapping, but black women were significantly more likely to restrict fluid intake than white women and marginally less likely to perform Kegels. CONCLUSIONS Black and white women seek healthcare for UI at similar, low rates. Improved patient-doctor relationships and public education may foster healthcare seeking behavior.
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Affiliation(s)
- Mitchell B Berger
- Department of Obstetrics and Gynecology, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA.
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Pakbaz M, Rolfsman E, Mogren I, Löfgren M. Vaginal prolapse--perceptions and healthcare-seeking behavior among women prior to gynecological surgery. Acta Obstet Gynecol Scand 2011; 90:1115-20. [PMID: 21692758 DOI: 10.1111/j.1600-0412.2011.01225.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate perceptions of vaginal prolapse and healthcare-seeking behavior in women prior to gynecological surgery. DESIGN Prospective, cross-sectional study using a web-based questionnaire. SETTING Clinics including patients in the Swedish National Register for Gynecological Surgery (Gynop-register). POPULATION 214 women with vaginal prolapse and 347 women without prolapse as reference patients. METHODS A questionnaire was developed for assessment of women's perception of prolapse and their healthcare-seeking behavior. Data were collected through the Gynop-register. For comparisons between the study groups, Student's t-test and the chi-squared test were used. MAIN OUTCOME MEASURES Perceptions of prolapse, healthcare-seeking behavior, and source of information. RESULTS The most common definition of prolapse reported by the women was presence of a vaginal bulge. Reasons for seeking healthcare were interference with physical activity and increasing symptoms. One in five women with prolapse could not relate the symptoms to prolapse. Participants in the prolapse group gained less information on their own condition from brochures and public media compared to participants in the reference group (p<0.001). CONCLUSION There appeared to be a lack of information on pelvic organ prolapse in the public domain. Healthcare professionals have a significant role to play in informing women about symptoms related to the condition and the available treatment options.
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Affiliation(s)
- Mojgan Pakbaz
- Department of Clinical Sciences, Obstetrics and Gynecology Department of Applied Educational Science, Umeå University, Umeå, Sweden.
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Jiwa M, Ping-Delfos WCS, Briffa K, Sherriff J, Merriman G, Nockolds J, Jardine L, Musiello T, Longman G. Developing a self-administered questionnaire as a guide to consultations with women treated for breast cancer. INTERNATIONAL JOURNAL OF FAMILY MEDICINE 2011; 2011:390692. [PMID: 22295185 PMCID: PMC3263838 DOI: 10.1155/2011/390692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Revised: 02/04/2011] [Accepted: 02/22/2011] [Indexed: 05/31/2023]
Abstract
Background. Health professionals, including general practitioners involved in followup of breast cancer patients, need to systematically assess opportunities to offer patients support with ongoing or new problems. Methods. A self-administered needs assessment questionnaire was developed with reference to a multidisciplinary team. Short, evidence-based, readable questions were emphasized, and questions were tested for face validity. The questions flowed across three domains: physical, social, and psychological. Content validity and user friendliness were assessed. Results. A final set of 30 questions was rated as easy to read and comprehend (Flesch Reading Ease score 65.8 and Flesch-Kincaid Grade Level 6.9). When piloted with twenty-one patients the self-administered questionnaire detected 121 items of unmet need encompassing all three domains. Conclusions. This self-administered questionnaire has the potential to assist in the holistic assessment of breast cancer patient after treatment. The clinical value of the self-administered questionnaire will need to be further tested before it can be widely adopted.
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Affiliation(s)
- Moyez Jiwa
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth,WA 6845, Australia
| | - Wendy Chan She Ping-Delfos
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth,WA 6845, Australia
| | - Kathy Briffa
- School of Physiotherapy, Curtin University, GPO Box U1987, Perth, WA 6845, Australia
| | - Jill Sherriff
- School of Public Health, Curtin University, GPO Box U1987, Perth, WA 6845, Australia
| | - Gareth Merriman
- School of Public Health, Curtin University, GPO Box U1987, Perth, WA 6845, Australia
| | - Janice Nockolds
- Ability Plus Therapy, 233, Berrigan Drive, Jandakot, WA 6164, Australia
| | - Liz Jardine
- Ability Plus Therapy, 233, Berrigan Drive, Jandakot, WA 6164, Australia
| | - Toni Musiello
- School of Surgery M507 QEII Medical Centre, The University of Western Australia, 35, Stirling Highway, Crawley, WA 6009, Australia
| | - Glenys Longman
- (Royal Perth Hospital), Level 2, MRF Building, GPO Box X 2213, Perth, WA 6847, Australia
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Yuan H, Williams BA. Knowledge of urinary incontinence among Chinese community nurses and community-dwelling older people. HEALTH & SOCIAL CARE IN THE COMMUNITY 2010; 18:82-90. [PMID: 19659948 DOI: 10.1111/j.1365-2524.2009.00876.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The purpose of this study was to describe knowledge of urinary incontinence among community nurses and community-dwelling older people in China. The descriptive study was undertaken in 2007 using a cross-sectional research design. A random sampling method was used to recruit 100 Chinese older people and 100 Chinese nurses in JinShan and NanHui communities, Shanghai, China. All participants completed all items of a demographic survey and the Urinary Incontinence Knowledge Scale (UIKS). Based on the literature, the UIKS was developed in 2007. The value of content validity index tested by five experts was 0.75. Measures of internal consistency (Kuder-Richardson formula 20) were 0.72 for the community nurses and 0.69 for the older people. The UIKS consisted of 30 items with dichotomous choices (Correct = 1; False or Do not know = 0). The mean UIKS score of the nurses (mean 20.7, SD 3.5) was significantly higher than that of the older people (mean 13.4, SD 4.0) with a 95% confidence interval for difference in means 6.3-8.4 (t = 13.84; df = 198; P < 0.001). Although community nurses had moderate knowledge of the impact of incontinence, they still lacked knowledge of risk factors, symptoms, prevention, treatment, and management. Older people had poor knowledge about risk factors, symptoms, impact, prevention, treatment and management of urinary incontinence. Because of their knowledge deficits, community nurses and older people viewed urinary incontinence as a normal part of the ageing process. The findings suggested that both nurses and older people in the community had educational needs related to the incontinence. Further studies to develop specific educational programmes concerning urinary incontinence are suggested. Ways to enhance support and acceptable forms of specific content knowledge, process measures and regulatory enforcement require additional exploration.
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Affiliation(s)
- Haobin Yuan
- School of Health Sciences, Macao Polytechnic Institute, Macao.
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Wallner LP, Porten S, Meenan RT, O'Keefe Rosetti MC, Calhoun EA, Sarma AV, Clemens JQ. Prevalence and severity of undiagnosed urinary incontinence in women. Am J Med 2009; 122:1037-42. [PMID: 19854332 PMCID: PMC2768650 DOI: 10.1016/j.amjmed.2009.05.016] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2008] [Revised: 04/09/2009] [Accepted: 05/04/2009] [Indexed: 11/15/2022]
Abstract
BACKGROUND Urinary incontinence is a highly prevalent condition in aging women that results in significant morbidity. Less than half of women who suffer from urinary incontinence seek treatment, resulting in a significant proportion of clinically relevant urinary incontinence remaining undiagnosed. Therefore, the purpose of this study was to quantify the prevalence of urinary incontinence in undiagnosed women in a managed care population. METHODS There were 136,457 women aged 25-80 years enrolled in Kaiser Permanente Northwest who were free of genitourinary diagnoses, including urinary incontinence, who were included in this study. Of the 2118 women who were mailed questionnaires ascertaining information on demographic and urinary incontinence characteristics, 875 completed the survey. A chart review of the 234 women who reported moderate to severe urinary incontinence was performed. RESULTS The prevalence of undiagnosed urinary incontinence was 53% in the preceding year, and 39% in the preceding week. The prevalence of undiagnosed stress, mixed, and urge incontinence was found to be 18.7%, 12.0%, and 6.8%, respectively. Quality of life was found to significantly decrease with increasing urinary incontinence severity. Of the 234 chart-reviewed women, 5% were found to have physician-documented urinary incontinence. CONCLUSIONS These results suggest that a significant proportion of women in this managed care population are suffering from urinary incontinence that remains undiagnosed. Efforts should be made to encourage women and physicians to initiate conversations about urinary incontinence symptoms in order to decrease the unnecessary burden of this disease.
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Affiliation(s)
- Lauren P Wallner
- Department of Urology, University of Michigan, Ann Arbor, MI 48109-5330, USA
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17
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Sexton CC, Coyne KS, Kopp ZS, Irwin DE, Milsom I, Aiyer LP, Tubaro A, Chapple CR, Wein AJ. The overlap of storage, voiding and postmicturition symptoms and implications for treatment seeking in the USA, UK and Sweden: EpiLUTS. BJU Int 2009; 103 Suppl 3:12-23. [DOI: 10.1111/j.1464-410x.2009.08369.x] [Citation(s) in RCA: 149] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Shah AD, Massagli MP, Kohli N, Rajan SS, Braaten KP, Hoyte L. A reliable, valid instrument to assess patient knowledge about urinary incontinence and pelvic organ prolapse. Int Urogynecol J 2008; 19:1283-9. [PMID: 18480958 DOI: 10.1007/s00192-008-0631-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2008] [Accepted: 03/30/2008] [Indexed: 11/28/2022]
Abstract
The objective of this study is to develop a reliable, validated questionnaire to assess patient knowledge about urinary incontinence (UI) and pelvic organ prolapse (POP). We designed a written questionnaire comprised of UI and POP scales and administered it to 133 gynecologic and 61 urogynecologic patients. We performed a principal components factor analysis for UI and POP items and assessed construct validity, internal consistency, and stability of each scale. For both scales, mean total urogynecologic group scores exceeded those for gynecologic patients (P values < 0.001), suggesting construct validity. Both scales had excellent internal consistency (Cronbach's alpha > 0.8). Mean test scores were slightly higher upon retest (UI, 0.46, P = 0.046; POP, 0.33, P = 0.126). Pearson's correlation between initial and repeat scores was high for UI (0.675) and POP scales (0.940), indicating questionnaire stability. We developed a reliable, valid instrument for assessing patient knowledge about UI and POP.
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Affiliation(s)
- Aparna D Shah
- Division of Urogynecology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
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19
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Do racial differences in knowledge about urogynecologic issues exist? Int Urogynecol J 2008; 19:1371-8. [DOI: 10.1007/s00192-008-0639-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2008] [Accepted: 04/06/2008] [Indexed: 10/22/2022]
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Abstract
AIMS The objective of this study was to establish the factor validity of a modified Melnyck's Barrier Scale and estimate its reliability in an ethnically heterogeneous incontinent female population. METHODS Computer assisted telephone interviews (CATI) were conducted on a nonprobability sample of 275 incontinent females (95 Caucasian, 95 African American, 80 Hispanic, 5 Other). Study participants were asked to rate the degree to which barrier items affected their seeking medical care for incontinence on a 4-point Likert scale ranging from 0 (none) to 3 (greatly). A confirmatory factor analysis was conducted to confirm the structure of the modified Melnyk's Barrier Scale and assess its fit in our racially heterogeneous incontinent female population. Cronbach's alpha coefficients were estimated to establish the reliability of the final barrier measurement model and its subscales. RESULTS The 14-item modified Melnyk's Barrier Scale contained 3 items that loaded on the inconvenience factor (factor loadings 0.659-0.812). Three items loaded on the relationship factor (factor loadings 0.452-0.796). Two items loaded on the site-related factor (factor loadings 0.554-0.960). Three items loaded on the cost factor (factor loadings 0.481-0.891). Three items loaded on the fear factor (factor loadings 0.457-0.624). Cronbach's alpha coefficient for the final 14-item modified Melnyk's Barrier Scale was 0.828 (Inconvenience subscale 0.79, Relationship subscale 0.68, Site related subscale 0.69, cost subscale 0.71, fear subscale 0.57). CONCLUSION We offer the Barriers to Incontinence Care Seeking questionnaire (BICS-Q) to epidemiologic researchers, given its factor validity and reliability, to operationalize barriers when studying relationships between ethnicity and health care disparities.
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Affiliation(s)
- Michael Heit
- Urogynecology Specialists of Kentuckiana, PLLC, Louisville, Kentucky, USA.
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21
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Porrett T, Carol L Cox s C. Coping mechanisms in women living with pelvic floor dysfunction. ACTA ACUST UNITED AC 2008. [DOI: 10.12968/gasn.2008.6.3.29128] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Carol Carol L Cox s
- Advanced Clinical Practice, Associate Dean, City Community and Health Sciences, City University, London
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22
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Heit M, Blackwell L, Kelly S. Measuring the utility of incontinence care seeking. Int Urogynecol J 2007; 19:143-9. [PMID: 17579800 DOI: 10.1007/s00192-007-0406-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2007] [Accepted: 05/10/2007] [Indexed: 10/23/2022]
Abstract
The purpose of this study was to establish the structure and factor validity of an expectation questionnaire and estimate its reliability in an ethnically heterogeneous incontinent female population. CATIs were conducted on a nonprobability sample of 275 incontinent women to assess the likelihood of a specific outcome of incontinence care seeking. Principal component and confirmatory factor analysis were performed to estimate factor loadings and establish the fit of the expectation questionnaire. Cronbach's alpha coefficients were estimated to establish the reliability of the final expectation questionnaire. Six items loaded on a control factor (factor loadings 0.502-0.806). The control item with the highest loading was "I would be able to resume my normal activities" (r = 0.806). Four items loaded on an internalized fear/anxiety factor (factor loadings 0.449-0.497). The internalized fear/anxiety item with the highest loading was "I would be told it was caused by something I had done in my past" (r = 0.485). Two items loaded on an externalized fear/anxiety factor (factor loadings 0.553-0.726). The externalized fear/anxiety item with the highest loading was "I would be referred to a specialist" (r = 0.553). A chi2/df value of 1.70, goodness-of-fit index of 0.95, comparative fit index of 0.95, and a root mean square error of approximation of 0.050 (probability of close fit of 0.463) established the fit of our final expectation questionnaire. Cronbach's alpha coefficient for the final 12-item expectation questionnaire was 0.56. The 12-item expectation questionnaire is a valid and reliable tool for measuring utility of incontinence care seeking in an ethnically heterogeneous incontinent female population.
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Affiliation(s)
- Michael Heit
- Urogynecology Specialists of Kentuckiana, PLLC, 4121 Dutchmans Lane, Ste 515, Louisville, KY 40207, USA.
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23
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Hägglund D, Wadensten B. Fear of humiliation inhibits women's care-seeking behaviour for long-term urinary incontinence. Scand J Caring Sci 2007; 21:305-12. [PMID: 17727542 DOI: 10.1111/j.1471-6712.2007.00481.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Most women with urinary incontinence (UI) do not seek professional help. Women's experiences of their behaviour when seeking care for incontinence are important to improve understanding by nurses and encourage as well as enable women to seek help. The aim of this study was to illuminate the meaning of women's lived experiences of their behaviour when seeking care for long-term UI. Thirteen women were interviewed (range 37-52 years) who had not sought professional help for incontinence. A phenomenological hermeneutic method was used to analyse and interpret the interview texts. Three themes evolved from data: being in an affected situation, having personal beliefs about seeking care and having desired expectations about care. Being in an affected situation, means that the women were negatively affected by their long-term incontinence. Living with shame, altered sexual relationships and a need for distancing have negatively influenced their care-seeking behaviour (CSB). Having personal beliefs about seeking care means that the women had their own beliefs regarding morally acceptable behaviour for seeking care because of incontinence. This led to a toning down of their problem and a minimization of the problem associated with incontinence as it was considered to be a normal consequence of pregnancy and childbirth. Having desired expectations about care means that the women had opinions relevant to the care and felt being asked about incontinence and an understanding atmosphere should be included. The conclusion is that fear of humiliation inhibited women from seeking care for long-term UI. The findings suggest that nurses should be precise when asking about women's experiences of UI because otherwise they do not bring it up. Additionally, CSB can help nurses to explain the experience and enable women to seek help for this manageable condition.
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Affiliation(s)
- Doris Hägglund
- Department of Health Sciences, Orebro University, Orebro, Sweden.
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Abstract
AIM This paper is a report of a systematic review on unassisted pelvic floor exercises for postnatal stress incontinence to identify effective interventions and highlight areas for further research. BACKGROUND Stress incontinence is a common and embarrassing problem. Childbirth is a major cause and problems can be persistent for some. However women are often reluctant to seek help. METHOD We conducted a systematic literature search in December 2006 using the CINAHL, Medline and Cochrane Library databases, hand-searching of selected textbooks, checking reference lists and contacting experts. There were no date restrictions. The review included randomized controlled trials, published in English, of unassisted pelvic floor exercises in postnatal women. Two reviewers independently extracted data and assessed study quality. Main outcomes were reduction in symptoms of incontinence, patient satisfaction and quality of life. RESULTS Four randomized controlled trials met the inclusion criteria. Interventions ranged from written information to structured exercise classes, while usual care varied from a leaflet to group sessions with a midwife. Three out of four studies demonstrated short-term improvement in incontinence symptoms, which was statistically significant in two. However, at later follow-up there was no longer a statistically significant effect on continence. All trials found that women in the intervention group were more likely to do the exercises. CONCLUSION We found few trials, quality was variable, and comparisons were difficult because of variations in interventions and outcomes measured. Further high quality evaluations are needed, using standardized interventions and outcome measures, patient-relevant outcomes such as quality of life, and follow-up periods that enable evaluation of long-term effectiveness.
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Affiliation(s)
- Ann Wagg
- Health Centre, Stevenage, Herts, UK.
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Strahle A, Stainton MC. Women's experience of revealing perinatal bladder function--implications for midwifery care. Women Birth 2006; 19:17-21. [PMID: 16792000 DOI: 10.1016/j.wombi.2006.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Comments of women engaged in a longitudinal study of urinary leaking from first trimester to 12 months following birth provide the data for this paper. Useful insights into the factors contributing to the maintenance of silence and ways to break the barriers to discussion of urinary incontinence before, during and following pregnancy were revealed. Given the prevalence of 30% of Australian women experiencing urinary leaking following pregnancy, it is imperative that midwives engage in discussion and support prevention of this unwelcome outcome of childbirth.
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Affiliation(s)
- Avon Strahle
- Centre for Women's Health Nursing, Royal Hospital for Women, Locked Bag 2000, Barker St., Randwick, Sydney, NSW 2031, Australia.
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26
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Currie CJ, McEwan P, Poole CD, Odeyemi IAO, Datta SN, Morgan CL. The impact of the overactive bladder on health-related utility and quality of life. BJU Int 2006; 97:1267-72. [PMID: 16686724 DOI: 10.1111/j.1464-410x.2006.06141.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To evaluate the impact of the overactive bladder (OAB) on quality of life and health-related utility. PATIENTS AND METHODS In a study conducted in Cardiff and Vale NHS Trust, patients were identified from an academic urology unit inpatient database for admissions and sent a postal survey. The survey pack comprised questionnaires on demography, urological functioning, health utility (EQ5D(index)), and health-related quality of life (Short Form-36, SF36). Respondents were classified according to general urinary status, frequency, urgency, and stress incontinence. RESULTS Of 2193 surveys dispatched, 609 (27.8%) were returned; of these patients, 52% had incontinence, of whom 83% had both frequency and urgency, and 60% stress incontinence. Patients with stress incontinence reported a mean (sd) EQ5D(index) of 0.578 (0.331), compared to 0.714 (0.281) for all other patients (P < 0.001). From the SF36, respondents scored lowest in the role physical domain and highest in the mental domain, with mean scores of 33.8 and 72.1, respectively. Multivariate analysis of SF36 and EQ5D(index) scores, controlling for age, gender and body mass index, showed that incontinence was associated with a notable reduction in the EQ5D(index) and SF36 scores across all domains. CONCLUSION This study showed a significant reduction in quality of life for all patient groups with OAB; in particular, stress incontinence had the greatest impact.
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Affiliation(s)
- Craig J Currie
- Department of Medicine, School of Medicine, Cardiff University, Cardiff, UK.
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Abstract
Special skills are needed in caring for an elderly patient with a neurogenic bowel and bladder. One not only has to take into account the age-related changes that occur, but also how these changes impact on a patient already struggling with bowel and bladder issues because of various neurogenic causes. Incontinence of bowel and bladder leads to a loss of quality of life and physicians should be educated on the treatment available to provide the best care for their patients.
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Affiliation(s)
- Michelle Stern
- Department of Clinical Rehabilitation Medicine, Columbia University College of Physician and Surgeons, 180 Fort Washington Avenue, HP1-194, New York, NY 10032, USA.
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28
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Melville JL, Newton K, Fan MY, Katon W. Health care discussions and treatment for urinary incontinence in U.S. women. Am J Obstet Gynecol 2006; 194:729-37. [PMID: 16522405 DOI: 10.1016/j.ajog.2005.09.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2005] [Revised: 08/05/2005] [Accepted: 09/29/2005] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The objective of the study was to determine the proportions of women with urinary incontinence who had discussed their condition with a health care provider or received treatment and to identify factors associated with seeking health care. STUDY DESIGN The study was a population-based, age-stratified postal survey of 6000 women aged 30 to 90 years enrolled in a large health maintenance organization in Washington state. RESULTS The response rate was 64% (n = 3536) after applying exclusion criteria. Eighty percent (n = 1160) of women with urinary incontinence completed a detailed set of questions on care seeking and treatments. Fifty percent had discussed their incontinence with a health care provider, 21% reported receiving surgery or prescription medication, 10% reported performing Kegel exercises, and 48% reported wearing a pad to absorb urine daily or weekly. The following factors were significantly associated with odds of discussing urinary incontinence with a health care provider: age (50 to 69 years, adjusted odds ratio 1.5 [1.1 to 2.0]; 70 to 89 years, adjusted odds ratio 1.9 [1.4, 2.7]); duration of urinary incontinence (2 to 5 years, adjusted odds ratio 1.9 [1.3 to 2.8]; more than 5 years, adjusted odds ratio 2.8 [2.0,4.1]); severe urinary incontinence (adjusted odds ratio 1.7 [1.2 to 2.6]); and greater effect on daily activities (adjusted odds ratio 2.7 [1.9,3.8]). CONCLUSION Among women with urinary incontinence, one half have discussed their incontinence with a health care provider and one third have received any form of treatment.
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Affiliation(s)
- Jennifer L Melville
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA.
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29
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Raza-Khan F, Graziano S, Kenton K, Shott S, Brubaker L. Peripartum urinary incontinence in a racially diverse obstetrical population. Int Urogynecol J 2006; 17:525-30. [PMID: 16435097 DOI: 10.1007/s00192-005-0061-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2005] [Accepted: 12/18/2005] [Indexed: 11/29/2022]
Abstract
To determine the rates of urinary incontinence in a racially diverse, tertiary care obstetrical population during the third trimester and postpartum using a validated symptom-screening questionnaire. Third trimester prenatal patients receiving obstetric care at Loyola University Medical Center between March and November 2003 participated in this prospective study approved by the Institutional Review Board. Third-trimester participants completed the 15-item, validated Medical, Epidemiological, and Social Aspects of Aging (MESA) questionnaire and the Hunskaar Severity Index. The MESA was readministered to participants during a 6- to 8-week postpartum visit. One hundred and thirteen women completed antenatal and postpartum MESAs. Seventy-four percent (83 of 113) of the patients in the third trimester were categorized as incontinent. The postpartum incontinence rates decreased to 44% (50 of 113). Twenty-one percent (24 of 113) of the participants after delivery reported pure stress incontinence, 3% (3 of 113) urge incontinence, and 20% (23 of 113) mixed incontinence. Only 4% (5 of 113) of the women developed de novo incontinence postpartum: three reported symptoms of pure stress incontinence and two reported symptoms consistent with urge incontinence. The MESA questionnaire identifies more women with antenatal and postpartum urinary incontinence than currently described in the literature.
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Stainton MC, Strahle A, Fethney J. Leaking urine prior to pregnancy: a risk factor for postnatal incontinence. Aust N Z J Obstet Gynaecol 2006; 45:295-9. [PMID: 16029295 DOI: 10.1111/j.1479-828x.2005.00414.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The prevalence of 30% for postnatal urinary incontinence is a major women's health issue. The majority of studies to date are retrospective, and evidence about contributing factors is inconsistent. AIMS To identify women at risk for postnatal urinary incontinence following the first pregnancy and birth. STUDY POPULATION AND METHODS One hundred and twenty four women participated in a longitudinal study. Questionnaires and interviews were conducted at 14, 24 and 38 weeks' gestation and 24-72 h, 6-8 weeks and 6-18 months postnatal. These, along with chart audits for pregnancy, labour and delivery factors and demographics, formed the database for logistic regression. RESULTS The only variable to emerge as a key indicator for predicting those women most at risk for developing postnatal urine leakage was a history of urinary leaking prior to the first pregnancy. Women with this history were 4.14 times more at risk of leaking urine 1 year after giving birth than women without previous urine leakage (P = 0.02). There was a pattern of leaking urine across the childbearing experience that suggests some resolution by 12 months regardless of parity. Length of second stage labour and method of delivery were the only labour and delivery variables to show significant differences between leaking and not leaking urine at 12 months postnatal. CONCLUSION Women who leak urine before their first pregnancy can be identified during early antenatal care as those at risk for postnatal urinary incontinence. Further research to test preventive measures is needed.
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Affiliation(s)
- M Colleen Stainton
- Centre for Women's Health Nursing, Royal Hospital for Women, University of Sydney, Australia.
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Abstract
Both urinary and fecal incontinence are frequently occurring problems with costly consequences - physically, emotionally, and economically. General self-management strategies to promote continence, as well as behavioral and medical interventions, are often advocated. In this article, strategies based on a cognitive model are directed toward 2 overall goals: managing cognitions that are largely outside the individual's control while altering those within the individual's control, and improving management of continence with cognitive techniques. This approach expands and supports the behavioral and medical approaches to continence care. Nurses can use this comprehensive approach to increase the likelihood of positive continence outcomes.
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Affiliation(s)
- Thérèse Dowd
- The University of Akron, College of Nursing, Akron, OH 44325-3701, USA.
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ter Meulen H, van Kerrebroeck E. Injection therapy for stress urinary incontinence in adult women. Expert Rev Med Devices 2005; 1:205-13. [PMID: 16293041 DOI: 10.1586/17434440.1.2.205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Stress urinary incontinence (SUI) is prevalent in adult women and has a considerable impact on quality of life. However, it often remains undiagnosed and therefore untreated. Noninvasive treatment is likely to be offered in mild cases and may entail pelvic floor muscle re-education, minimally invasive devices or pharmacotherapy. Surgical intervention is widely considered as the only effective option for more severe SUI, although it is not suitable for all patients. Injection therapy with urethral bulking agents represents an alternative minimally invasive procedure and can be used for all types of SUI. Many bulking agents have been developed, although the ideal remains to be discovered. The safety and durability of agents remain a concern. No differences in agents from an efficacy point of view have been found. For many years urethral injection could only be administered endoscopically. The recent development of devices for blind injection has increased the speed and convenience of urethral injection, removing the need for surgical facilities. The subjective cure rate after injection therapy is higher than the objective one. A focus on the patient's wishes and expectations with respect to success and risks of a treatment for SUI is required. In addition, randomized clinical trials are mandatory to establish the place and efficacy of urethral bulking agents compared with conservative therapy (pelvic floor muscle re-education) in treating SUI in adult women.
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Affiliation(s)
- H ter Meulen
- University Hospital Maastricht, Department of Urology, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
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Strahle A, Stainton MC, Fethney J. The pattern of perinatal urine leakage — a template for care. ACTA ACUST UNITED AC 2005. [DOI: 10.1016/s1448-8272(05)80015-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Boyington AR, Wildemuth BM, Dougherty MC, Hall EP. Development of a computer-based system for continence health promotion. Nurs Outlook 2004; 52:241-7. [PMID: 15499313 DOI: 10.1016/j.outlook.2004.04.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Computer-based systems (CBS) can provide information to help individuals analyze their health care needs and make decisions about management of health problems. This article discusses the development of a CBS that delivers an individualized educational intervention for continence health promotion. System development included cycles of prototype design, testing, analysis, and redesign. Knowledge acquisition, representation methods, and design decisions are discussed. Participants completed 4 rounds of usability testing and a pilot test, which resulted in enhancements to both the CBS and the expert system feature that produced individualized feedback. This iterative design process involved users throughout system development. User involvement resulted in a tutorial to explain navigation and other features of the CBS, graphics to enhance the written message, and clarification of continence-related content. The procedures resulted in an informative, usable product; they can be used to develop systems that provide information about symptom self-management for other health conditions.
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Affiliation(s)
- Alice R Boyington
- School of Nursing, University of North Carolina at Chapel Hill, UNC-CH, Carrington Hall, CB #7460, Chapel Hill, NC 27599-7460, USA.
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Abstract
Urinary incontinence, the complaint of any involuntary loss of urine, is a troubling symptom experienced by men and women of all ages. Options for treatment include a range of behavioral, pharmacologic, and surgical therapies. Behavioral therapies, such as dietary modification, pelvic floor muscle training, and bladder training, are noninvasive, with little risk of side effects, and experts agree they should represent the first line of treatment whenever possible. These therapies can be initiated and monitored at the primary care level, thereby enhancing the accessibility of care for those affected. The purpose of this article is to methodically review what is and is not known about behavioral therapies, with attention to research needs. Although there is clear evidence for pelvic floor muscle training in women with urinary incontinence and modest evidence in men for a short time after radical prostatectomy, less is known about bladder training, prompted voiding, habit retraining, and timed voiding. Additional research is required to enhance our understanding of the comparative efficacy of behavioral interventions in specific populations. This research must take an increasingly long-term focus, given the potentially chronic nature of urinary incontinence.
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Avery JC, Gill TK, MacLennan AH, Chittleborough CR, Grant JF, Taylor AW. The impact of incontinence on health-related quality of life in a South Australian population sample. Aust N Z J Public Health 2004; 28:173-9. [PMID: 15233358 DOI: 10.1111/j.1467-842x.2004.tb00932.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To assess prevalence of incontinence in a South Australian representative population sample and compare the health-related quality-of-life impact of incontinence with other chronic conditions. METHOD The 1998 South Australian Health Omnibus Survey interviewed 3,010 male and female respondents aged 15 to 97 years (response rate 70.2%). This representative population survey included questions to determine the prevalence of urinary (stress and urge), and anal (faecal and flatus) incontinence, and other chronic conditions. Respondents also completed the MOS SF-36 questionnaire. RESULTS Self-reported prevalence of all types of incontinence was 26.0%. The prevalence of anal and urinary incontinence were 10.5% and 20.3% respectively, with 4.8% of respondents experiencing both. Univariate analysis found the prevalence of incontinence was statistically significantly higher among females, and those who were older, widowed, had no post-school education, and lower incomes. After adjusting for differences in age and sex, it was found that people with incontinence were significantly impaired across all dimensions of the SF-36, scoring in the lowest 42% of the population, compared with those people without incontinence. People with incontinence exhibited different SF-36 profiles to those with other chronic conditions. CONCLUSIONS Incontinence is common in South Australia, affecting more than one-quarter of the population, particularly older women (56.2% for 60 years and over). The impact of incontinence on health-related quality of life is characteristically different to that demonstrated by other chronic conditions. IMPLICATIONS In an ageing population, identification of the impact of incontinence is necessary to direct policy development and resource allocation to this area.
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Affiliation(s)
- Jodie C Avery
- Population Research and Outcome Studies Unit, Department of Human Services, Adelaide, South Australia.
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Kubik K, Blackwell L, Heit M. Does socioeconomic status explain racial differences in urinary incontinence knowledge? Am J Obstet Gynecol 2004; 191:188-93. [PMID: 15295363 DOI: 10.1016/j.ajog.2004.03.084] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This study was undertaken to discover whether urinary incontinence knowledge differs between racial/ethnic groups. If incontinence knowledge differs between racial/ethnic groups, is the difference explained by socioeconomic status (SES). STUDY DESIGN In this cross-sectional study, 212 women from 3 counties in California were interviewed by telephone. Urinary incontinence knowledge was measured by an Incontinence Quiz. SES was calculated. Race was categorized as white or minority (non-Hispanic black, Hispanic, and other). RESULTS White women scored better than minority women on the Incontinence Quiz (6.16 +/- 2.86 vs 5.46 +/- 2.66, P=.071). Higher SES was significantly associated with higher Incontinence Quiz total score (r=0.177, P=.010). Racial differences in Incontinence Quiz total score no longer trended toward significance after adjusting for SES in multivariable analysis. Race/ethnicity and SES were analyzed for association with each question of the Incontinence Quiz CONCLUSION Socioeconomic status explains racial differences in total urinary incontinence knowledge. Consideration of socioeconomic status may improve the effectiveness of urinary incontinence educational programs.
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Affiliation(s)
- Kari Kubik
- Department of Obstetrics, Gynecology, and Women's Health, University of Louisville HSC, Louisville, KY, USA
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Heidrich SM, Wells TJ. EFFECTS OF Urinary Incontinence: Psychological Well-Being and Distress in Older Community-Dwelling Women. J Gerontol Nurs 2004; 30:47-54. [PMID: 15152744 DOI: 10.3928/0098-9134-20040501-10] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Urinary incontinence (UI) has been related to lower quality of life. However, the research has generally been cross-sectional, and causal relationships have not been determined. This research was a secondary analysis of a 6-year longitudinal study of chronic illness and psychological well-being in older (mean age = 73 at Time 1), community-dwelling women (n = 103). Over time, women with UI reported significantly lower subjective health, purpose in life, affect balance, personal growth, positive relations with others, and self-esteem and higher scores for depression, compared to women without UI. Incontinence had broad effects on multiple domains of psychological well-being that persisted over time and need to be addressed by clinicians.
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Affiliation(s)
- Susan M Heidrich
- Clinical Science Center, University of Wisconsin-Madison, 53792, USA
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Kinchen KS, Burgio K, Diokno AC, Fultz NH, Bump R, Obenchain R. Factors associated with women's decisions to seek treatment for urinary incontinence. J Womens Health (Larchmt) 2004; 12:687-98. [PMID: 14583109 DOI: 10.1089/154099903322404339] [Citation(s) in RCA: 179] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Urinary incontinence is a highly prevalent and burdensome condition among women. However, fewer than half of women with symptoms talk to a physician about incontinence, and the determinants of treatment seeking are not well understood. DESIGN A two-stage cross-sectional survey of adult U.S. women; 45,000 households participating in NFO Worldgroup survey research received a questionnaire to identify adults with incontinence. Based on stratified random sampling of identified incontinent women, 2310 women received a detailed questionnaire. RESULTS Among 1970 women with urinary incontinence symptoms, 38% had initiated a conversation with a physician about incontinence. In multivariate logistic regression analysis, some of the factors associated significantly with treatment seeking were symptom duration >3 years (OR 2.33, 95% CI 1.57-3.45), having a history of a noticeable accident (OR 1.41, 95% CI 1.06-1.87), worse disease-specific quality of life scores (OR 1.89, 95% CI 1.32-2.70), not being embarrassed to talk with a physician about urinary symptoms (OR 1.65, 95% CI 1.28-2.14), talking with others about urinary incontinence (OR 3.34, 95% CI 2.49-4.49), and keeping regular appointments for routine/preventive care (OR 2.25, 95% CI 1.54-3.29). CONCLUSIONS Less than half of community-dwelling adult U.S. women with symptoms of urinary incontinence have talked with a physician about urinary incontinence. In addition to duration of symptoms, factors associated with treatment seeking included the impact of incontinence on quality of life, lack of embarrassment about talking to a physician about urinary symptoms, and attitudes toward healthcare use. Concerns about the meaning of incontinence for overall and future health were important reasons for women choosing to seek treatment.
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Affiliation(s)
- Kraig S Kinchen
- Lilly Research Labs, Eli Lilly and Company, Indianapolis, Indiana 46278, USA.
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Sampselle CM. Behavioral intervention: the first-line treatment for women with urinary incontinence. Curr Urol Rep 2003; 4:356-61. [PMID: 14499057 DOI: 10.1007/s11934-003-0006-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Urinary incontinence is a women's health problem that imposes major consequences for personal quality of life and for national health care costs. The evidence base for the efficacy of the behavioral interventions of bladder training and pelvic muscle training to treat urinary incontinence in women is strong. Bladder and pelvic muscle training should be considered as basic health promotion education for all women. Screening for incontinence should be a routine component of women's health care and bladder and pelvic muscle training should be prescribed by clinicians as a first-line treatment for women who screen positive. This article summarizes the relevant research and outlines intervention strategies that clinicians can readily translate into everyday practice.
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Affiliation(s)
- Carolyn M Sampselle
- University of Michigan, School of Nursing, 400 North Ingalls, Room 4236, Ann Arbor, MI 48109-0482, USA. E-mail:
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Avellanet M, Fiter M, Cirera E, Coll M. Prevalence of urinary incontinence in Andorra: impact on women's health. BMC Womens Health 2003; 3:5. [PMID: 12866950 PMCID: PMC169172 DOI: 10.1186/1472-6874-3-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2002] [Accepted: 07/16/2003] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND: Urinary incontinence (UI) is a frequent public health problem with negative social consequences, particularly for women. Female susceptibility is the result of anatomical, social, economic and cultural factors. The main objectives of this study are to evaluate the prevalence of UI in the female population of Andorra over the age of 15 and, specifically, to determine the influence of socio-demographic factors. A secondary aim of the study is to measure the degree of concern associated with UI and whether the involved subjects have asked for medical assistance, or not. METHODS: Women aged 15 and over, answered a self-administered questionnaire while attending professional health units in Andorra during the period November 1998 to January 2000. A preliminary study was carried out to ensure that the questionnaire was both understandable and simple. RESULTS: 863 completed questionnaires were obtained during a one year period. The breakdown of the places where the questionnaires were obtained and filled out is as follows: 32.4% - medical specialists' offices; 31.5% - outpatient centres served exclusively by nurses; 24% - primary care doctors' offices; 12% from other sources. Of the women who answered the questionnaire, 37% manifested urine losses. Of those,45.3% presented regular urinary incontinence (RUI) and 55.7% presented sporadic urinary incontinence (SporadicUI). In those women aged between 45 and 64, UI was present in 56% of the subjects. UI was more frequent among parous than non-parous women. UI was perceived as a far more bothersome and disabling condition by working, middle-class women than in other socio-economic groups. Women in this particular group are more limited by UI, less likely to seek medical advice but more likely to follow a course of treatment. From a general point of view, however, less than 50% of women suffering from UI sought medical advice. CONCLUSION: The prevalence of UI in the female population of Andorra stands at about 37%, a statistic which should encourage both health professionals and women to a far greater awareness of this condition.
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Affiliation(s)
- Mercè Avellanet
- Andorran Women Research Group (WRG), Andorran Science Society, Andorra la Vella, Principality of Andorra
- Rehabilitation Department, Nostra Senyora de Meritxell Hospital. Escaldes-Engordany. Principality of Andorra
| | - Meritxell Fiter
- Andorran Women Research Group (WRG), Andorran Science Society, Andorra la Vella, Principality of Andorra
- Consultori Medic de Grup, Sant Julia de Loria, Principality of Andorra
| | - Eva Cirera
- Andorran Women Research Group (WRG), Andorran Science Society, Andorra la Vella, Principality of Andorra
- Municipal Institute of Public Health, Barcelona, Spain
| | - Margarida Coll
- Andorran Women Research Group (WRG), Andorran Science Society, Andorra la Vella, Principality of Andorra
- Public Health Deparment, Ministry of Health and Welfare, Principality of Andorra
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Lin SY, Dougherty MC. Incontinence impact, symptom distress and treatment-seeking behavior in women with involuntary urine loss in Southern Taiwan. Int J Nurs Stud 2003; 40:227-34. [PMID: 12605945 DOI: 10.1016/s0020-7489(02)00081-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Urinary incontinence (UI) in women is common worldwide, but is studied more often in the West. This correlational study conducted in southern Taiwan employed two frequently used instruments, which were translated into Chinese. Incontinence impact, symptom distress, and treatment-seeking behavior were studied in 106 women with UI of whom 76 (72%) had not received UI treatment. Incontinence impact (mean=49.75; range=30-120) was significantly correlated (r=0.76, p<0.01) with symptom distress (mean=18.38; range=2-68). Women with high incontinence impact and symptom distress were more likely to seek treatment than those with lower impact and symptom distress.
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Affiliation(s)
- Shu-Yuan Lin
- College of Nursing, Koahsiung Medical University, Taiwan.
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43
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Sampselle CM. Behavioral interventions in young and middle-age women: simple interventions to combat a complex problem. Am J Nurs 2003; Suppl:9-19. [PMID: 12612489 DOI: 10.1097/00000446-200303001-00003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Carolyn M Sampselle
- Obstetrics and Gynecology and Women's Studies, University of Michigan School of Nursing, Ann Arbor, MI, USA.
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van Kerrebroeck P, ter Meulen F, Farrelly E, Larsson G, Edwall L, Fianu-Jonasson A. Treatment of stress urinary incontinence: recent developments in the role of urethral injection. UROLOGICAL RESEARCH 2003; 30:356-62. [PMID: 12599014 DOI: 10.1007/s00240-002-0290-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2002] [Accepted: 11/06/2002] [Indexed: 10/25/2022]
Abstract
Stress urinary incontinence is prevalent in adult women and has a considerable impact on quality of life. However, it often remains undiagnosed and therefore untreated. Non-invasive treatment is likely to be offered in mild cases and may entail physiotherapy, minimally invasive devices or pharmacotherapy. Surgical intervention is widely considered as the only effective option for more severe cases. These strategies are not suitable for all patients, and urethral injection represents an alternative, minimally invasive procedure. The choice of the bulking agent is the key to the success of this treatment: the most extensively studied are silicone, polytetrafluoroethylene and bovine collagen. However, doubts regarding the safety and efficacy of these materials has led to the development of carbon-coated zirconium beads, calcium hydroxylapatite and dextranomer/hyaluronic acid (Dx/HA) copolymer. Of these, the most clinical experience has been gained with Dx/HA copolymer. Until 2 years ago, urethral injection could only be administered endoscopically. The recent development of devices for 'blind' injection has increased the speed and convenience of urethral injection, removing the need for surgical facilities. Although few data are yet available, it is conceivable that urethral injection administered 'blind' may in future be considered as an option for all patients failing non-invasive treatment.
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“Oh, Thatʼs a Bit of a Nuisance”. J Wound Ostomy Continence Nurs 2002. [DOI: 10.1097/00152192-200211000-00010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Affiliation(s)
- Sharon Castina
- Division of Cardiology, University of North Carolina Hospitals, Chapel Hill, NC, USA.
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Locher JL, Burgio KL, Goode PS, Roth DL, Rodriguez E. Effects of age and causal attribution to aging on health-related behaviors associated with urinary incontinence in older women. THE GERONTOLOGIST 2002; 42:515-21. [PMID: 12145379 PMCID: PMC2759979 DOI: 10.1093/geront/42.4.515] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
PURPOSE The purpose of this study was to assess the effects of age and patients' attribution of incontinence to aging on health-related behaviors associated with incontinence. DESIGN AND METHODS Participants in this study were 74 women who either sought treatment for urinary incontinence at a multidisciplinary continence program or volunteered for a randomized clinical trial of behavioral and drug therapy for incontinence. As part of their clinical evaluation, women were interviewed about how they managed their incontinence and their perceptions of what had caused the condition. Self-management of incontinence was defined as behaviors used to cope with incontinence, rather than treat or cure incontinence. Self-treatment was defined as self-implementation of Kegel exercises, and formal treatment was defined as interaction with a health care provider. RESULTS Over half of the respondents attributed their incontinence to aging. In multivariate analyses, age was associated with self-management of incontinence, but not self-treatment or formal treatment. In contrast, attribution of incontinence to aging was associated with self-management and self-treatment of incontinence. There was also a trend for attribution of incontinence to aging to be associated with formal treatment for incontinence. Women who attributed their incontinence to aging were less likely to have engaged in self-management strategies and to have received a previous evaluation or treatment; but, they were more likely to have engaged in self-treatment for incontinence. When other relevant variables were added to the regression models, perception that incontinence restricted one's activities became the most significant predictor of performing self-management strategies and performing Kegel exercises. IMPLICATIONS Attribution to aging may be an impediment to seeking treatment. Education to promote understanding of the actual causes and treatment of urinary incontinence may encourage people to seek appropriate intervention. Additionally, whereas attribution to aging is an important factor contributing to health-related behaviors, other factors, such as perception that one's activities are restricted, may play an important role.
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Affiliation(s)
- Julie L Locher
- Center for Aging, Division of Gerontology and Geriatric Medicine, and Department of Sociology, University of Alabama at Birmingham, USA.
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Mason L, Glenn S, Walton I, Hughes C. Women's reluctance to seek help for stress incontinence during pregnancy and following childbirth. Midwifery 2001; 17:212-21. [PMID: 11502141 DOI: 10.1054/midw.2001.0259] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE to identify whether women were made aware of stress incontinence around the time of childbirth, whether symptomatic women sought help from professionals caring for them at this time, to look at what help they receive in the first instance and to understand why some of those experiencing it chose not to seek help. DESIGN a qualitative survey was conducted using semi-structured interviews. SETTING interviews were conducted in participants' own homes. PARTICIPANTS 42 women who reported symptoms of stress incontinence at eight weeks postpartum, and 15 women who were symptomatic one year following the birth of their baby. FINDINGS women were reluctant to seek help, although they were often inconvenienced and troubled by the condition. This was predominantly due to the nature of the condition itself, although the relationship with their health care professionals was also a consideration in some cases. The majority of women were not provided with information on the condition but wanted health professionals to provide a warning that the condition could occur. They also wanted health professionals to seek out information about symptoms, rather than the women themselves having to broach the subject. The first line of treatment at this time was usually a recommendation to perform pelvic floor exercises. IMPLICATIONS FOR PRACTICE health professionals caring for women during pregnancy or following the birth of their baby need to raise awareness of the condition, the treatment available, and to be pro-active in seeking out those experiencing incontinence rather than expecting women to approach them for help.
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Affiliation(s)
- L Mason
- Centre For Health Care Research, Liverpool John Moores University, 79 Tithebarn Street, Liverpool, L2 2ER, UK
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Ricci JA, Baggish JS, Hunt TL, Stewart WF, Wein A, Herzog AR, Diokno AC. Coping strategies and health care-seeking behavior in a US national sample of adults with symptoms suggestive of overactive bladder. Clin Ther 2001; 23:1245-59. [PMID: 11558861 DOI: 10.1016/s0149-2918(01)80104-1] [Citation(s) in RCA: 94] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Although millions of individuals have symptoms suggestive of overactive bladder (OAB), few ever seek or receive medical treatment for their condition. OBJECTIVE The purpose of this study was to describe coping strategies and health care-seeking behavior in a community-based sample of adults with symptoms suggestive of OAB. METHODS A cross-sectional household telephone survey of an age- and sex-stratified sample of adults was conducted. The survey consisted of general health-related questions as well as questions related to OAB symptoms. A total of 4896 adults completed the interview Respondents were considered to have OAB if they reported > or = 1 symptom of urinary urgency, frequency, or urge incontinence. A follow-up questionnaire was then mailed to a subsample of the telephone interview respondents. The mailed questionnaire contained questions related to type and severity of OAB symptoms, coping strategies, medical care/treatment, feelings/beliefs about OAB, and quality of life. Half of the phone respondents with urinary incontinence (n = 638) and a random sample of all other phone respondents received the mailed questionnaire (n = 873); 1,034 questionnaires were returned. RESULTS Of the respondents with OAB, 69.6% tried > or = 1 nonmedical coping strategy. Respondents with incontinent OAB were significantly more likely than those with continent OAB or those with no OAB (controls) to use nonmedical coping strategies (incontinent OAB, 76.1%; continent OAB, 59.0%; controls, 31.9%; P < 0.001). Fewer than half of the respondents with OAB (43.5%) had spoken with a provider about OAB in the previous 12 months. Medical consultation was associated with sex, type and severity of OAB, number of nonmedical coping strategies tried, number of OAB information sources consulted, inclination to try new OAB medications, and feelings/beliefs about OAB. In 90% of patient-provider discussions about OAB, the patient initiated the topic. CONCLUSIONS Individuals manage symptoms suggestive of OAB primarily by using nonmedical coping strategies rather than consulting health care providers. Results of this study support the need for improved clinical recognition of OAB and increased patient-provider communication about this condition.
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Affiliation(s)
- J A Ricci
- Innovative Medical Research, Hunt Valley, Maryland 21031, USA.
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Gavira Iglesias F, Pérez Del Molino Martín J, Valderrama Gama E, Caridad Y Ocerín J, López Pérez M, Romero López M, Pavón Aranguren M, Guerrero Muñoz J. [Communication, diagnosis and treatment of urinary incontinence in the elderly in a basic health area]. Aten Primaria 2001; 28:97-104. [PMID: 11440646 PMCID: PMC7677969 DOI: 10.1016/s0212-6567(01)78908-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2001] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To investigate the frequency in which aged people who suffers on urinary incontinence (UI) talk about this problem with primary care professionals, variables related to no healthcare-seeking as well as diagnostic and therapeutic habits of these professionals. DESIGN Cross-sectional study.Location. Basic Health Zone of Cabra (Córdoba, Spain). PATIENTS A random age-stratified sample of 869 patients selected from a total of 5139 persons >= 65 years of age.Interventions. Home interview. MEASUREMENTS Proper questionnaire with questions about reporting of incontinence to health professionals and the procedures used for routine screening as well as diagnostic and therapeutic assessment of incontinence. A logistic regression model was elaborated to identify explanatory factors for reporting incontinence to healthcare professionals. RESULTS Of 330 incontinents, only 32% reported their problem to healthcare professionals. The remaining 68% did not report their incontinence because most thought it was a minor problem and/or part of the ageing process. The explanatory factors for seeking medical help were the frequency, duration and impact of incontinence, and dependence in self-care. Physicians performed routine screening for incontinence in 10% of 827 inquired aged. In 1 out of 5 incontinents, the physician did not take any diagnostic or therapeutic measures. CONCLUSIONS Seeking of UI medical help was very limited and depends on variables related to perception in symptom's changes. Diagnosis and treatment done by professionals was suboptimal. Severity of UI conditions diagnosis and treatment.
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