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Brubaker L, Nodora J, Bavendam T, Connett J, Claussen AM, Lewis CE, Rudser K, Sutcliffe S, Wyman JF, Miller JM. A policy toolkit for authorship and dissemination policies may benefit NIH research consortia. Account Res 2024; 31:222-240. [PMID: 35998252 PMCID: PMC9975116 DOI: 10.1080/08989621.2022.2116318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Authorship and dissemination policies vary across NIH research consortia. We aimed to describe elements of real-life policies in use by eligible U01 clinical research consortia. Principal investigators of eligible, active U01 clinical research projects identified in the NIH Research Portfolio Online Reporting Tools database shared relevant policies. The characteristics of key policy elements, determined a priori, were reviewed and quantified, when appropriate. Twenty one of 81 research projects met search criteria and provided policies. K elements (e.g., in quotations): "manuscript proposals reviewed and approved by committee" (90%); "guidelines for acknowledgements" (86%); "writing team formation" (71%); "process for final manuscript review and approval" (71%), "responsibilities for lead author" (67%), "guidelines for other types of publications" (67%); "draft manuscript review and approval" (62%); "recommendation for number of members per consortium site" (57%); and "requirement to identify individual contributions in the manuscript" (19%). Authorship/dissemination policies for large team science research projects are highly variable. Creation of an NIH policies repository and accompanying toolkit with model language and recommended key elements could improve comprehensiveness, ethical integrity, and efficiency in team science work while reducing burden and cost on newly funded consortia and directing time and resources to scientific endeavors.
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Affiliation(s)
- Linda Brubaker
- UC San Diego School of Medicine, University of California San Diego, La Jolla, California
| | - Jesse Nodora
- UC San Diego School of Medicine, University of California San Diego, La Jolla, California
| | | | - John Connett
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Amy M. Claussen
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Cora E. Lewis
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Kyle Rudser
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, St. Louis, Missouri
| | - Jean F. Wyman
- School of Nursing, University of Minnesota, Minneapolis, Minnesota
| | - Janis M. Miller
- School of Nursing, University of Michigan, Ann Arbor, Michigan
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Markland AD, Hellemann G, Shan L, Brady SS, Huling JD, Schreiner PJ, Sidney S, Van Den Eeden SK, Lewis CE. Characterizing the spectrum of bladder health and lower urinary tract symptoms among men: Results from the CARDIA study. Neurourol Urodyn 2024; 43:840-848. [PMID: 38407331 PMCID: PMC11031325 DOI: 10.1002/nau.25430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/31/2024] [Accepted: 02/12/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES To operationalize a new definition for bladder health, we examined the distribution and impact of lower urinary tract symptoms (LUTS), along with risk factors, among men in the Coronary Artery Risk Development in Young Adults (CARDIA) study. METHODS LUTS were defined by American Urologic Association Symptom Index (AUASI) scores and impact on quality of life (QoL). Separate questions assessed urinary incontinence (UI) and postvoid dribbling. We performed cluster analyses using AUASI scores, with and without urine incontinence and postvoid dribbling, and impact collected in 2010-11. We performed analyses to evaluate sociodemographic and cardiovascular risk factors between clusters. RESULTS Among CARDIA men (mean age: 50.0, SD = 3.6; range: 42-56 years) with complete LUTS data (n = 929), we identified and compared four clusters: men who reported no or very mild symptoms and no impact on well-being (bladder health, n = 696, 75%), men with moderate symptoms and moderate impact on well-being (moderate symptoms/impact, n = 84, 9%), men with high symptoms and high impact on well-being (severe symptoms/impact, n = 117, 13%), and a separate group that reported moderate symptoms and UI with a high impact on well-being (UI + moderate symptoms/severe impact, n = 32, 3%). Exploration of the groupings showed a large percentage of postvoid dribbling across groups (overall 69%). Sociodemographic and cardiovascular risk factors were not associated with symptom/impact groups. CONCLUSIONS Bladder health clustered into four categories. A majority of middle-aged men in the community showed no or mild bladder symptoms without impact on QoL. Postvoid dribbling is pervasive but did not cluster with a specific LUTS or impact category.
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Affiliation(s)
- Alayne D Markland
- Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Birmingham, Alabama, USA
- Heersink School of Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Gerhard Hellemann
- School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Liang Shan
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sonya S Brady
- School of Public Health, Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jared D Huling
- School of Public Health, Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Pamela J Schreiner
- School of Public Health, Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Stephen Sidney
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | | | - Cora E Lewis
- School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Williams BR, Brady SS, Levin EC, Brown O, Lipman TH, Klusaritz H, Nodora J, Coyne-Beasley T, Putnam S, Gahagan S, Burgio KL. Black women's perspectives on bladder health: Social-ecological and life course contexts. Neurourol Urodyn 2024; 43:849-861. [PMID: 38451032 DOI: 10.1002/nau.25437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/21/2024] [Accepted: 02/19/2024] [Indexed: 03/08/2024]
Abstract
AIMS This paper explores Black women's perspectives on bladder health using a social-ecological conceptual framework and life course perspective. METHODS We conducted a directed content analysis of data from the Study of Habits, Attitudes, Realities, and Experiences (SHARE), a focus group study by the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium. Analysis was conducted on data from five focus groups and a member-checking session where all participants self-identified as Black or African American. RESULTS Forty-two participants aged 11-14 or 45+ years reported life course experiences with their bladder. The intersection of race and gender was the lens through which participants viewed bladder health. Participants' accounts of their perspectives on bladder health explicitly and implicitly revealed structural racism as an explanatory overarching theme. Participants described (a) historically-rooted and still pervasive practices of discrimination and segregation, engendering inequitable access to quality medical care and public facilities, (b) institutional barriers to toileting autonomy in educational and occupational settings, promoting unhealthy voiding habits, (c) internalized expectations of Black women's stereotyped role as family caregiver, compromising caregiver health, (d) lack of reliable information on bladder health, leading to unhealthy bladder behaviors, and (e) potentially stress-related comorbid chronic conditions and associated medication use, causing or exacerbating bladder problems. CONCLUSIONS Bladder health promotion interventions should address social-ecological and life course factors shaping Black women's bladder health, including social and structural barriers to accessing equitable health information and medical care.
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Affiliation(s)
- Beverly R Williams
- 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, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham, Alabama, USA
| | - Sonya S Brady
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Elise C Levin
- Division of Community Health Services, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Oluwateniola Brown
- Division of Female Pelvic Medicine and Reconstructive Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Terri H Lipman
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Heather Klusaritz
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jesse Nodora
- Division of Applied Sciences, Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California, USA
| | - Tamera Coyne-Beasley
- Department of Pediatrics, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA
| | - Sara Putnam
- Division of Biostatistics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Sheila Gahagan
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, California, USA
| | - 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, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham, Alabama, USA
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Smith AL, Berry A, Brubaker L, Cunningham SD, Gahagan S, Low LK, Mueller M, Sutcliffe S, Williams BR, Brady SS. The brain, gut, and bladder health nexus: A conceptual model linking stress and mental health disorders to overactive bladder in women. Neurourol Urodyn 2024; 43:424-436. [PMID: 38078701 PMCID: PMC10872494 DOI: 10.1002/nau.25356] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/28/2023] [Accepted: 11/25/2023] [Indexed: 02/06/2024]
Abstract
OBJECTIVE A small, but growing literature links stressors and mental health disorders (MHDs) across the life course to overactive bladder (OAB) and urinary incontinence symptoms. Mechanisms by which stressors and MHDs may impact bladder health are not fully understood, limiting novel prevention and treatment efforts. Moreover, potential biopsychosocial mechanisms involving the brain and gut have not been considered in an integrated, comprehensive fashion. METHODS Members of the prevention of lower urinary tract symptoms Research Consortium developed conceptual models to inform research on biopsychosocial mechanisms through which stress and MDHs may impact bladder health among girls and women, focusing on brain and gut physiology. RESULTS Two conceptual models were developed-one to explain central (brain-based) and peripheral (gut-based) mechanisms linking stressors and MHDs to OAB and bladder health, and one to highlight bidirectional communication between the brain, gut, and bladder. Traumatic events, chronic stressors, and MHDs may lead to a maladaptive stress response, including dysregulated communication and signaling between the brain, gut, and bladder. Gut bacteria produce molecules and metabolites that alter production of neurotransmitters, amino acids, short-chain fatty acids, and inflammatory immune response molecules that mediate communication between the gut and brain. Microbiota signal neurogenesis, microglia maturation, and synaptic pruning; they also calibrate brain-gut-bladder axis communication through neurotransmission and synaptogenesis, potentially influencing bladder symptom development. Life course trajectories of risk may be prevented or interrupted by central and peripheral resources for neuropsychological resilience. CONCLUSIONS Depicted pathways, including brain-gut-bladder communication, have implications for research and development of novel prevention and treatment approaches.
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Affiliation(s)
- Ariana L. Smith
- Division of Urology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Amanda Berry
- Division of Urology, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Linda Brubaker
- Department of Obstetrics, Gynecology, and Reproductive Sciences, UC San Diego School of Medicine, University of California San Diego, La Jolla, California
| | - Shayna D. Cunningham
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT
| | - Sheila Gahagan
- Department of Pediatrics, UC San Diego School of Medicine, University of California, San Diego CA
| | - Lisa Kane Low
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan
| | - Margaret Mueller
- Department of Ob/Gyn, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, St. Louis, MO
| | - Beverly R. Williams
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, University of Alabama at Birmingham (UAB) and Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs
| | - Sonya S. Brady
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN
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Cunningham SD, Lindberg S, Joinson C, Shoham D, Chu H, Newman D, Epperson N, Brubaker L, Low L, Camenga DR, Yvette LaCoursiere D, Meister M, Kenton K, Sutcliffe S, Markland AD, Gahagan S, Coyne-Beasley T, Berry A. Association Between Maternal Depression and Lower Urinary Tract Symptoms in Their Primary School-Age Daughters: A Birth Cohort Study. J Wound Ostomy Continence Nurs 2024; 51:53-60. [PMID: 38215298 PMCID: PMC10794027 DOI: 10.1097/won.0000000000001039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2024]
Abstract
PURPOSE Although maternal depression is associated with adverse outcomes in women and children, its relationship with lower urinary tract symptoms (LUTS) in offspring is less well-characterized. We examined the association between prenatal and postpartum maternal depression and LUTS in primary school-age daughters. DESIGN Observational cohort study. SUBJECTS AND SETTING The sample comprised 7148 mother-daughter dyads from the Avon Longitudinal Study of Parents and Children. METHOD Mothers completed questionnaires about depressive symptoms at 18 and 32 weeks' gestation and 21 months postpartum and their children's LUTS (urinary urgency, nocturia, and daytime and nighttime wetting) at 6, 7, and 9 years of age. Multivariable logistic regression models were used to estimate the association between maternal depression and LUTS in daughters. RESULTS Compared to daughters of mothers without depression, those born to mothers with prenatal and postpartum depression had higher odds of LUTS, including urinary urgency (adjusted odds ratio [aOR] range = 1.99-2.50) and nocturia (aOR range = 1.67-1.97) at 6, 7, and 9 years of age. Additionally, daughters born to mothers with prenatal and postpartum depression had higher odds of daytime wetting (aOR range = 1.81-1.99) and nighttime wetting (aOR range = 1.63-1.95) at 6 and 7 years of age. Less consistent associations were observed for depression limited to the prenatal or postpartum periods only. CONCLUSIONS Exposure to maternal depression in the prenatal and postpartum periods was associated with an increased likelihood of LUTS in daughters. This association may be an important opportunity for childhood LUTS prevention. Prevention strategies should reflect an understanding of potential biological and environmental mechanisms through which maternal depression may influence childhood LUTS.
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Affiliation(s)
- Shayna D. Cunningham
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT
| | - Sarah Lindberg
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN
| | - Carol Joinson
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, England
| | - David Shoham
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN
| | - Haitao Chu
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN
| | - Diane Newman
- Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Neill Epperson
- Department of Psychiatry, University of Colorado, Aurora, CO
| | - Linda Brubaker
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, San Diego, CA
| | - Lisa Low
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI
| | - Deepa R. Camenga
- Department of Pediatrics, Yale School of Medicine, New Haven, CT
| | - D. Yvette LaCoursiere
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, San Diego, CA
| | - Melanie Meister
- Department of Obstetrics and Gynecology, University of Kansas, Kansas City, KS
| | - Kimberly Kenton
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, and the Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO
| | - Alayne D. Markland
- Department of Medicine and the Birmingham/Atlanta Geriatrics Research Education and Clinical Center, University of Alabama at Birmingham, Birmingham, AL
| | - Sheila Gahagan
- Department of Pediatrics, University of California San Diego, La Jolla, CA
| | - Tamera Coyne-Beasley
- Departments of Pediatrics and Internal Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Amanda Berry
- Division of Urology, Children’s Hospital of Philadelphia, Philadelphia, PA
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Parlas M, Bilgiç D, Dişsiz M. Reliability and validity of the Toileting Behaviors-Women's Elimination Behaviors scale in a Turkish pregnant population. Int Urogynecol J 2023; 34:2125-2132. [PMID: 37004519 DOI: 10.1007/s00192-023-05511-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/02/2023] [Indexed: 04/04/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Toileting behaviors are related to lower urinary tract symptoms and bladder dysfunction and are an important factor affecting bladder health. The aim of this study was to translate the Toileting Behaviors-Women's Elimination Behaviors (TB-WEB) Scale into Turkish and to validate its internal consistency, test-retest reliability, and construct and criterion validity for use in Turkish pregnant women. METHOD The research was conducted with 226 pregnant women who presented to the antenatal outpatient clinics of a university hospital in Türkiye for antenatal follow-up. Data were collected using a sociodemographic questionnaire prepared by the researchers and the TB-WEB Scale. Descriptive data were analyzed using numbers, percentage and mean values, whereas psychometric analysis of the scale was performed using semantic equivalence, content validity, explanatory and confirmatory factor analysis, Cronbach's α, item-total correlation, and test-retest analysis. RESULTS The scale consisted of 20 items and five subscales. The content validity index of the items was found to be 93%. Cronbach's α coefficient was found to be 0.77 for the whole scale; 0.60 for the place preference for voiding subscale; 0.73 for the premature voiding subscale; 0.84 for the delayed voiding subscale; 0.83 for the straining voiding subscale; and 0.88 for the position preference for voiding subscale. The scale mediates 62% of the total variance. Confirmatory factor analysis found that item factor loadings varied between 0.31 and 0.99 and root mean square error of approximation (RMSEA) value was found 0.078. CONCLUSION The Turkish version of the TB-WEB Scale is a valid and reliable instrument in evaluating women's toileting behaviors during pregnancy.
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Affiliation(s)
- Manolya Parlas
- Department of Gynecological and Obstetrical Nursing, Dokuz Eylul University Faculty of Nursing, Izmir, Türkiye.
| | - Dilek Bilgiç
- Department of Gynecological and Obstetrical Nursing, Dokuz Eylul University Faculty of Nursing, Izmir, Türkiye
| | - Melike Dişsiz
- Department of Gynecological and Obstetrical Nursing, Health Sciences University Hamidiye Faculty of Nursing, Istanbul, Türkiye
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LaCoursiere DY, Kane Low L, Putnam S, Wyman JF, Newman DK, Cunningham S, Rickey L, Berry A, Gahagan S, Vaughan CP, Brown O, Brady SS. Development of a tool to assess bladder health knowledge, attitudes, and beliefs (BH-KAB). Neurourol Urodyn 2023; 42:1055-1067. [PMID: 36905331 PMCID: PMC10293102 DOI: 10.1002/nau.25168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 02/20/2023] [Accepted: 02/25/2023] [Indexed: 03/12/2023]
Abstract
INTRODUCTION Few instruments measure knowledge, attitudes, and beliefs (KAB) related to bladder health. Existing questionnaires have predominantly focused on KAB related to specific conditions such as urinary incontinence, overactive bladder, and other pelvic floor disorders. To address this literature gap, the Prevention of Lower Urinary Tract Symptoms (PLUS) research consortium developed an instrument that is being administered in the baseline assessment of the PLUS RISE FOR HEALTH longitudinal study. METHODS The bladder health knowledge, attitudes, and beliefs (BH-KAB) instrument development process consisted of two phases, item development and evaluation. Item development was guided by a conceptual framework, review of existing KAB instruments, and a review of qualitative data from the PLUS consortium Study of Habits, Attitudes, Realities, and Experiences (SHARE). Evaluation comprised three methods to assess content validity and reduce and refine items: q-sort, e-panel survey, and cognitive interviews. RESULTS The final 18-item BH-KAB instrument assesses self-reported bladder knowledge; perceptions of bladder function, anatomy, and related medical conditions; attitudes toward different patterns of fluid intake, voiding, and nocturia; the potential to prevent or treat urinary tract infections and incontinence; and the impact of pregnancy and pelvic muscle exercises on bladder health. CONCLUSION The PLUS BH-KAB instrument may be used independently or in conjunction with other KAB instruments for a more comprehensive assessment of women's KAB related to bladder health. The BH-KAB instrument can inform clinical conversations, health education programming, and research examining potential determinants of bladder health, LUTS, and related behavioral habits (e.g., toileting, fluid intake, pelvic muscle exercises).
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Affiliation(s)
- Daphne Yvette LaCoursiere
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Diego, La Jolla, California, USA
| | - Lisa Kane Low
- School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Sara Putnam
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Jean F Wyman
- School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA
| | - Diane K Newman
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Shayna Cunningham
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Leslie Rickey
- Yale School of Medicine, New Haven, Connecticut, USA
| | - Amanda Berry
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Sheila Gahagan
- Department of Pediatrics, University of California, San Diego, California, USA
| | - Camille P Vaughan
- Department of Veterans Affairs Birmingham, Atlanta Geriatric Research, Education, and Clinical Center, Atlanta, Georgia, USA
- Department of Medicine, Division of Geriatrics & Gerontology, Emory University, Atlanta, Georgia, USA
| | - Oluwateniola Brown
- Division of Female Pelvic Medicine and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sonya S Brady
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
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Smith AL, Rudser K, Harlow BL, McGwin G, Barthold J, Brady SS, Brubaker L, Cunningham SD, Griffith JW, Kenton K, Klusaritz H, Lewis CE, Lukacz ES, Maki J, Markland AD, Mueller ER, Newman DK, Nodora J, Rickey LM, Rockwood T, Simon M, Wyman JF, Sutcliffe S. RISE FOR HEALTH: Rationale and protocol for a prospective cohort study of bladder health in women. Neurourol Urodyn 2023; 42:998-1010. [PMID: 36321762 PMCID: PMC10151425 DOI: 10.1002/nau.25074] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/09/2022] [Accepted: 10/16/2022] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The spectrum of bladder health and the factors that promote bladder health and prevent lower urinary tract symptoms (LUTS) among women are not well understood. This manuscript describes the rationale, aims, study design, sampling strategy, and data collection for the RISE FOR HEALTH (RISE) study, a novel study of bladder health in women conducted by the Prevention of Lower Urinary Tract Symptom (PLUS) Research Consortium. METHODS AND RESULTS RISE is a population-based, multicenter, prospective longitudinal cohort study of community-dwelling, English- and Spanish-speaking adult women based in the United States. Its goal is to inform the distribution of bladder health and the individual factors (biologic, behavioral, and psychosocial) and multilevel factors (interpersonal, institutional, community, and societal) that promote bladder health and/or prevent LUTS in women across the life course. Key study development activities included the: (1) development of a conceptual framework and philosophy to guide subsequent activities, (2) creation of a study design and sampling strategy, prioritizing diversity, equity, and inclusion, and (3) selection and development of data collection components. Community members and cross-cultural experts shaped and ensured the appropriateness of all study procedures and materials. RISE participants will be selected by simple random sampling of individuals identified by a marketing database who reside in the 50 counties surrounding nine PLUS clinical research centers. Participants will complete self-administered surveys at baseline (mailed paper or electronic) to capture bladder health and LUTS, knowledge about bladder health, and factors hypothesized to promote bladder health and prevent LUTS. A subset of participants will complete an in-person assessment to augment data with objective measures including urogenital microbiome specimens. Initial longitudinal follow-up is planned at 1 year. DISCUSSION Findings from RISE will begin to build the necessary evidence base to support much-needed, new bladder health promotion and LUTS prevention interventions in women.
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Affiliation(s)
- Ariana L. Smith
- University of Pennsylvania, Perelman School of Medicine, Division of Urology, Philadelphia, Pennsylvania
| | - Kyle Rudser
- University of Minnesota, Division of Biostatistics, Minneapolis, Minnesota, United States
| | - Bernard L Harlow
- Boston University School of Public Health, Department of Epidemiology, Boston, Massachusetts
| | - Gerald McGwin
- University of Alabama at Birmingham, Department of Epidemiology, Birmingham, Alabama
| | - Julia Barthold
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda MD
| | - Sonya S. Brady
- University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, Minnesota
| | - Linda Brubaker
- University of California San Diego, Department of Obstetrics, Gynecology, and Reproductive Sciences, UC San Diego School of Medicine, La Jolla, California
| | - Shayna D. Cunningham
- University of Connecticut, School of Medicine, Department of Public Health Sciences, Farmington, Connecticut
| | - James W. Griffith
- Northwestern University, Feinberg School of Medicine, Department of Medical Social Sciences, Chicago, Illinois
| | - Kim Kenton
- Northwestern University, Feinberg School of Medicine, Department of Obstetrics and Gynecology, Chicago, Illinois
| | - Heather Klusaritz
- University of Pennsylvania, Perelman School of Medicine, Department of Family Medicine and Community Health, Philadelphia, Pennsylvania
| | - Cora E. Lewis
- University of Alabama at Birmingham, Department of Epidemiology, Birmingham, Alabama
| | - Emily S. Lukacz
- University of California San Diego, Department of Obstetrics, Gynecology, and Reproductive Sciences, UC San Diego School of Medicine, La Jolla, California
| | - Julia Maki
- Washington University in St. Louis, Division of Public Health Sciences, Department of Surgery, St. Louis, Missouri
| | - Alayne D. Markland
- University of Alabama at Birmingham, Department of Medicine, Birmingham, Alabama and Birmingham VA Medical Center Birmingham, Alabama
| | - Elizabeth R. Mueller
- Loyola University Chicago, Department of Obstetrics, Gynecology and Urology, Maywood, Illinois
| | - Diane K. Newman
- University of Pennsylvania, Perelman School of Medicine, Division of Urology, Philadelphia, Pennsylvania
| | - Jesse Nodora
- University of California San Diego, Herbert Wertheim School of Public Health & Human Longevity Science, La Jolla, California
| | | | - Todd Rockwood
- University of Minnesota, Division of Health Policy and Management, Minneapolis, Minnesota
| | - Melissa Simon
- Northwestern School of Medicine, Department of Obstetrics and Gynecology, Chicago, Illinois
| | - Jean F. Wyman
- University of Minnesota, School of Nursing, Minneapolis, Minnesota, United States
| | - Siobhan Sutcliffe
- Washington University in St. Louis, Division of Public Health Sciences, Department of Surgery, St. Louis, Missouri, United States
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Camenga DR, Wang Z, Chu H, Lindberg S, Sutcliffe S, Brady SS, Coyne-Beasley T, Fitzgerald CM, Gahagan S, Low LK, LaCoursiere DY, Lavender M, Smith AL, Stapleton A, Harlow BL. Sexual Health Behaviors by Age 17 and Lower Urinary Tract Symptoms at Age 19: PLUS Research Consortium Analysis of ALSPAC Data. J Adolesc Health 2023; 72:737-745. [PMID: 36781327 PMCID: PMC10826680 DOI: 10.1016/j.jadohealth.2022.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 12/05/2022] [Accepted: 12/07/2022] [Indexed: 02/13/2023]
Abstract
PURPOSE We examined how antecedent sexual health factors affect lower urinary tract symptoms (LUTS) in adolescent women. METHODS We analyzed 1,941 adolescent women from the Avon Longitudinal Study of Parents and Children at age 19. At ages 15 and 17, participants reported use of oral contraceptives (OCs), history of sexual intercourse, number of sexual partners, and condom use. At age 19, The Bristol Female Lower Urinary Tract Symptoms questionnaire quantified the frequency over the past month: stress incontinence, any incontinence, urgency, sensation of incomplete emptying, bladder pain, and urinary tract infection. Multivariable regression models examined associations between sexual health behaviors reported at ages 15 and 17 and six LUTS reported at age 19, after controlling for covariates. RESULTS Commonly reported LUTS at age 19 were past-month stress incontinence (26.8%), bladder pain (26.3%), any urine leakage (22.1%), and urinary tract infection (15.4%). OC use by age 17 was associated with urgency (odds ratio [OR] = 1.62, 95% confidence interval [CI] 1.19-2.20), incomplete emptying (OR = 1.62, 95% CI = 1.17-2.26), bladder pain (OR = 1.45, 95% CI = 1.15-1.83), and urinary tract infections (OR = 1.68, 95% CI = 1.28-2.21) at age 19 after adjustment for covariates. However, associations were attenuated after adjustment for condom use and number of sexual partners. Sexual intercourse by age 17 was associated with 1.53-2.65 increased odds of LUTs categories except incontinence, with lower confidence interval boundaries > 1.0. Associations were stronger among women with ≥ 3 sexual partners (vs. 0) by age 17. DISCUSSION We found longitudinally assessed associations between OC use, sexual intercourse, and number of sexual partners during adolescence and LUTS at age 19.
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Affiliation(s)
- Deepa R Camenga
- Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut
| | - Zhenxun Wang
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneaspolis, Minnesota
| | - Haitao Chu
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneaspolis, Minnesota
| | - Sarah Lindberg
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneaspolis, Minnesota
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Sonya S Brady
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota
| | - Tamera Coyne-Beasley
- Division of Adolescent Medicine, Departments of Pediatrics and Internal Medicine, University of Alabama at Birmingham Medical School, Birmingham, Alabama
| | - Colleen M Fitzgerald
- Department of Obstetrics and Gynecology, Loyola University Chicago Stritch School of Medicine, Chicago, Illinois
| | - Sheila Gahagan
- Division of Academic General Pediatrics, University of California San Diego School of Medicine, San Diego, California
| | - Lisa Kane Low
- Department Obstetrics and Gynecology, University of Michigan School of Nursing, Women's and Gender Studies, Ann Arbor, Michigan
| | - D Yvette LaCoursiere
- Department of Obstetrics and Gynecology, University of California San Diego, La Jolla, California
| | | | - Ariana L Smith
- Division of Urology, Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Ann Stapleton
- Division of Allergy & Infectious Disease, Department of Medicine, University of Washington, Seattle, Washington
| | - Bernard L Harlow
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts.
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Constantine ML, Rockwood TH, Rickey LM, Bavendam T, Low LK, Lowder JL, Markland AD, McGwin G, Mueller ER, Newman DK, Putnam S, Rudser K, Smith AL, Stapleton AE, Miller JM, Lukacz ES. Validation of bladder health scales and function indices for women's research. Am J Obstet Gynecol 2023; 228:566.e1-566.e14. [PMID: 36596439 PMCID: PMC10425263 DOI: 10.1016/j.ajog.2022.12.319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/15/2022] [Accepted: 12/21/2022] [Indexed: 01/02/2023]
Abstract
BACKGROUND Existing bladder-specific measures lack the ability to assess the full range of bladder health, from poor to optimal health. OBJECTIVE This study aimed to report evidence of validity of the self-administered, multidimensional bladder health scales and function indices for research in adult women. STUDY DESIGN A cross-sectional population-based validation study with random assignment to paper or electronic administration was conducted using national address-based probability sampling supplemented by purposive sampling of women with lower urinary tract symptoms in 7 clinical research centers. Construct validity of the bladder health scales and function indices was guided by a multitrait-multimethod approach using health and condition-specific questionnaires, bladder diaries, expert ratings of bladder health, and noninvasive bladder function testing. Internal dimensional validity was evaluated using factor analysis; internal reliability was assessed using paired t-tests and 2-way mixed-effects intraclass correlation coefficient models. Chi-square, Fisher exact, or t-tests were used for mode comparisons. Convergent validity was evaluated using Pearson correlations with the external construct measures, and known-group validity was established with comparison of women known and unknown to be symptomatic of urinary conditions. RESULTS The sample included 1072 participants. Factor analysis identified 10 scales, with Cronbach's alpha ranging from 0.74 to 0.94. Intraclass correlation coefficients of scales ranged from 0.55 to 0.94. Convergent validity of the 10 scales and 6 indices ranged from 0.52 to 0.83. Known-group validity was confirmed for all scales and indices. Item distribution was similar by mode of administration. CONCLUSION The paper and electronic forms of the bladder health scales and function indices are reliable and valid measures of bladder health for use in women's health research.
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Affiliation(s)
- Melissa L Constantine
- Division of Biostatistics, University of Minnesota, Minneapolis, MN; Patient Centered Research, Evidera, Bethesda, MD.
| | - Todd H Rockwood
- Department of Health Policy, University of Minnesota, Minneapolis, MN
| | - Leslie M Rickey
- Departments of Urology and Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT
| | - Tamara Bavendam
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | - Lisa Kane Low
- School of Nursing, University of Michigan, Ann Arbor, MI
| | - Jerry L Lowder
- Department of Obstetrics and Gynecology, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO
| | - Alayne D Markland
- Division of Gerontology, Geriatrics and Palliative Care, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL
| | - Gerald McGwin
- School of Public Health, The University of Alabama at Birmingham, Birmingham, AL
| | - Elizabeth R Mueller
- Departments of Urology and Obstetrics and Gynecology, Loyola University Medical Center, Loyola University Chicago, Chicago, IL
| | - Diane K Newman
- Division of Urology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Sara Putnam
- Division of Biostatistics, University of Minnesota, Minneapolis, MN
| | - Kyle Rudser
- Division of Biostatistics, University of Minnesota, Minneapolis, MN
| | - Ariana L Smith
- Division of Urology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Ann E Stapleton
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA
| | - Janis M Miller
- School of Nursing, University of Michigan, Ann Arbor, MI
| | - Emily S Lukacz
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Diego, La Jolla, CA.
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12
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LUKACZ ES, FALKE C, GEYNISMAN-TAN J, WYMAN JF, MUELLER ER, MARKLAND AD, RICKEY L, LOWDER JL, RUDSER K, LOW LKANE, NEWMAN DK. Healthy bladder storage and emptying functions in community-dwelling women measured by a 2-day bladder health diary. Neurourol Urodyn 2023; 42:725-735. [PMID: 36891924 PMCID: PMC10101892 DOI: 10.1002/nau.25169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/08/2023] [Accepted: 02/25/2023] [Indexed: 03/10/2023]
Abstract
INTRODUCTION The prevalence of healthy bladder storage and emptying function in community-dwelling women is not well established. METHODS A planned secondary analysis of a US cross-sectional study designed to validate a bladder health instrument was conducted in women aged ≥18 years. A subset was invited to complete the novel 2-day bladder health diary capturing bladder storage and emptying experiences. Overall healthy bladder function was defined as ≤8 waking/daytime voids and ≤1 void during sleeping/nighttime; along with the absence of leakage, urgency, emptying difficulties (initiation, flow, efficacy, relief of urge sensation) and pain. Descriptive statistics of healthy bladder functions and regression models of factors associated with healthy function are reported. RESULTS Of the 383 invited, 237 (62%) eligible women returned complete dairies. Of these, 12% (29/237) met criteria for overall healthy bladder function. Most (96%) denied pain, 74% had healthy daytime and 83% had healthy nighttime voiding frequency, 64% were continent, 36% reported healthy emptying and 30% denied any urgency episodes. Middle income (odds ratio [OR]:95% confidence interval [CI] = 11.4:1.9-67.4 for $75k-$99 999 vs. $25 000-$49 999), Graduate education (4.8:1.4-17) and previously seeking treatment for bladder problems (OR:95%CI = 0.1; 0-0.9) were associated with overall healthy function. CONCLUSION The prevalence of overall healthy bladder function was very low based on our strict definition of health as measured on a 2-day diary. However, most women had healthy voiding frequency and denied pain or urinary leakage. Postvoid dribbling and urgency most commonly contributed to an overall unhealthy bladder. Further investigation is needed to determine whether these diary derived measures are meaningful for patient-oriented bladder health research.
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Affiliation(s)
- Emily S. LUKACZ
- University of California San Diego, Department of Obstetrics, Gynecology & Reproductive Sciences, La Jolla, CA
| | - Chloe FALKE
- Division of Biostatistics, University of Minnesota, Minneapolis, MN
| | - Julia GEYNISMAN-TAN
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL
| | - Jean F. WYMAN
- School of Nursing, University of Minnesota, Minneapolis, MN
| | - Elizabeth R MUELLER
- Departments of Urology & Obstetrics/Gynecology, Loyola University Medical Center, Loyola University, Chicago, IL
| | - Alayne D. MARKLAND
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, University of Alabama at Birmingham, Birmingham, AL and the Birmingham/Atlanta Geriatric Research, Education, and Clinical Center
| | - Leslie RICKEY
- Departments of Urology & Obstetrics/Gynecology, Yale University School of Medicine, New Haven, CT
| | - Jerry L. LOWDER
- Department of Obstetrics and Gynecology, Washington University in St Louis School of Medicine, St Louis, MO
| | - Kyle RUDSER
- Division of Biostatistics, University of Minnesota, Minneapolis, MN
| | - Lisa KANE LOW
- School of Nursing, University of Michigan, Ann Arbor, MI
| | - Diane K. NEWMAN
- Division of Urology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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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] [What about the content of this article? (0)] [Affiliation(s)] [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
- Address correspondence to: Kathryn L. Burgio, PhD, Department of Veterans Affairs, Geriatric Research, Education, and Clinical Center (GRECC), Birmingham VA Medical Center, 11G, 700 South 19th Street, Birmingham, AL 35233, 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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Newman DK, Lowder JL, Meister M, Low LK, Fitzgerald CM, Fok CS, Geynisman-Tan J, Lukacz ES, Markland A, Putnam S, Rudser K, Smith AL, Miller JM. Comprehensive pelvic muscle assessment: Developing and testing a dual e-Learning and simulation-based training program. Neurourol Urodyn 2023. [PMID: 36626146 DOI: 10.1002/nau.25125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 12/04/2022] [Accepted: 12/16/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The Prevention of Lower Urinary Tract Symptoms (PLUS) research consortium launched the RISE FOR HEALTH (RISE) national study of women's bladder health which includes annual surveys and an in-person visit. For the in-person exam, a standardized, replicable approach to conducting a pelvic muscle (PM) assessment was necessary. The process used to develop the training, the products, and group testing results from the education and training are described. METHODS A comprehensive pelvic muscle assessment (CPMA) program was informed by literature view and expert opinion. Training materials were prepared for use on an electronicLearning (e-Learning) platform. An in-person hands-on simulation and certification session was then designed. It included a performance checklist assessment for use by Clinical Trainers, who in collaboration with a gynecology teaching assistant, provided an audit and feedback process to determine Trainee competency. RESULTS Five discrete components for CPMA training were developed as e-Learning modules. These were: (1) overview of all the clinical measures and PM anatomy and examination assessments, (2) visual assessment for pronounced pelvic organ prolapse, (3) palpatory assessment of the pubovisceral muscle to estimate muscle integrity, (4) digital vaginal assessment to estimate strength, duration, symmetry during PM contraction, and (5) pressure palpation of both myofascial structures and PMs to assess for self-report of pain. Seventeen Trainees completed the full CPMA training, all successfully meeting the a priori certification required pass rate of 85% on checklist assessment. CONCLUSIONS The RISE CPMA training program was successfully conducted to assure standardization of the PM assessment across the PLUS multicenter research sites. This approach can be used by researchers and healthcare professionals who desire a standardized approach to assess competency when performing this CPMA in the clinical or research setting.
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Affiliation(s)
- Diane K Newman
- Division of Urology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jerry L Lowder
- Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Melanie Meister
- Department of Obstetrics and Gynecology, University of Kansas, Kansas City, Kansas, USA
| | - Lisa K Low
- School of Nursing, University of Michigan, Ann Arbor Michigan, USA
| | - Colleen M Fitzgerald
- Department of Obstetrics and Gynecology, Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois, USA
| | - Cynthia S Fok
- Department of Urology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Julia Geynisman-Tan
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Emily S Lukacz
- Department of Obstetrics, Gynecology, and Reproductive Sciences, UC San Diego School of Medicine, University of California San Diego, La Jolla, California, USA
| | - Alayne Markland
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham, Alabama, USA
| | - Sara Putnam
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Kyle Rudser
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ariana L Smith
- Division of Urology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Janis M Miller
- School of Nursing, University of Michigan, Ann Arbor Michigan, USA
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Smoyer AB, Pittman A, Borzillo P. Humans peeing: Justice-involved women's access to toilets in public spaces. PLoS One 2023; 18:e0282917. [PMID: 36897925 PMCID: PMC10004595 DOI: 10.1371/journal.pone.0282917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 02/24/2023] [Indexed: 03/11/2023] Open
Abstract
Justice-involved women face myriad challenges as they negotiate the terms of community supervision and manage the long-term implications and stigma of living with a criminal record. Major tasks that women juggle include securing safe, affordable housing, finding and retaining employment, accessing physical and mental health care (including substance use treatment), and handling relationships with family, friends, children, and intimate partners. In addition to these responsibilities, women must meet their basic physiological needs to eat, sleep, and use the toilet. Women's ability to safely meet their personal care needs may impact their capacity to manage their criminal-legal challenges. This study uses qualitative methods to understand justice-involved women's lived experiences related to urination. Specifically, the study reports on a thematic analysis of 8 focus groups conducted with justice-involved women (n = 58) and the results of a toilet audit conducted in the downtown areas of the small city in the United States where the focus group participants were living. Findings suggest that women had limited access to restrooms and reported urinating outside. Lack of restroom access impacted their engagement with social services support and employment and their ability to travel through public spaces. Women perceived their public toilet options as unsafe, increasing their sense of vulnerability and reinforcing the idea that they did not have full access to citizenship in the community because of their criminal-legal involvement. The exclusion and denial of women's humanity that is perpetuated by a lack of public toilet access impacts women's psychosocial outcomes. City governments, social service agencies, and employers are encouraged to consider how lack of toilet access may impact their public safety and criminal-legal objectives and expand opportunities for people to access safe restroom facilities.
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Affiliation(s)
- Amy B. Smoyer
- Department of Social Work, College of Health and Human Services, Southern Connecticut State University, New Haven, Connecticut, United States of America
- * E-mail:
| | - Adam Pittman
- Department of Sociology, College of Arts and Sciences, Southern Connecticut State University, New Haven, Connecticut, United States of America
| | - Peter Borzillo
- Department of Curriculum and Learning, College of Education, Southern Connecticut State University, New Haven, Connecticut, United States of America
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Yavuz A, Kocaöz S, Kara P, Destegül E. The effects of gestational diabetes on lower urinary tract symptoms of pregnant women: a case-control study. J OBSTET GYNAECOL 2022; 42:3531-3536. [PMID: 36476042 DOI: 10.1080/01443615.2022.2152657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Gestational diabetes mellitus (GDM) and lower urinary tract symptoms (LUTS) are common health problems in pregnant women. The aim of this case-control study was to evaluate the effects of GDM on LUTS in pregnant women. This study was conducted with 44 pregnant women diagnosed with GDM and 44 pregnant without GDM. Patients with GDM had significantly lower likelihood of experiencing urgency (7.069-fold lower likelihood); whereas they had significantly greater likelihoods for urinary incontinence (UI) during sexual intercourse (OR: 0.185; 5.4-fold higher), need for clothing change due to UI (OR: 0.268; 3.7-fold higher), and adverse effects on daily life due to UI (OR: 0.338; 2.9-fold higher) compared to women without GDM (p < .05 for all). Although pregnant women with GDM appear to have a lower likelihood of urgency, this may be associated with the adverse effects of GDM since the likelihoods for UI-related outcomes were increased and quality of life was reduced among pregnant women with GDM compared to those without GDM.Impact statementWhat is already known on this subject? Lower urinary tract symptoms (LUTS) are very common among pregnant women, and negatively affect social, sexual and working life. There are many risk factors that affect the development of LUTS in pregnant women. It is stated that gestational diabetes mellitus (GDM) may be a predisposing factor in the development of LUTS in women.What do the results of this study add? Women with GDM experienced storage symptoms at a lower frequency (especially urgency) compared to the control group. In addition, we determined worse quality of life among women with GDM who experienced a greater frequency of urinary incontinence.What are the implications of these findings for clinical practice and/or further research? It may be beneficial to provide training on the prevention and management of LUTS to all pregnant women, especially women with GDM, and to increase the sensitivity of health professionals on the subject.
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Affiliation(s)
- Adem Yavuz
- Department of Obstetrics and Gynecology, Faculty of Medicine, Niğde Ömer Halisdemir University, Niğde, Turkey
| | - Semra Kocaöz
- Department of Obstetrics and Gynecology Nursing, Niğde Ömer Halisdemir University, Zübeyde Hanım Faculty of Health, Niğde, Turkey
| | - Pınar Kara
- Nursing Department, Faculty of Health, Kahramanmaraş İstiklal University, Kahramanmaraş, Turkey
| | - Emre Destegül
- Department of Obstetrics and Gynecology, Adana City Training and Research Hospital, Adana, Turkey
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17
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Williams BR, Burgio KL, Hebert-Beirne J, James A, Kenton K, LaCoursiere DY, Rickey L, Brady SS, Kane Low L, Newman DK. A multisite focus group study of US adult women's beliefs and assumptions about bladder health and function. Neurourol Urodyn 2022; 41:1590-1600. [PMID: 35819129 PMCID: PMC9595129 DOI: 10.1002/nau.25006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/11/2022] [Accepted: 06/23/2022] [Indexed: 11/05/2022]
Abstract
AIMS This analysis explored and characterized the ideas adult women have about how the bladder works, the assumptions guiding their bladder-related behaviors, and the beliefs they hold about how their behaviors affect bladder health. METHODS This was a directed content analysis of qualitative data from the Study of Habits, Attitudes, Realities, and Experiences, a focus group study conducted at seven United States research centers (July 2017 to April 2018). Participants were 316 adult women organized by four age categories (age range: 18-93 years). Analysis and interpretation focused on the "bladder assumptions and beliefs" code using a transdisciplinary lens and inductive approach. RESULTS During their focus group discourse, participants exhibited a speculative mode of thinking about bladder health and function characterized by uncertainty about how the bladder works. They described the bladder as a mechanism for cleansing the body of impurities, viewing it as part of a larger interconnected bodily system to enable the body to stay healthy. They saw it as susceptible to anatomical changes, such as those related to pregnancy and aging. The women also postulated perceived relationships between bladder function and several health behaviors, including eating healthy foods, staying hydrated, engaging in physical activity and exercise, and adopting specific toileting and hygiene practices. CONCLUSIONS The findings underscore the importance of guidance from healthcare professionals and systematic community based educational programs for promoting women's understanding about bladder health and empowering them to exert agency to engage in healthy bladder behaviors.
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Affiliation(s)
- Beverly Rosa Williams
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
- Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham, Alabama, USA
| | - Kathryn L Burgio
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
- Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham, Alabama, USA
| | - Jeni Hebert-Beirne
- School of Public Health, Division of Community Health Sciences, University of Illinois, Chicago, Illinois, USA
| | - Aimee James
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Kimberly Kenton
- Obstetrics & Gynecology, Division of Female Pelvic Medicine & Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Daphne Yvette LaCoursiere
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Diego, San Diego, California, USA
| | - Leslie Rickey
- Departments of Urology and Obstetrics, Gynecology & Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Sonya S Brady
- School of Public Health, Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Lisa Kane Low
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Diane K Newman
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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18
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Gonzalez G, Kuhlmann P, Scott V. Patient Engagement in Management of Recurrent Urinary Tract Infections. Curr Bladder Dysfunct Rep 2022. [DOI: 10.1007/s11884-022-00663-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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19
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Palmer MH. The making of a nurse scientist: A personal narrative. Int J Nurs Sci 2022. [PMID: 36285088 PMCID: PMC9587395 DOI: 10.1016/j.ijnss.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 08/08/2022] [Accepted: 08/16/2022] [Indexed: 11/23/2022] Open
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20
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Rickey LM, Camenga DR, Brady SS, Williams BR, Wyman JF, Brault MA, Smith AL, LaCoursiere DY, James AS, Lavender MD, Low LK. Women’s Knowledge of Bladder Health: What We Have Learned in the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium. Curr Bladder Dysfunct Rep 2022; 17:188-195. [DOI: 10.1007/s11884-022-00655-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Kyaw WT, Sakakibara M. Transdisciplinary Communities of Practice to Resolve Health Problems in Southeast Asian Artisanal and Small-Scale Gold Mining Communities. Int J Environ Res Public Health 2022; 19:5422. [PMID: 35564816 PMCID: PMC9104413 DOI: 10.3390/ijerph19095422] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 04/22/2022] [Accepted: 04/27/2022] [Indexed: 02/05/2023]
Abstract
Artisanal and small-scale gold mining (ASGM) has been a major part of people's livelihood in the rural areas of many developing countries, including those in Southeast Asia (SEA). Nevertheless, because of the use of mercury, ASGM activities have significant local and global adverse impacts on the environment and ASGM community health. Although there have been many monodisciplinary projects by academic researchers and governments to solve the environmental and health problems in SEA ASGM communities, they have not been sufficient to solve the complex socioeconomic problems. This review first outlines the nature of the SEA ASGM activities and the consequent environmental, community health, and socioeconomic problems and then introduces an approach using transdisciplinary communities of practice that involves both academic and nonacademic participants to relieve these wicked ASGM problems and to improve the environmental governance and community health in ASGM communities in SEA.
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Affiliation(s)
- Win Thiri Kyaw
- Research Institute for Humanity and Nature, Kyoto 603-8047, Japan;
| | - Masayuki Sakakibara
- Research Institute for Humanity and Nature, Kyoto 603-8047, Japan;
- Graduate School of Science and Engineering, Ehime University, Matsuyama 790-8577, Japan
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22
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Xu Z, Elrashidy RA, Li B, Liu G. Oxidative Stress: A Putative Link Between Lower Urinary Tract Symptoms and Aging and Major Chronic Diseases. Front Med (Lausanne) 2022; 9:812967. [PMID: 35360727 PMCID: PMC8960172 DOI: 10.3389/fmed.2022.812967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
Aging and major chronic diseases are risk factors for lower urinary tract symptoms (LUTS). On the other hand, oxidative stress (OS) is one of the fundamental mechanisms of aging and the development of chronic diseases. Therefore, OS might be a candidate mechanism linking these two clinical entities. This article aims to summarize the studies on the prevalence of LUTS, the role of OS in aging and chronic diseases, and the potential mechanisms supporting the putative link. A comprehensive literature search was performed to identify recent reports investigating LUTS and OS in major chronic diseases. In addition, studies on the impact of OS on the lower urinary tract, including bladder, urethra, and prostate, were collected and summarized. Many studies showed LUTS are prevalent in aging and major chronic diseases, including obesity, metabolic syndrome, diabetes, cardiovascular disease, hypertension, obstructive sleep apnea, autoimmune diseases, Alzheimer’s disease, and Parkinson’s disease. At the same time, OS is a key component in the pathogenesis of those chronic diseases and conditions. Recent studies also provided evidence that exacerbated OS can cause functional and/or structural changes in the bladder, urethra, and prostate, leading to LUTS. The reviewed data support the concept that OS is involved in multiple risk factors-associated LUTS, although further studies are needed to confirm the causative relationship. The specific ROS/RNS and corresponding reactions/pathways involved in chronic diseases and associated LUTS should be identified in the future and could serve as therapeutic targets.
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Affiliation(s)
- Zhenqun Xu
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, United States
- Department of Urology, Shengjing Hospital, China Medical University, Shenyang, China
| | - Rania A. Elrashidy
- Department of Biochemistry, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
| | - Bo Li
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, United States
- Department of Urology, Shengjing Hospital, China Medical University, Shenyang, China
| | - Guiming Liu
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, United States
- *Correspondence: Guiming Liu,
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23
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Cui Y, Li Q, Wang D, Bao R, Li L, Zhu J, Li J, Li Z, Yin J, Zhou X, Yin H, Sun Z. Does electroacupuncture benefit mixed urinary incontinence? A systematic review and meta-analysis with trial sequential analysis. Int Urogynecol J 2022. [PMID: 35088093 DOI: 10.1007/s00192-021-05057-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/01/2021] [Indexed: 12/28/2022]
Abstract
Introductin and hypothesis Mixed urinary incontinence (MUI) comprises a combination of urgency and stress. The efficacy and safety of electroacupuncture (EA) for the treatment of MUI remain unclear. Objective To assess the efficacy and safety of EA in treating MUI. Methods We searched PubMed, CENTRAL, Embase, Web of Science, four Chinese databases, clinical research registration platforms, grey literature, and the reference lists of the selected studies. Risk of bias and quality were evaluated using the Revman 5.4 and Jadad scores. Meta-analysis was performed using Stata 15.1 software. Trial sequential analysis (TSA) was used to assess the stability of the results. Results Eight randomized controlled trials comprising 847 patients were included. The meta-analysis results showed that compared with antimuscarinic drugs plus pelvic floor muscle training, EA resulted in significantly less pad weight on the 1-h pad test and statistically significantly lower severity scores on the International Consultation on Incontinence Questionnaire Short Form. The change in the 72-h incontinence episode frequency difference was not statistically significant, and there was no outcome of overall response rate and quality of life in this meta-analysis. Few adverse events occurred in the EA group. The TSA results suggested that the result of change from baseline in the 1-h pad test was stable and the evidence was conclusive. Conclusions EA could be a potential treatment option for MUI and is relatively safe. Nevertheless, because of the limitations of this study, our conclusions should be interpreted with caution, and further studies are needed to confirm the comprehensive clinical efficacy and placebo effect of EA.
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24
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Gonzalez G, Vaculik K, Khalil C, Zektser Y, Arnold C, Almario CV, Spiegel B, Anger J. Using Large-scale Social Media Analytics to Understand Patient Perspectives About Urinary Tract Infections: Thematic Analysis. J Med Internet Res 2022; 24:e26781. [PMID: 35076404 PMCID: PMC8826307 DOI: 10.2196/26781] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 10/23/2021] [Accepted: 12/10/2021] [Indexed: 11/19/2022] Open
Abstract
Background Current qualitative literature about the experiences of women dealing with urinary tract infections (UTIs) is limited to patients recruited from tertiary centers and medical clinics. However, traditional focus groups and interviews may limit what patients share. Using digital ethnography, we analyzed free-range conversations of an online community. Objective This study aimed to investigate and characterize the patient perspectives of women dealing with UTIs using digital ethnography. Methods A data-mining service was used to identify online posts. A thematic analysis was conducted on a subset of the identified posts. Additionally, a latent Dirichlet allocation (LDA) probabilistic topic modeling method was applied to review the entire data set using a semiautomatic approach. Each identified topic was generated as a discrete distribution over the words in the collection, which can be thought of as a word cloud. We also performed a thematic analysis of the word cloud topic model results. Results A total of 83,589 posts by 53,460 users from 859 websites were identified. Our hand-coding inductive analysis yielded the following 7 themes: quality-of-life impact, knowledge acquisition, support of the online community, health care utilization, risk factors and prevention, antibiotic treatment, and alternative therapies. Using the LDA topic model method, 105 themes were identified and consolidated into 9 categories. Of the LDA-derived themes, 25.7% (27/105) were related to online community support, and 22% (23/105) focused on UTI risk factors and prevention strategies. Conclusions Our large-scale social media analysis supports the importance and reproducibility of using online data to comprehend women’s UTI experience. This inductive thematic analysis highlights patient behavior, self-empowerment, and online media utilization by women to address their health concerns in a safe, anonymous way.
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Affiliation(s)
- Gabriela Gonzalez
- Department of Urology, Davis School of Medicine, University of California, Davis, Sacramento, CA, United States
| | - Kristina Vaculik
- Cedars-Sinai Center for Outcomes Research and Education, Los Angeles, CA, United States
| | - Carine Khalil
- Cedars-Sinai Center for Outcomes Research and Education, Los Angeles, CA, United States
| | - Yuliya Zektser
- David Geffen School of Medicine, University of California, Los Angeles, CA, United States
| | - Corey Arnold
- Computational Diagnostics, Departments of Radiology and Pathology, University of California, Los Angeles, CA, United States
| | - Christopher V Almario
- Cedars-Sinai Center for Outcomes Research and Education, Los Angeles, CA, United States
| | - Brennan Spiegel
- Cedars-Sinai Center for Outcomes Research and Education, Los Angeles, CA, United States
| | - Jennifer Anger
- Department of Urology, University of California San Diego, La Jolla, CA, United States
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25
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Wu C, Newman D, Palmer MH. Postmenopausal women's adherence to pelvic floor muscle exercises over 2 years. Climacteric 2021; 25:401-406. [PMID: 34881664 DOI: 10.1080/13697137.2021.2006177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study aimed to investigate women's adherence patterns to pelvic floor muscle exercises (PFME), their associated factors and within-pattern changes. METHODS This was a secondary analysis using data collected from 647 women aged 55 years and older in the USA. Women were randomly assigned to either a 2-h class group or an equivalent content 20-min DVD group to receive PFME complemented with adherence enhancement strategies. Adherence was assessed at 3, 12 and 24 months using three self-reported items matching PFME parameters. The k-mean clustering and multinomial logistic regression were used to investigate adherence patterns and their associated factors, respectively. Descriptive statistics were used for within-pattern changes over time. RESULTS Four adherence patterns, A, B, C and D, were identified. Women who displayed optimal adherence to all three aforementioned items, i.e. adherence pattern A, constituted 49.1%, 38.2% and 37.2% of women at 3, 12 and 24 months, respectively. Women with income > US$100,000 were more likely to display adherence pattern A within 12 months. Of women who had adherence pattern A at 3 months, 63.9% and 49.2% continued in this pattern at 12 and 24 months. CONCLUSIONS Fewer than half of women displayed adherence pattern A for 2 years. Early optimal adherence predicted women's subsequent optimal adherence.
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Affiliation(s)
- C Wu
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - D Newman
- Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - M H Palmer
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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26
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Newman DK, Burgio KL, Cain C, Hebert-Beirne J, Low LK, Palmer MH, Smith AL, Rickey L, Rudser K, Gahagan S, Harlow BL, James AS, Lacoursiere DY, Hardacker CT, Wyman JF. Toileting behaviors and lower urinary tract symptoms: A cross-sectional study of diverse women in the United States. International Journal of Nursing Studies Advances 2021; 3. [DOI: 10.1016/j.ijnsa.2021.100052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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27
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Kołodyńska G, Zalewski M, Fink-Lwow F, Mucha A, Andrzejewski W. Quality of Life of Physically Active and Inactive Women Who Are Older after Surgery for Stress Urinary Incontinence Using a Transobturator Tape (TOT). J Clin Med 2021; 10:4761. [PMID: 34682882 DOI: 10.3390/jcm10204761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/29/2021] [Accepted: 10/15/2021] [Indexed: 12/13/2022] Open
Abstract
Urinary incontinence is a major health problem. According to various authors, it concerns 30–40% of the population and grows with age, affecting approximately 50% of women aged over 70. According to the recommendations of the International Continence Society, the treatment of urinary incontinence should commence with conservative treatment and, above all, with physiotherapy. If the conservative treatment fails or the level of urinary incontinence is too high, surgery is recommended. With regard to female patients examined at work, the TOT method was applied. The aim of this study was to assess the relationship between regular physical activity and the quality of life of women aged 65–87 who underwent surgical treatment for stress urinary incontinence (SUI) using the TOT method. The study group involved 60 postmenopausal women, patients of the Department of Gynaecology of the Hospital of Ministry of the Interior and Administration in Wroclaw, with SUI diagnosed during ultrasonography. The female patients were surveyed before and 12 months after the surgery using standardised IPAQ and WHOQOL-BREF.FL questionnaires. Significant positive relationships between quality of life and physical activity before and 12 months after the surgery were demonstrated in the somatic and social domains. Physically active postmenopausal women presented higher values in all domains and total quality of life according to the WHOQOL-BREF compared with physically inactive women, both before and 12 months after the procedure using the TOT method.
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28
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DEĞİRMENCİOĞLU AZ, KOCAÖZ S, ÇIRPAN R. Prevalence of lower urinary tract symptoms and influencing factors in women. Cukurova Medical Journal 2021. [DOI: 10.17826/cumj.908652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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29
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Meister MR, Zhou J, Chu H, Coyne-Beasley T, Gahagan S, Yvette LaCoursiere D, Mueller ER, Scal P, Simon L, Stapleton AE, Stoll CRT, Sutcliffe S, Berry A, Wyman JF. Non-invasive bladder function measures in healthy, asymptomatic female children and adolescents: A systematic review and meta-analysis. J Pediatr Urol 2021; 17:452-462. [PMID: 34090791 PMCID: PMC8502197 DOI: 10.1016/j.jpurol.2021.04.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 01/25/2021] [Accepted: 04/27/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Lower urinary tract symptoms (LUTS) are common in children and adolescents. Non-invasive tests evaluating bladder function are generally preferred over invasive tests, yet few studies have explored the range of normative values for these tests in healthy, asymptomatic children. OBJECTIVE To define normative reference ranges for non-invasive tests of bladder function in healthy, asymptomatic girls and adolescents. STUDY DESIGN A comprehensive search strategy was performed in seven electronic databases through October 2019. English-language studies reporting data on voiding frequency, voided and postvoid residual volumes (PVR) and uroflowmetry results in healthy, asymptomatic girls (mean age ≥ 5 years) were included. Two independent reviewers performed study review, data extraction, and quality assessment. Overall mean estimates and 95% confidence intervals for each bladder function parameter were calculated using random effects models, and 95% normative reference values were estimated. RESULTS Ten studies met eligibility criteria for the meta-analysis (n = 2143 girls, age range: 3-18). Mean estimates of maximum voided volume and PVR were 233.4 ml (95% CI 204.3-262.6; n = 1 study) and 8.6 ml (95% CI 4.8-12.4; n = 2 studies) respectively. Pooled mean estimates for uroflowmetry parameters were: 21.5 ml/s (95% CI 20.5-2.5) for maximum flow rate (n = 6 studies), 12.5 ml/s (95% CI 11.2-13.8) for mean flow rate (n = 6 studies), 6.8 s (95% CI 4.4-9.3) for time to maximum flow (n = 3 studies), 15.7 s (95% CI 13.0-18.5) for flow time (n = 3 studies), and 198.7 ml (95% CI 154.2-234.2) for voided volume (n = 9 studies). No studies reported estimates of voiding frequency. Between-study heterogeneity was high (89.0-99.6%). CONCLUSIONS Although we were able to calculate pooled mean estimates for several parameters, the small number of included studies and the wide age ranges of participants preclude generalization of reference values to all healthy girls. Further research is needed to determine normative reference values within specific age groups.
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Affiliation(s)
- Melanie R Meister
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Kansas, Kansas City, KS, USA.
| | - Jincheng Zhou
- Center for Design and Analysis, Amgen Inc., Thousand Oaks, CA, USA
| | - Haitao Chu
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Tamera Coyne-Beasley
- Division of Adolescent Medicine, Department of Pediatrics and Internal Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sheila Gahagan
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA, USA
| | - D Yvette LaCoursiere
- Division of General Obstetrics and Gynecology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla, CA, USA
| | - Elizabeth R Mueller
- Division of Female Pelvic Medicine and Reconstructive Surgery, Departments of Urology and Obstetrics/Gynecology, Loyola University, Loyola University Medical Center, Chicago, IL, USA
| | - Peter Scal
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Laura Simon
- Bernard Becker Medical Library, Washington University in St. Louis, St. Louis, MO, USA
| | - Ann E Stapleton
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Carolyn R T Stoll
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, St. Louis, MO, USA
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, St. Louis, MO, USA
| | - Amanda Berry
- Division of Urology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jean F Wyman
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
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Mun DH, Yang L, Shariat SF, Reitter-Pfoertner S, Gredinger G, Waldhoer T. Difference in Incontinence Pad Use between Patients after Radical Prostatectomy and Cancer-Free Population with Subgroup Analysis for Open vs. Minimally Invasive Radical Prostatectomy: A Descriptive Analysis of Insurance Claims-Based Data. Int J Environ Res Public Health 2021; 18:6891. [PMID: 34199008 PMCID: PMC8296932 DOI: 10.3390/ijerph18136891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/20/2021] [Accepted: 06/22/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE to quantify and compare pre- and post-surgical incontinence pad use between men treated with radical prostatectomy (RP) for prostate cancer (PCa) and cancer-free controls, using population-based Austrian insurance claims data. METHODS Men who underwent RP for treating PCa between 2013-2015 were identified. Cancer-free men ≥45 years with and without benign prostate hyperplasia (BPH) were used as controls. Longitudinal data on ICD-diagnoses, type of surgery, prescribed incontinence pads, and hospitals' surgery volumes were aggregated between 2011-2018 to capture pre- and up to three years post-RP follow-up. Monthly rates of pad use were calculated and compared between RP types and cancer-free controls. RESULTS A total of 6248 RP patients, 7158 cancer-free men with BPH, and 50,257 cancer-free men without BPH were analyzed. Comparing to pre-RP (0.03, 95%CI: 0.02-0.05), RP resulted in significantly higher rates of prescribed pads (at 3 months: 12.61, 95%CI: 11.59-13.65; 12 months: 6.71, 95%CI: 6.10-7.34; 36 months: 4.91, 95%CI: 3.76-4.62). These rates were also higher than those for cancer free controls (with BPH:0.06, 95%CI: 0.04-0.09; without BPH:0.12, 95%CI: 0.10-0.14). The rate of prescribed pads after surgery continued to decline over time and remained higher among men who underwent minimally invasive RP compared to those who underwent an open procedure. CONCLUSION Despite progress in surgical techniques, post-RP incontinence remains a prevalent adverse event. The rate of pad usage steadily improved over the first three years post RP. The rate of patients with incontinence needing pads was higher among those who were treated minimally invasive compared to open approach.
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Affiliation(s)
- Dong-Ho Mun
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (D.-H.M.); (S.F.S.)
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB T2S 3C3, Canada;
- Departments of Oncology and Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Shahrokh F. Shariat
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (D.-H.M.); (S.F.S.)
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, 119435 Moscow, Russia
- Department of Urology, Weill Cornell Medical College, New York, NY 10065, USA
- Department of Urology, University of Texas Southwestern, Dallas, TX 75390, USA
- Karl Landsteiner Institute of Urology and Andrology, 3100 St. Poelten, Austria
- Department of Urology, Second Faculty of Medicine, Charles University, 150 06 Prague, Czech Republic
- Department of Special Surgery, Division of Urology, Jordan University Hospital, The University of Jordan, Amman 2V89+CR, Jordan
- European Association of Urology Research Foundation, NL-6803 AA Arnhem, The Netherlands
| | - Sylvia Reitter-Pfoertner
- Competence Center Integrated Care, c/o Austrian Health Insurance Fund, 1100 Vienna, Austria; (S.R.-P.); (G.G.)
| | - Gerald Gredinger
- Competence Center Integrated Care, c/o Austrian Health Insurance Fund, 1100 Vienna, Austria; (S.R.-P.); (G.G.)
| | - Thomas Waldhoer
- Center for Public Health, Department of Epidemiology, Medical University of Vienna, 1090 Vienna, Austria
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Gonzalez G, Vaculik K, Khalil C, Zektser Y, Arnold CW, Almario CV, Spiegel BMR, Anger JT. Social media analytics of overactive bladder posts: what do patients know and want to know? Int Urogynecol J 2021; 32:2729-2736. [PMID: 33710426 DOI: 10.1007/s00192-021-04686-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 01/10/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess women's knowledge, patient experience, and treatment decision making regarding overactive bladder (OAB) using digital ethnography. METHODS Online posts were identified using a data mining service. Two hundred randomized posts were reviewed and coded using grounded theory. We then applied a latent Dirichlet allocation (LDA) probabilistic topic modeling process to review the entire collection of identified posts. RESULTS A total of 2618 posts by 1867 unique users from 203 different websites were identified. Our analysis yielded six themes: the impact of OAB on quality of life, patient-physician interactions, online engagement, symptom management, patient knowledge acquisition, and alternative therapies. CONCLUSION Overall, online communities are a source of support for women to self-manage the OAB symptom complex and help overcome treatment pathway challenges. Digital ethnography provides insight into patient knowledge and barriers to patient-centered care, which are important to improve patient outreach. Additionally, we identify similar findings to prior work, indicating the reliability of studying social media.
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Affiliation(s)
- Gabriela Gonzalez
- Department of Urology, Davis School of Medicine, University of California, Sacramento, CA, USA
| | - Kristina Vaculik
- Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA, USA
| | - Carine Khalil
- Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA, USA
| | - Yuliya Zektser
- David Geffen School of Medicine at University of California, Los Angeles, CA, USA
| | - Corey W Arnold
- Computational Diagnostics, Departments of Radiology and Pathology, UCLA, Los Angeles, CA, USA
| | - Christopher V Almario
- Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA, USA
| | - Brennan M R Spiegel
- Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA, USA
| | - Jennifer T Anger
- Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
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Gonzalez G, Vaculik K, Khalil C, Zektser Y, Arnold C, Almario CV, Spiegel BM, Anger JT. Using Digital Ethnography to Understand the Experience of Women With Pelvic Organ Prolapse. Female Pelvic Med Reconstr Surg 2021; 27:e363-e367. [PMID: 32910076 PMCID: PMC9354566 DOI: 10.1097/spv.0000000000000938] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To characterize the decision-making process and illness experience of women with pelvic organ prolapse (POP) using large-scale social media analysis. METHODS Digital ethnographic analysis of online posts identified through data mining was performed. Grounded theory methodology was applied to 200 posts via traditional hand coding. To supplement our qualitative approach, we applied a Latent Dirichlet Allocation probabilistic topic modeling process to review the entire data set of identified posts to ensure thematic saturation. RESULTS There were 3451 posts by 2088 unique users from 117 websites worldwide that were identified via social media data mining. We found that the anonymity of online forums allowed for information and support exchange among women with POP. Our analysis revealed that the exchange of online information aids in the decision-making process and, in some instances, appears to be the primary source of information. There was confusion about the anatomical and surgical complexities of prolapse. Our study also identified misconceptions, perceived risk factors, prevention methods, and management recommendations that were discussed online. CONCLUSIONS This large-scale online community-based analysis demonstrated the utility of social media to better understand women's experiences with POP. Thematic findings highlighted essential concerns and challenges involved in the surgical decision-making process and the understating of the anatomical complexity of sector defects, specifically to cystocele, rectocele, State specific defects.
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Affiliation(s)
- Gabriela Gonzalez
- Department of Urology, University of California, Davis School of Medicine, Sacramento, CA
| | - Kristina Vaculik
- Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA
| | - Carine Khalil
- Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA
| | - Yuliya Zektser
- David Geffen School of Medicine at University of California, Los Angeles
| | - Corey Arnold
- Medical Imaging Informatics, Department of Radiology, UCLA, Los Angeles, CA
| | | | - Brennan M.R. Spiegel
- Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA
| | - Jennifer T. Anger
- Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Los Angeles, CA
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Hebert-Beirne J, Camenga DR, James AS, Brady SS, Newman DK, Burgio KL, Kane Low L, Hardacker CT, Gahagan S, Williams BR. Social Processes Informing Toileting Behavior Among Adolescent and Adult Women: Social Cognitive Theory as an Interpretative Lens. Qual Health Res 2021; 31:430-442. [PMID: 33427071 PMCID: PMC8053251 DOI: 10.1177/1049732320979168] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Little is known about social processes shaping adolescent and adult women's toileting behaviors. The "Study of Habits, Attitudes, Realities, and Experiences" (SHARE) examines adolescent and adult women's experiences related to bladder health across the life course. Forty-four focus groups with 360 participants organized by six age groups were conducted across seven sites. A transdisciplinary team used social cognitive theory as an interpretive lens across a five-stage analysis. The act of observing was identified as the overarching social process informing women's toileting behaviors in three ways: (a) observing others' toileting behavior, (b) being aware that one's own toileting behaviors are monitored by others, and (c) observing oneself relative to others. We found that underlying processes of toileting behaviors, seemingly private are, in fact, highly social. We suggest, given this social embeddedness that health promotion efforts should leverage interpersonal networks for "social norming" interventions and policies to promote healthy toileting behaviors.
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Affiliation(s)
| | | | | | - Sonya S Brady
- University of Minnesota, Minneapolis, Minnesota, USA
| | - Diane K Newman
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kathryn L Burgio
- University of Alabama, Birmingham, Alabama, USA
- Birmingham/Atlanta Geriatric Research, Education and Clinical Center, Birmingham, Alabama, USA
| | | | | | - Sheila Gahagan
- University of California San Diego, La Jolla, California, USA
| | - Beverly Rosa Williams
- University of Alabama, Birmingham, Alabama, USA
- Birmingham/Atlanta Geriatric Research, Education and Clinical Center, Birmingham, Alabama, USA
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Lukacz ES, Constantine ML, Kane Low L, Lowder JL, Markland AD, Mueller ER, Newman DK, Rickey LM, Rockwood T, Rudser K. Rationale and design of the validation of bladder health instrument for evaluation in women (VIEW) protocol. BMC Womens Health 2021; 21:18. [PMID: 33413284 PMCID: PMC7789348 DOI: 10.1186/s12905-020-01136-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/24/2020] [Indexed: 12/04/2022]
Abstract
Background Bladder health is an understudied state and difficult to measure due to lack of valid and reliable instruments. While condition specific questionnaires assess presence, severity and degree of bother from lower urinary tract symptoms, the absence of symptoms is insufficient to assume bladder health. This study describes the methodology used to validate a novel bladder health instrument to measure the spectrum of bladder health from very healthy to very unhealthy in population based and clinical research.
Methods Three samples of women are being recruited: a sample from a nationally representative general population and two locally recruited clinical center samples—women with a targeted range of symptom severity and type, and a postpartum group. The general population sample includes 694 women, 18 years or older, randomly selected from a US Postal delivery sequence file. Participants are randomly assigned to electronic or paper versions of the bladder health instrument along with a battery of criterion questionnaires and a demographic survey; followed by a retest or a two-day voiding symptom diary. A total of 354 women around 7 clinical centers are being recruited across a spectrum of self-reported symptoms and randomized to mode of completion. They complete the two-day voiding symptom diary as well as a one-day frequency volume diary prior to an in-person evaluation with a standardized cough stress test, non-invasive urine flowmetry, chemical urine analysis and post void residual measurement. Independent judge ratings of bladder health are obtained by interview with a qualified health care provider. A total of 154 postpartum women recruited around 6 of the centers are completing similar assessments within 6–12 weeks postpartum. Dimensional validity will be evaluated using factor analysis and principal components analysis with varimax rotation, and internal consistency with Cronbach’s alpha. Criterion validity will be assessed using multitrait-multimethod matrix including correlations across multiple data sources and multiple types of measures. Discussion We aim to validate a bladder health instrument to measure the degree of bladder health within the general population and among women (including postpartum) recruited from local clinical centers.
Trial registration NCT04016298 Posted July 11, 2019 (https://www.clinicaltrials.gov/ct2/show/NCT04016298?cond=bladder+health&draw=2&rank=1).
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Affiliation(s)
- Emily S Lukacz
- Division of Female Pelvic Medicine and Reconstructive Surgery, University of California San Diego, San Diego, CA, USA. .,Department of Obstetrics, Gynecology and Reproductive Sciences, UC San Diego Health, 9500 Gilman Dr. #0971, La Jolla, CA, 92093, USA.
| | | | - Lisa Kane Low
- Practice and Professional Graduate Programs, School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Jerry L Lowder
- Division of Female Pelvic Medicine and Reconstructive Surgery, Washington University in St. Louis, St. Louis, MO, USA
| | - Alayne D Markland
- Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama At Birmingham, Birmingham, AL, USA.,Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Birmingham, AL, USA
| | - Elizabeth R Mueller
- Division of Female Pelvic Medicine and Reconstructive Surgery, Loyola University Medical Center, Loyola University Chicago, Maywood, IL, USA
| | - Diane K Newman
- Division of Urology, Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Leslie M Rickey
- Departments of Urology and Obstetrics, Gynecology and Reproductive Sciences, Yale University, New Haven, CT, USA
| | - Todd Rockwood
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA
| | - Kyle Rudser
- Division of Biostatistics, University of Minnesota, Minneapolis, MN, USA
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Rickey LM, Constantine ML, Lukacz ES, Lowder JL, Newman DK, Brubaker L, Rudser K, Lewis CE, Low LK, Palmer MH, Rockwood T. Measuring Bladder Health: Development and Cognitive Evaluation of Items for a Novel Bladder Health Instrument. J Urol 2021; 205:1407-14. [PMID: 33350312 DOI: 10.1097/JU.0000000000001581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE We describe the item development and cognitive evaluation process used in creating the Prevention of Lower Urinary Tract Symptoms Bladder Health Instrument (PLUS-BHI). MATERIALS AND METHODS Questions assessing bladder health were developed using reviews of published items, expert opinion, and focus groups' transcript review. Candidate items were tested through cognitive interviews with community-dwelling women and an online panel survey. Items were assessed for comprehension, language, and response categories and modified iteratively to create the PLUS-BHI. RESULTS Existing measures of bladder function (storage, emptying, sensation components) and bladder health impact required modification of time frame and response categories to capture a full range of bladder health. Of the women 167 (18-80 years old) completed individual interviews and 791 women (18-88 years) completed the online panel survey. The term "bladder health" was unfamiliar for most and was conceptualized primarily as absence of severe urinary symptoms, infection, or cancer. Coping mechanisms and self-management strategies were central to bladder health perceptions. The inclusion of prompts and response categories that captured infrequent symptoms increased endorsement of symptoms across bladder function components. CONCLUSIONS Bladder health measurement is challenged by a lack of awareness of normal function, use of self-management strategies to mitigate impact on activities, and a common tendency to overlook infrequent lower urinary tract symptoms. The PLUS-BHI is designed to characterize the full spectrum of bladder health in women and will be validated for research use.
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Williams BR, Vargo K, Newman DK, Yvette Lacoursiere D, Mueller ER, Connett J, Low LK, James AS, Smith AL, Schmitz KH, Burgio KL. It's About Time: The Temporal Burden of Lower Urinary Tract Symptoms Among Women. Urol Nurs 2020; 40:10.7257/1053-816x.2020.40.6.277. [PMID: 33642840 PMCID: PMC7906293 DOI: 10.7257/1053-816x.2020.40.6.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This secondary analysis studied 50 transcripts of women who shared day-to-day experiences of lower urinary tract symptoms (LUTS) and characterized temporal (time-associated) features of living with LUTS. Findings revealed two overarching time-associated themes: The Complexity of LUTS and The Quest for Empowerment over LUTS. Findings suggest that the temporal burden of LUTS is the accumulated impact of symptoms and symptom management on women's daily lives within multiple contexts across the life course. Increasing nurses' knowledge of the temporal context of LUTS may heighten awareness and improve symptom detection and management.
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Affiliation(s)
- Beverly Rosa Williams
- University of Alabama at Birmingham School of Medicine, Department of Veterans Affairs, Birmingham, AL
| | - Keith Vargo
- University of Minnesota School of Public Health
| | - Diane K Newman
- Division of Urology, Department of Surgery, University of Pennsylvania, Perelman School of Medicine
| | | | | | | | | | - Aimee S James
- Washington University in St. Louis School of Medicine
| | | | | | - Kathryn L Burgio
- University of Alabama at Birmingham School of Medicine, Department of Veterans Affairs, Birmingham, AL
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Siegel L, Rudser K, Sutcliffe S, Markland A, Brubaker L, Gahagan S, Stapleton AE, Chu H. A Bayesian multivariate meta-analysis of prevalence data. Stat Med 2020; 39:3105-3119. [PMID: 32510638 PMCID: PMC7571488 DOI: 10.1002/sim.8593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 04/11/2020] [Accepted: 05/09/2020] [Indexed: 01/01/2023]
Abstract
When conducting a meta-analysis involving prevalence data for an outcome with several subtypes, each of them is typically analyzed separately using a univariate meta-analysis model. Recently, multivariate meta-analysis models have been shown to correspond to a decrease in bias and variance for multiple correlated outcomes compared with univariate meta-analysis, when some studies only report a subset of the outcomes. In this article, we propose a novel Bayesian multivariate random effects model to account for the natural constraint that the prevalence of any given subtype cannot be larger than that of the overall prevalence. Extensive simulation studies show that this new model can reduce bias and variance when estimating subtype prevalences in the presence of missing data, compared with standard univariate and multivariate random effects models. The data from a rapid review on occupation and lower urinary tract symptoms by the Prevention of Lower Urinary Tract Symptoms Research Consortium are analyzed as a case study to estimate the prevalence of urinary incontinence and several incontinence subtypes among women in suspected high risk work environments.
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Affiliation(s)
- Lianne Siegel
- Division of Biostatistics, University of Minnesota, Minneapolis, MN
| | - Kyle Rudser
- Division of Biostatistics, University of Minnesota, Minneapolis, MN
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO
| | - Alayne Markland
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Birmingham Geriatric Research, Education, and Clinical Center at the Birmingham VA Medical Center, Birmingham, Alabama
| | - Linda Brubaker
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla, CA
| | - Sheila Gahagan
- Division of Child Development and Community Health, Department of Pediatrics„ University of California San Diego, La Jolla, CA
| | - Ann E. Stapleton
- Division of Allergy and Infectious Disease, University of Washington, Seattle, WA
| | - Haitao Chu
- Division of Biostatistics, University of Minnesota, Minneapolis, MN
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Xue K, Palmer MH, Zhou F. Prevalence and associated factors of urinary incontinence in women living in China: a literature review. BMC Urol 2020; 20:159. [PMID: 33054777 PMCID: PMC7559450 DOI: 10.1186/s12894-020-00735-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 10/05/2020] [Indexed: 12/15/2022] Open
Abstract
Background This review of studies on urinary incontinence (UI) was focused primarily on UI prevalence rates and associated factors across the adult lifecourse of Chinese women. UI is a urologic symptom that can have a significant impact on women's physical and mental health and quality of life. In addition, women with UI may experience socioeconomic burdens due to UI’s effect on their ability to work and function in society. Although researchers from many countries have reported prevalence rates and associated factors for UI, little is known about the prevalence of UI in China’s large female population. Language may act as a barrier to the inclusion of published studies in English-language journals. To overcome this barrier and to add to the global knowledge base about UI in women, the authors reviewed and discussed findings from epidemiological studies published in China and in Chinese language. Methods The authors retrieved research studies from the Wanfang database using the following search terms: "Subject: (Female) × Subject: (Urinary incontinence) × Subject: (Prevalence) × Date: 2013 to 2019". Searches employed the China National Knowledge Infrastructure Database, VIP Database for Chinese Technical Periodicals and China Biology Medicine Database. The authors also used PubMed to search English-language studies published in Chinese journals on UI in Chinese women. Results This literature review includes 48 articles published between January 2013 and December 2019. The overall UI prevalence rates reported in adult Chinese women ranged from 8.7 to 69.8%, representing 43–349 million women, respectively. For women aged 17–40 years, 41–59 years, and 60 years and older, prevalence rates ranged from 2.6–30.0, 8.7–47.7, to 16.9–61.6%, respectively. Significant associated factors for overall UI included age, body mass index, constipation, parity, and menopause. Despite the 17–40 age range being peak reproductive years, the literature revealed little focus on UI prevalence rates. For women aged 41–59 years, the main associated factors included those related to pregnancy and gynecologic diseases. For women 60 years and older, chronic diseases represented most of the associated factors. Conclusions About 43–349 million Chinese women may experience UI. Many of the identified associated factors could be mitigated to reduce UI incidence and prevalence rates. Little is known about the prevalence rates and associated factors for UI among young (aged 17–40) Chinese women. Future research should investigate UI in young women to improve bladder health across their lifecourse.
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Affiliation(s)
- Kaikai Xue
- School of Nursing, Xuzhou Medical University, Xuzhou, China.,School of Nursing and Midwifery, Jiangsu College of Nursing, Huai'an, China
| | - Mary H Palmer
- School of Nursing, University of North Carolina at Chapel Hill, CB 7460, Chapel Hill, USA
| | - Fang Zhou
- School of Nursing, Xuzhou Medical University, Xuzhou, China.
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Burgio KL, James AS, LaCoursiere DY, Mueller ER, Newman DK, Low LK, Weinfurt KP, Wyman JF, Cunningham SD, Vargo K, Connett J, Williams BR. Views of Normal Bladder Function Among Women Experiencing Lower Urinary Tract Symptoms. Urology 2020; 150:103-109. [PMID: 32841655 DOI: 10.1016/j.urology.2020.08.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/28/2020] [Accepted: 08/10/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To explore the perspectives of normal bladder function among women with lower urinary tract symptoms. METHODS This was a secondary analysis of qualitative data from structured interviews with 50 adult women with lower urinary tract symptoms. A directed content analysis of the transcripts explored women's perspectives on normal bladder function. RESULTS Participants' descriptions of "normal" took many forms and were based on several aspects of bladder function. A prominent feature of normal was that voiding occurred as a seamless process, beginning with an urge sensation, followed by voiding with ease and to completion, and then "being done." Descriptions of normal were based largely on concepts of voiding regularity, including voiding frequency, intervals, and patterns during the day and night. Another aspect of normal bladder function was the notion of having control in terms of not leaking urine, as well as the ability to hold urine and defer urination. Views of normal bladder function extended to the absence of symptoms and the impact of being symptom-free on day-to-day life, including not having to think about or worry about the bladder or limit daily activities. CONCLUSION Women's perspectives on normal bladder function are multifaceted, reflecting attributes most salient to each individual and likely informed by their personal experience with symptoms and their influence on daily life. This work has implications for how clinicians might engage women in discussing bladder symptoms and can inform future research and public health messaging about normal bladder function.
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Affiliation(s)
- Kathryn L Burgio
- University of Alabama at Birmingham School of Medicine, Birmingham, AL; Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham, AL.
| | - Aimee S James
- Washington University School of Medicine, St. Louis, MO
| | | | | | - Diane K Newman
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
| | - Lisa Kane Low
- University of Michigan School of Nursing, Ann Arbor, MI
| | | | - Jean F Wyman
- University of Minnesota, School of Nursing, Minneapolis, MN
| | | | - Keith Vargo
- University of Minnesota School of Public Health, Minneapolis, MN
| | - John Connett
- University of Minnesota School of Public Health, Minneapolis, MN
| | - Beverly Rosa Williams
- University of Alabama at Birmingham School of Medicine, Birmingham, AL; Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham, AL
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- National Institutes of Health (NIH), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Bethesda, MD
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Brady SS, Brubaker L, Fok CS, Gahagan S, Lewis CE, Lewis J, Lowder JL, Nodora J, Stapleton A, Palmer MH. Development of Conceptual Models to Guide Public Health Research, Practice, and Policy: Synthesizing Traditional and Contemporary Paradigms. Health Promot Pract 2020; 21:510-524. [PMID: 31910039 PMCID: PMC7869957 DOI: 10.1177/1524839919890869] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This applied paper is intended to serve as a "how to" guide for public health researchers, practitioners, and policy makers who are interested in building conceptual models to convey their ideas to diverse audiences. Conceptual models can provide a visual representation of specific research questions. They also can show key components of programs, practices, and policies designed to promote health. Conceptual models may provide improved guidance for prevention and intervention efforts if they are based on frameworks that integrate social ecological and biological influences on health and incorporate health equity and social justice principles. To enhance understanding and utilization of this guide, we provide examples of conceptual models developed by the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium. PLUS is a transdisciplinary U.S. scientific network established by the National Institutes of Health in 2015 to promote bladder health and prevent lower urinary tract symptoms, an emerging public health and prevention priority. The PLUS Research Consortium is developing conceptual models to guide its prevention research agenda. Research findings may in turn influence future public health practices and policies. This guide can assist others in framing diverse public health and prevention science issues in innovative, potentially transformative ways.
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Affiliation(s)
| | | | | | | | - Cora E Lewis
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Jerry L Lowder
- Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Jesse Nodora
- University of California San Diego, La Jolla, CA, USA
| | | | - Mary H Palmer
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Gonzalez G, Vaculik K, Khalil C, Zektser Y, Arnold C, Almario CV, Spiegel BM, Anger JT. Women's Experience with Stress Urinary Incontinence: Insights from Social Media Analytics. J Urol 2020; 203:962-968. [PMID: 31855097 PMCID: PMC9354536 DOI: 10.1097/ju.0000000000000706] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE We conducted a large-scale digital ethnographic analysis of anonymous online posts to capture the complete patient experience, knowledge and perceptions among women with stress urinary incontinence. MATERIALS AND METHODS Online posts were identified through data mining. Overall, 200 randomized posts were analyzed using grounded theory qualitative methods. To ensure full thematic discovery we also applied a Latent Dirichlet Allocation probabilistic topic modeling approach to the entire data set of identified posts. Latent Dirichlet Allocation topics are represented as a distribution of words, similar to a word cloud, which were manually reviewed to identify themes. RESULTS A total of 985 online posts by 762 unique users were extracted from 98 websites. There was significant overlap between the grounded theory and Latent Dirichlet Allocation identified themes. Our analysis suggests that these online communities help women manage the quality of life impact of their stress urinary incontinence, navigate specialty care and reach a decision regarding surgical vs nonsurgical management. Additionally, we identified risk factors, prevention strategies and treatment recommendations discussed online. CONCLUSIONS Findings demonstrated patient values that may influence decision making when seeking care for stress urinary incontinence and choosing a treatment. Social media interactions provide insight into patient behaviors that are important in order to improve patient centered care and decision making.
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Affiliation(s)
- Gabriela Gonzalez
- David Geffen School of Medicine at University of California, Los Angeles
| | - Kristina Vaculik
- Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA
| | - Carine Khalil
- Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA
| | - Yuliya Zektser
- David Geffen School of Medicine at University of California, Los Angeles
| | - Corey Arnold
- Medical Imaging Informatics, Department of Radiology, UCLA, Los Angeles, CA
| | | | - Brennan M.R. Spiegel
- Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA
| | - Jennifer T. Anger
- Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Los Angeles, CA
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Schmitz KH, Bavendam T, Brady SS, Brubaker L, Burgio K, Harlow BL, James A, Lukacz ES, Miller JM, Newman DK, Palmer MH, Rudser K, Sutcliffe S. Is the juice worth the squeeze? Transdisciplinary team science in bladder health. Neurourol Urodyn 2020; 39:1601-1611. [PMID: 32320497 DOI: 10.1002/nau.24357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 02/25/2020] [Accepted: 03/09/2020] [Indexed: 12/13/2022]
Abstract
AIMS Prior research on lower urinary tract symptoms (LUTS) has focused on the treatment and management of these conditions with scant attention to prevention. The Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium was formed to address the complexities of preventing LUTS and promoting bladder health. METHODS Herein, we describe challenges faced and strategies used to develop the PLUS Research Consortium into an engaged and productive transdisciplinary scientific team. We apply four previously defined team science phases (development, conceptualization, implementation, and translation) to frame our progress. RESULTS Strategies to progress through the development phase included the generation of a shared mission, and valuing of other disciplinary perspectives. The conceptualization phase included generating a shared language and developing a team transdisciplinary orientation. During the implementation phase, the group developed roles and procedures and focused on conflict management. The translation phase includes continued refinement of the mission and goals, implementation of research protocols, and robust dissemination of the scientific work products related to bladder health. CONCLUSION A diverse group has matured into a productive transdisciplinary team science consortium. Achieving this outcome required dedicated effort for each member to engage in activities that often required more time than single discipline research activities. Provision of the necessary time and tools has fostered a transdisciplinary team science culture and rich research agenda that reflects the complexity of the health issue to be addressed. Our experience may be useful for others embarking on team science projects.
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Affiliation(s)
- Kathryn H Schmitz
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
| | - Tamara Bavendam
- Women's Urologic Health, National Institutes of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland
| | - Sonya S Brady
- Department of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota
| | - Linda Brubaker
- Division of Obstetrics, Gynecology, and Reproductive Sciences, UC San Diego, San Diego, California
| | - Kathryn Burgio
- Department of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs, Birmingham, Alabama
| | - Bernard L Harlow
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Aimee James
- Department of Surgery, Washington University, St. Louis, Missouri
| | - Emily S Lukacz
- Division of Obstetrics, Gynecology, and Reproductive Sciences, UC San Diego, San Diego, California
| | - Janis M Miller
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, Michigan
| | - Diane K Newman
- Department of Surgery, Division of Urology, University of Pennsylvania's Perelman School of Medicine, Philadelphia, Pennsylvania
| | | | - Kyle Rudser
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, Minnesota
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- Department of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs, Birmingham, Alabama
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Brady SS, Berry A, Camenga DR, Fitzgerald CM, Gahagan S, Hardacker CT, Harlow BL, Hebert-Beirne J, LaCoursiere DY, Lewis JB, Low LK, Lowder JL, Markland AD, McGwin G, Newman DK, Palmer MH, Shoham DA, Smith AL, Stapleton A, Williams BR, Sutcliffe S. Applying concepts of life course theory and life course epidemiology to the study of bladder health and lower urinary tract symptoms among girls and women. Neurourol Urodyn 2020; 39:1185-1202. [PMID: 32119156 PMCID: PMC7659467 DOI: 10.1002/nau.24325] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 01/23/2020] [Indexed: 01/18/2023]
Abstract
AIMS Although lower urinary tract symptoms (LUTS) may occur at different periods during the life course of women, a little research on LUTS has adopted a life course perspective. The purpose of this conceptual paper is to demonstrate how life course theory and life course epidemiology can be applied to study bladder health and LUTS trajectories. We highlight conceptual work from the Prevention of Lower Urinary Tract Symptoms Research Consortium to enhance the understanding of life course concepts. METHODS Consortium members worked in transdisciplinary teams to generate examples of how life course concepts may be applied to research on bladder health and LUTS in eight prioritized areas: (a) biopsychosocial ecology of stress and brain health; (b) toileting environment, access, habits, and techniques; (c) pregnancy and childbirth; (d) physical health and medical conditions; (e) musculoskeletal health; (f) lifestyle behaviors; (g) infections and microbiome; and (h) hormonal status across the life span. RESULTS Life course concepts guided consortium members' conceptualization of how potential risk and protective factors may influence women's health. For example, intrapartum interventions across multiple pregnancies may influence trajectories of bladder health and LUTS, illustrating the principle of life span development. Consortium members also identified and summarized methodologic and practical considerations in designing life course research. CONCLUSIONS This paper may assist researchers from a variety of disciplines to design and implement research identifying key risk and protective factors for LUTS and bladder health across the life course of women. Results from life course research may inform health promotion programs, policies, and practices.
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Affiliation(s)
- Sonya S Brady
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota
| | - Amanda Berry
- Department of Surgery, Division of Urology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Deepa R Camenga
- Department of Emergency Medicine and Pediatrics, Yale School of Medicine, New Haven, Connecticut
| | - Colleen M Fitzgerald
- Department of Obstetrics and Gynecology, Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois
| | - Sheila Gahagan
- Department of Pediatrics, Division of Academic General Pediatrics, University of California San Diego School of Medicine, San Diego, California
| | | | - Bernard L Harlow
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Jeni Hebert-Beirne
- Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, Illinois
| | - D Yvette LaCoursiere
- Department of Obstetrics, Gynecology, and Reproductive Sciences, UC San Diego School of Medicine, San Diego, California
| | - Jessica B Lewis
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
| | - Lisa K Low
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, Michigan
| | - Jerry L Lowder
- Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - Alayne D Markland
- Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, School of Medicine, University of Alabama, Birmingham, Alabama
- Geriatric Research, Education, and Clinical Center, Birmingham VA Medical Center, Birmingham, Alabama
| | - Gerald McGwin
- Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, Alabama
| | - Diane K Newman
- Department of Surgery, Division of Urology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mary H Palmer
- School of Nursing, University of North Carolina, Chapel Hill, North Carolina
| | - David A Shoham
- Department of Public Health Sciences, Loyola University Chicago, Maywood, Illinois
| | - Ariana L Smith
- Department of Surgery, Division of Urology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ann Stapleton
- Department of Medicine, Division of Allergy and Infectious Disease, University of Washington, Seattle, Washington
| | - Beverly R Williams
- Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, School of Medicine, University of Alabama, Birmingham, Alabama
| | - Siobhan Sutcliffe
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, Missouri
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Dowling-Castronovo A, Bradway C, Kitson A, Ostaszkiewicz J, Palmer MH. A Call to Action - Nursing Must Do More to Reduce Lower Urinary Tract Symptoms. Int J Nurs Stud 2020; 107:103577. [PMID: 32339932 DOI: 10.1016/j.ijnurstu.2020.103577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 03/11/2020] [Accepted: 03/12/2020] [Indexed: 12/26/2022]
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Smith AL, Rickey LM, Brady SS, Fok CS, Lowder JL, Markland AD, Mueller ER, Sutcliffe S, Bavendam TG, Brubaker L. Laying the Foundation for Bladder Health Promotion in Women and Girls. Urology 2020; 150:227-233. [PMID: 32197984 DOI: 10.1016/j.urology.2020.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 02/27/2020] [Accepted: 03/05/2020] [Indexed: 01/03/2023]
Abstract
Prevention strategies have been effective in many areas of human health, yet have not been utilized for lower urinary tract symptoms (LUTS) or bladder health (BH). This commentary outlines LUTS prevention research initiatives underway within the NIH-sponsored Prevention of Lower Urinary Tract Symptoms Research Consortium (PLUS). Prevention science involves the systematic study of factors associated with health and health problems, termed protective and risk factors, respectively. PLUS is enhancing traditional prevention science approaches through use of: (1) a transdisciplinary team science approach, (2) both qualitative and quantitative research methodology (mixed methodology), and (3) community engagement. Important foundational work of PLUS includes development of clear definitions of both BH and disease, as well as a BH measurement instrument that will be validated for use in the general population, adolescents, and Latinx and Spanish-speaking women.1 The BH measurement instrument will be used in an upcoming nationally-representative cohort study that will measure BH and investigate risk and protective factors. PLUS investigators also developed a conceptual framework to guide their research agenda; this framework organizes a broad array of candidate risk and protective factors that can be studied across the life course of girls and women.1 As PLUS begins to fill existing knowledge gaps with new information, its efforts will undoubtedly be complemented by outside investigators to further advance the science of LUTS prevention and BH across additional populations. Once the BH community has broadened its understanding of modifiable risk and protective factors, intervention studies will be necessary to test LUTS prevention strategies and support public health efforts. LUTS providers may be able to translate this evolving evidence for individual patients under their care and act as BH advocates in their local communities.
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Affiliation(s)
- Ariana L Smith
- Department of Surgery, University of Pennsylvania's Perelman School of Medicine, Philadelphia, PA.
| | - Leslie M Rickey
- Department of Urology, Yale University School of Medicine, New Haven, CT
| | - Sonya S Brady
- Department of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN
| | - Cynthia S Fok
- Department of Urology, University of Minnesota, Minneapolis MN
| | - Jerry L Lowder
- Department of Obstetrics and Gynecology, Washington University, St Louis, MO
| | - Alayne D Markland
- Department of Medicine, University of Alabama at Birmingham and the Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham, AL
| | - Elizabeth R Mueller
- Departments of Obstetrics and Gynecology & Urology, Stritch School of Medicine, Loyola University Chicago, Chicago IL
| | | | | | - Linda Brubaker
- Department of Obstetrics, Gynecology and Reproductive Sciences, UC San Diego, San Diego, CA
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Abstract
Urinary incontinence (UI) is common among women and contributes to decreased quality of life. Several effective treatment options are available for the most common types of UI (stress, urge, and mixed), including lifestyle and behavioral therapy, drug therapy, and minimally invasive procedures. Most women improve with treatment, and UI is not an inevitable part of aging. To maximize the opportunity for successful treatment, it is critical to align the treatment approach with patient goals and expectations for care, including an assessment of patient-driven priorities regarding potential adverse effects, costs, and expected benefit of different treatment approaches.
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Affiliation(s)
- Camille P Vaughan
- Birmingham/Atlanta VA Geriatric Research Education and Clinical Center and Emory University, Atlanta, Georgia (C.P.V.)
| | - Alayne D Markland
- Birmingham/Atlanta VA Geriatric Research Education and Clinical Center and University of Alabama at Birmingham, Birmingham, Alabama (A.D.M.)
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Rickey LM, Casilla-lennon M. Prevention of Stress Urinary Incontinence in Women. Curr Bladder Dysfunct Rep 2020; 15:30-7. [DOI: 10.1007/s11884-019-00570-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Wyman JF, Zhou J, Yvette LaCoursiere D, Markland AD, Mueller ER, Simon L, Stapleton A, Stoll CRT, Chu H, Sutcliffe S. Normative noninvasive bladder function measurements in healthy women: A systematic review and meta-analysis. Neurourol Urodyn 2020; 39:507-522. [PMID: 31917870 DOI: 10.1002/nau.24265] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 12/18/2019] [Indexed: 01/01/2023]
Abstract
AIM To conduct an evidence synthesis of normative reference values for bladder function parameters in women. METHODS We conducted a systematic review and meta-analysis of studies reporting bladder function parameters obtained from noninvasive tests in healthy women. Seven databases were searched for relevant studies from inception through December 2018, with manual searching of reference lists. We included English language articles that provided quantitative data on urination frequency, voided and postvoid residual volumes, and uroflowmetry results in women without lower urinary tract symptoms. Study selection, data extraction, and quality assessment were undertaken by at least two independent reviewers. Random-effects meta-analytic models were used to derive study-level pooled mean estimates and 95% confidence intervals. RESULTS A total of 24 studies (N = 3090 women, age range, 18-91 years) met eligibility criteria. Pooled mean estimates of bladder function parameters were: 6.6 daytime voids (95% confidence interval (95% CI), 6.2, 7.0), 0.4 nighttime voids (95% CI, 0.0, 0.8), 1577 mL for 24-hour voided volume (95% CI 1428,1725); 12 mL for postvoid residual volume (95% CI, 4, 20); and 28 mL/sec for maximum flow rate (95% CI, 27,30). Between-study heterogeneity was high for all outcomes (I2 = 61.1-99.6%), but insufficient data were available to explore reasons for this high heterogeneity (eg, differences by age). CONCLUSION Although summary mean estimates of bladder function parameters were calculated, the wide heterogeneity across studies precludes generalization of these estimates to all healthy women. Further research is needed to determine normative reference values within specific groups, such as those defined by age.
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Affiliation(s)
- Jean F Wyman
- School of Nursing, University of Minnesota, Minneapolis, Minnesota
| | - Jincheng Zhou
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - D Yvette LaCoursiere
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, LaJolla, California
| | - Alayne D Markland
- Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, Birmingham/Atlanta Geriatrics Research, Education, and Clinical Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Elizabeth R Mueller
- Departments of Urology and Obstetrics/Gynecology, Loyola University Medical Center, Loyola University Chicago, Maywood, Illinois
| | - Laura Simon
- Bernard Becker Medical Library, Washington University in St. Louis, St. Louis, Missouri
| | - Ann Stapleton
- Department of Medicine, University of Washington, Seattle, Washington
| | - Carolyn R T Stoll
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, St. Louis, Missouri
| | - Haitao Chu
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, St. Louis, Missouri
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Williams BR, Nodora J, Newman DK, Kane Low L, James AS, Camenga DR, Hebert-Beirne J, Brady SS, Hardacker CT, Smith AL, Cunningham SD, Burgio KL, Prevention Of Lower Urinary Tract Symptoms Plus Research Consortium. I never knew anyone who peed on themselves on purpose: Exploring adolescent and adult women's lay language and discourse about bladder health and function. Neurourol Urodyn 2020; 39:225-236. [PMID: 31578778 PMCID: PMC8126963 DOI: 10.1002/nau.24174] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 09/09/2019] [Indexed: 11/06/2022]
Abstract
AIMS This analysis explored and characterized adolescent and adult women's lay language and discourse related to bladder health/function. METHODS Forty-four focus groups were conducted across seven United States research centers with 360 adolescents and adult women, organized by six age categories. Multilevel content analyses classified emergent themes. A transdisciplinary lens and inductive approach guided data interpretation. Interpretive insights were validated by a community engagement panel. RESULTS A repertoire of bladder function terms emerged, including explicit functional terms, formal and polite euphemistic terms, and informal familiar terms, as well as cultural and regional metaphors and idioms. Terminology usage was historically grounded, developmental, and cumulative across the life course. Lay discourse was contextual and affectively valent, suggesting unspoken, commonly understood, situation-based "rules" for talking about bladder function. Discourse appeared to be siloed within family and friendship circles. Adolescents and adult women often described, rather than named, bladder sensations or problems. Terminology for bladder issues tended to minimize severity and frequency, with medical language only relevant to extreme examples and not applicable to mild episodes. CONCLUSIONS A definitional discordance between medical and lay views of bladder problems was identified, signifying a need to clarify the meaning of medical terms for lay persons. Adolescents and adult women do not have or use standardized precise terminology for bladder health and function, relying instead on social convention and interpersonal context. Findings can be used to foster shared understandings between lay persons and health professionals, informing development of clinical, research, and public health initiatives to promote bladder health.
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Affiliation(s)
- Beverly Rosa Williams
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, University of Alabama at Birmingham (UAB), Alabama
| | - Jesse Nodora
- Department of Family Medicine and Public Health, University of California-San Diego Moores Cancer Center, San Diego, California
| | - Diane K Newman
- Adjunct Professor of Urology in Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Pennsylvania
| | - Lisa Kane Low
- Women's Studies and Department of Obstetrics and Gynecology, University of Michigan, Michigan
| | - Aimee S James
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, Washington
| | - Deepa R Camenga
- Department of Emergency Medicine (Pediatrics), Section of Research, Yale School of Medicine, Connecticut
| | - Jeni Hebert-Beirne
- Community Health Sciences, School of Public Health, University of Illinois at Chicago, Illinois
| | - Sonya S Brady
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minnesota
| | - Cecilia T Hardacker
- Department of Education, Center for Education, Research and Advocacy, Howard Brown Health, Chicago, Illinois
- Adjunct Instructor, Rush University College of Nursing, Illinois
| | - Ariana L Smith
- Division of Urology, Department of Surgery, University of Pennsylvania Health System, Pennsylvania
| | - Shayna D Cunningham
- Social and Behavioral Sciences Department, Yale School of Public Health, Connecticut
| | - Kathryn L Burgio
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, Geriatric Research, Education and Clinical Center, Department of Veterans Affairs, University of Alabama at Birmingham (UAB) and Birmingham/Atlanta, Alabama
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
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