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Mjelde LME, Litherland AT, Beisland EG. Women's experiences of assessment for urinary incontinence: a qualitative study. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:168-174. [PMID: 38386533 DOI: 10.12968/bjon.2024.33.4.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
BACKGROUND One in four women experience urinary incontinence. A woman's medical history, a physical examination and certain tests can guide specialists in diagnosing and offering treatment. Despite the high prevalence, little is known about women's experience of urinary incontinence assessment. AIM To explore the experience of a group of women undergoing an assessment for urinary incontinence. METHODS Individual semi-structured interviews were conducted with 10 women who had been assessed for urinary incontinence. A thematic reflective analysis method was used. FINDINGS The women experienced a lot of shame and worry related to their urinary incontinence and the assessment. Having a safe relationship with the urotherapist was very important, and being given information about treatment options gave hope for a better life. CONCLUSION Urinary incontinence and its assessment are associated with shame and anxiety. A good patient-urotherapist relationship is paramount and learning that treatments are available made women feel more optimistic about the future.
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Affiliation(s)
| | | | - Elisabeth Grov Beisland
- Associate Professor, Department of Health and Caring sciences, Western Norway University of Applied Sciences, Bergen, Norway
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Care-Seeking for Stress Incontinence and Overactive Bladder Among Parous Women in the First Two Decades After Delivery. Female Pelvic Med Reconstr Surg 2016; 22:199-204. [PMID: 26945268 DOI: 10.1097/spv.0000000000000262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to establish the extent to which care-seeking for urinary incontinence is a function of symptom bother; and to identify bother-score thresholds that predict care-seeking in the first 2 decades after delivery. METHODS In this longitudinal cohort, women were assessed annually for symptom bother related to stress urinary incontinence (SUI) and overactive bladder (OAB), as well as for recent episodes of care-seeking for urinary symptoms. Because the goal was to model care-seeking as a function of the woman's characteristics at her prior visit, women who completed 2 or more consecutive visits were included. The population was randomly divided into "training" (model development) and "testing" (model validation) sets. The predictive model was developed in the training set. For SUI and OAB bother scores, we identified thresholds to define statistically distinct probabilities of care-seeking. A multivariable model was created, including SUI and OAB bother categories as well as characteristics associated with care seeking at the P < 0.05 level. The resultant prediction model was then applied to the "testing set"; predicted and observed care-seeking frequencies were compared. RESULTS Care-seeking was strongly associated with SUI and OAB bother. We defined 3 categories for OAB score and 4 categories for SUI score. The resulting 12 risk categories were then collapsed into 5 distinct risk-groups. These groups accurately predicted care-seeking in the testing set (area under the receiver operating curve, 0.760; 95% confidence interval, 0.713-0.807). Inclusion of other risk factors did not improve the model. CONCLUSIONS Symptom bother is a strong determinant of care-seeking in the first 2 decades after delivery. These results define 5 ordinal categories that predict seeking care for urinary symptoms in a community population.
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Morhason-Bello IO, Ojengbede OA, Adedokun BO, Okonkwo NS, Kolade C. Theories of urinary incontinence causation: aetiological descriptions by sub-Saharan African women. Eur J Obstet Gynecol Reprod Biol 2012; 162:109-12. [PMID: 22377228 DOI: 10.1016/j.ejogrb.2012.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Revised: 01/06/2012] [Accepted: 01/31/2012] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To describe the perceived causes of urinary incontinence (UI) and factors associated with awareness of causes of UI among women in the community. STUDY DESIGN Secondary analysis of data extracted from the Ibadan Urinary Incontinence Household Survey (IUIHS), a multi-stage community survey conducted among 5001 women in Nigeria. RESULTS The mean age was 34.8 years (SD=14.2). The majority had at least secondary education and were currently married. Within this population, 13% had ever leaked urine. On their perception of possible aetiological factors of UI, 20.5% mentioned pelvic floor or bladder-related causes such as stress incontinence triggers and bladder problems; 14.6% mentioned uncontrollable factors such as medical comorbidity, age and prior surgery; 8.8% attributed the cause to being female; and 6.8% mentioned sex-related factors. Multiple logistic regression analysis revealed significantly lower odds of awareness of the aetiology of urinary incontinence among women aged less than 30 years, those with lower level of education, rural women, those with five or more children and women without history of urine leakage. CONCLUSIONS The study shows a low level of awareness of possible cause of UI amongst women surveyed. We recommend health education and mobilization of women on the right aetiological factors of UI.
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Affiliation(s)
- Imran O Morhason-Bello
- Department of Obstetrics and Gynaecology, College of Medicine/University College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria.
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Welch LC, Taubenberger S, Tennstedt SL. Patients' experiences of seeking health care for lower urinary tract symptoms. Res Nurs Health 2011; 34:496-507. [PMID: 21898454 DOI: 10.1002/nur.20457] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2011] [Indexed: 11/10/2022]
Abstract
A gap between experiencing symptoms and receiving effective treatment persists for people with lower urinary tract symptoms (LUTS), even for those who seek health care. In order to better understand how patients experience treatment seeking for LUTS, we interviewed a racially diverse sample of 90 men and women with a range of LUTS about their experiences seeking care. Thematic analysis revealed that patients often disclosed urinary symptoms first to primary care providers during a general examination or a visit for another health problem. Patients seek provider assistance typically when symptoms have intensified or are causing worry, and a desire for treatment trumps potential embarrassment; among women patients, feeling comfortable with a provider also is important for disclosing LUTS.
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Affiliation(s)
- Lisa C Welch
- New England Research Institutes, Watertown, Massachusetts 02472, USA
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Botelho EM, Elstad EA, Taubenberger SP, Tennstedt SL. Moderating perceptions of bother reports by individuals experiencing lower urinary tract symptoms. QUALITATIVE HEALTH RESEARCH 2011; 21:1229-1238. [PMID: 21483026 PMCID: PMC3840894 DOI: 10.1177/1049732311405682] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We compared reports of symptom bother for the same urinary symptoms to understand why symptom severity and bother do not correspond in a straightforward manner. We used a grounded theory approach to analyze qualitative data from 123 individual interviews and developed a conceptual framework, identifying three symptom perceptions that might moderate symptom bother: causal, relative, and uncertainty. Symptom bother was lower for respondents who viewed symptoms causally (symptoms seemed explainable or "normal") or relatively (urinary symptoms were compared to other symptoms or conditions). Bother tended to be higher for respondents who viewed symptoms with uncertainty (when symptom etiology and course were unknown). A greater portion of respondents in the causal perception group had not sought health care for their symptoms. This conceptual framework is useful for understanding the relationship between reactions to and health care seeking for other symptoms.
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Affiliation(s)
- Elizabeth M Botelho
- Center for Qualitative Research, New England Research Institutes, Watertown, Massachusetts 02472, USA.
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Pakbaz M, Rolfsman E, Mogren I, Löfgren M. Vaginal prolapse--perceptions and healthcare-seeking behavior among women prior to gynecological surgery. Acta Obstet Gynecol Scand 2011; 90:1115-20. [PMID: 21692758 DOI: 10.1111/j.1600-0412.2011.01225.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate perceptions of vaginal prolapse and healthcare-seeking behavior in women prior to gynecological surgery. DESIGN Prospective, cross-sectional study using a web-based questionnaire. SETTING Clinics including patients in the Swedish National Register for Gynecological Surgery (Gynop-register). POPULATION 214 women with vaginal prolapse and 347 women without prolapse as reference patients. METHODS A questionnaire was developed for assessment of women's perception of prolapse and their healthcare-seeking behavior. Data were collected through the Gynop-register. For comparisons between the study groups, Student's t-test and the chi-squared test were used. MAIN OUTCOME MEASURES Perceptions of prolapse, healthcare-seeking behavior, and source of information. RESULTS The most common definition of prolapse reported by the women was presence of a vaginal bulge. Reasons for seeking healthcare were interference with physical activity and increasing symptoms. One in five women with prolapse could not relate the symptoms to prolapse. Participants in the prolapse group gained less information on their own condition from brochures and public media compared to participants in the reference group (p<0.001). CONCLUSION There appeared to be a lack of information on pelvic organ prolapse in the public domain. Healthcare professionals have a significant role to play in informing women about symptoms related to the condition and the available treatment options.
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Affiliation(s)
- Mojgan Pakbaz
- Department of Clinical Sciences, Obstetrics and Gynecology Department of Applied Educational Science, Umeå University, Umeå, Sweden.
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Franzén K, Johansson JE, Andersson G, Pettersson N, Nilsson K. Urinary incontinence in women is not exclusively a medical problem: A population-based study on urinary incontinence and general living conditions. ACTA ACUST UNITED AC 2009; 43:226-32. [DOI: 10.1080/00365590902808566] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Karin Franzén
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden
- Departments of Obstetrics and Gynaecology
| | - Jan-Erik Johansson
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden
- Urology, Örebro University Hospital, Örebro, Sweden
- Centre for Assessment of Medical Technology, Örebro County Council, Örebro, Sweden
| | - Gunnel Andersson
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden
- Urology, Örebro University Hospital, Örebro, Sweden
| | | | - Kerstin Nilsson
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden
- Departments of Obstetrics and Gynaecology
- Centre for Assessment of Medical Technology, Örebro County Council, Örebro, Sweden
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Franzén K, Johansson JE, Andersson G, Nilsson K. Urinary incontinence: Evaluation of an information campaign directed towards the general public. ACTA ACUST UNITED AC 2009; 42:534-8. [DOI: 10.1080/00365590802229962] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Karin Franzén
- Department of Clinical Medicine and Section of Obstetrics and Gynaecology, Örebro University Hospital, Sweden
| | - Jan-Erik Johansson
- Department of Clinical Medicine and Section of Urology, Örebro University Hospital, Sweden
- Centre for Assessment of Medical Technology, Örebro County Council, Örebro, Sweden
| | - Gunnel Andersson
- Department of Clinical Medicine and Section of Urology, Örebro University Hospital, Sweden
- Centre for Assessment of Medical Technology, Örebro County Council, Örebro, Sweden
| | - Kerstin Nilsson
- Department of Clinical Medicine and Section of Obstetrics and Gynaecology, Örebro University Hospital, Sweden
- Centre for Assessment of Medical Technology, Örebro County Council, Örebro, Sweden
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Lewicky-Gaupp C, Margulies RU, Larson K, Fenner DE, Morgan DM, DeLancey JOL. Self-perceived natural history of pelvic organ prolapse described by women presenting for treatment. Int Urogynecol J 2009; 20:927-31. [PMID: 19390760 DOI: 10.1007/s00192-009-0890-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2009] [Accepted: 03/31/2009] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND HYPOTHESIS This study aimed to describe the self-perceived natural history of pelvic organ prolapse (POP) in women seeking care. METHODS Women presenting to a university-based urogynecology clinic for POP (n = 107) completed a questionnaire including questions about how and when their prolapse was discovered. A urogynecologic examination including the pelvic organ prolapse quantification (POP-Q) was also performed. RESULTS Forty-eight percent of these women sought medical attention "immediately" after discovering a bulge. The median time to seek care was 4 months (range from 1 month to 45 years). Twenty-six percent associated their prolapse with a specific event (e.g., moving furniture or pushing a car). POP was self-discovered by 76% (81/107) of women. Self-discovered prolapses were larger than those diagnosed by physicians (Ba +1.3 vs 0.1 cm, P = .03, respectively). CONCLUSIONS Women seek medical advice within months of discovering their prolapse. Self-discovery is associated with higher stage prolapse than prolapse diagnosed by health care providers.
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Affiliation(s)
- Christina Lewicky-Gaupp
- Pelvic Floor Research Group, Division of Gynecology, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.
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Andersson G, Johansson JE, Nilsson K, Sahlberg-Blom E. Perceptions of Urinary Incontinence Among Syrian Christian Women Living in Sweden. J Transcult Nurs 2009; 20:296-303. [DOI: 10.1177/1043659609334850] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose: The purpose of this study was to describe the perception of urinary incontinence (UI) among Syrian women living in Sweden. Design: A qualitative, descriptive design with focus group discussions (FGDs) was used and analyzed with content analysis. Fourteen Syrian women were interviewed in three FGDs. Findings: Three categories emerged, “Thoughts on UI,” “Managing UI,” and “Communication With the Health Care System.” Among the interviewees, UI was a common, and expected, problem, which could be managed. However, some expressed shame and embarrassment. Some talked about communication problems with health care. Discussion and Implications for Practice: The health care system should be adjusted to the women's needs, with awareness of the communication difficulties, which could result in misunderstanding and neglected treatments.
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Morrill M, Lukacz ES, Lawrence JM, Nager CW, Contreras R, Luber KM. Seeking healthcare for pelvic floor disorders: a population-based study. Am J Obstet Gynecol 2007; 197:86.e1-6. [PMID: 17618770 DOI: 10.1016/j.ajog.2007.02.051] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2006] [Revised: 01/31/2007] [Accepted: 02/27/2007] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of this study was to identify characteristics that are associated with seeking care for pelvic floor disorders (PFD). STUDY DESIGN Strategies for seeking care for pelvic organ prolapse, urinary incontinence (UI), and anal incontinence (AI) were assessed in 4392 women. Women were dichotomized into women who had sought care and women with disorders who had not. Chi-square and t tests were used to compare demographic and medical variables. Logistic regression was used to calculate adjusted odds ratios (ORs) with 95% CI. RESULTS Women who sought care were significantly older (64 +/- 13.1 vs 55 +/- 14.8 years old; P < .001). After an adjustment for significant variables, care-seeking was associated with increasing age per year (prolapse OR, 1.07 [95% CI, 1.04-1.11]; UI OR, 1.04 [95% CI, 1.02-1.05]), hysterectomy (prolapse OR, 4.30 [95% CI, 2.16-8.55]; UI OR, 1.40 [95% CI, 1.05-1.89]), hormone replacement (UI OR, 1.78 [95% CI, 1.29-2.45]), and urinary infections (AI OR, 1.67 [95% CI, 1.04-2.68]). CONCLUSION Seeking care for PFD is associated with older age, hysterectomy, hormone use, and frequent urinary tract infection. This reinforces the need for PFD treatment as our population ages and demand increases.
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Affiliation(s)
- Michelle Morrill
- Department of Women's Pelvic Medicine, University of California, San Diego, School of Medicine, San Diego, CA 92037, USA.
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