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McAuley JA, Mahoney AT, Austin MM. The Executive Summary of Clinical Practice Guideline: Rehabilitation Interventions for Urgency Urinary Incontinence, Urinary Urgency, and/or Urinary Frequency in Adult Women. UROGYNECOLOGY (PHILADELPHIA, PA.) 2024; 30:797-800. [PMID: 39172457 DOI: 10.1097/spv.0000000000001554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Affiliation(s)
- J Adrienne McAuley
- From the Department of Physical Therapy, University of New England, Portland, ME
| | - Amanda T Mahoney
- Department of Physical Therapy, School of Allied Health Professions, Louisiana State University Health, Shreveport, LA
| | - Mary M Austin
- Department of Physical Medicine and Rehabilitation, The Johns Hopkins Hospital, Baltimore, MD
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Rotem R, Zamstein O, Rottenstreich M, O'Sullivan OE, O'reilly BA, Weintraub AY. The future of patient education: A study on AI-driven responses to urinary incontinence inquiries. Int J Gynaecol Obstet 2024. [PMID: 38944693 DOI: 10.1002/ijgo.15751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/30/2024] [Accepted: 06/14/2024] [Indexed: 07/01/2024]
Abstract
OBJECTIVE To evaluate the effectiveness of ChatGPT in providing insights into common urinary incontinence concerns within urogynecology. By analyzing the model's responses against established benchmarks of accuracy, completeness, and safety, the study aimed to quantify its usefulness for informing patients and aiding healthcare providers. METHODS An expert-driven questionnaire was developed, inviting urogynecologists worldwide to assess ChatGPT's answers to 10 carefully selected questions on urinary incontinence (UI). These assessments focused on the accuracy of the responses, their comprehensiveness, and whether they raised any safety issues. Subsequent statistical analyses determined the average consensus among experts and identified the proportion of responses receiving favorable evaluations (a score of 4 or higher). RESULTS Of 50 urogynecologists that were approached worldwide, 37 responded, offering insights into ChatGPT's responses on UI. The overall feedback averaged a score of 4.0, indicating a positive acceptance. Accuracy scores averaged 3.9 with 71% rated favorably, whereas comprehensiveness scored slightly higher at 4 with 74% favorable ratings. Safety assessments also averaged 4 with 74% favorable responses. CONCLUSION This investigation underlines ChatGPT's favorable performance across the evaluated domains of accuracy, comprehensiveness, and safety within the context of UI queries. However, despite this broadly positive reception, the study also signals a clear avenue for improvement, particularly in the precision of the provided information. Refining ChatGPT's accuracy and ensuring the delivery of more pinpointed responses are essential steps forward, aiming to bolster its utility as a comprehensive educational resource for patients and a supportive tool for healthcare practitioners.
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Affiliation(s)
- Reut Rotem
- Department of Urogynaecology, Cork University Maternity Hospital, Cork, Ireland
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University School of Medicine, Jerusalem, Israel
| | - Omri Zamstein
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Misgav Rottenstreich
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University School of Medicine, Jerusalem, Israel
| | | | - Barry A O'reilly
- Department of Urogynaecology, Cork University Maternity Hospital, Cork, Ireland
| | - Adi Y Weintraub
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Jouanny C, Abhyankar P, Maxwell M. A mixed methods systematic literature review of barriers and facilitators to help-seeking among women with stigmatised pelvic health symptoms. BMC Womens Health 2024; 24:217. [PMID: 38570870 PMCID: PMC10993589 DOI: 10.1186/s12905-024-03063-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 03/29/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Women's pelvic health is a globally important subject, included in international and United Kingdom health policies, emphasising the importance of improving information and access to pelvic health services. Consequences of pelvic symptoms are intimate, personal, and varied, often causing embarrassment and shame, affecting women's quality of life and wellbeing. AIM To understand the experience of seeking healthcare for stigmatised pelvic health symptoms by synthesising all types of published primary research and mapping the results to behavioural theory, to identify potential targets for intervention. METHODS Systematic search of MEDLINE, CINAHL, PsycINFO, SocINDEX, PubMED databases, CDSR and CENTRAL registers, from inception to May 2023 for all types of research capturing women's views and experiences of seeking help with stigmatised urogenital and bowel symptoms. Studies only reporting prevalence, predictors of help-seeking, non-health related help-seeking, or written in languages other than English, German, French, Spanish and Swedish were excluded. Reference checking and forward citation searching for all included studies was performed. A results-based synthesis approach was used to integrate quantitative and qualitative data. Themes were mapped to the Common-Sense model and Candidacy framework. The Mixed Methods Appraisal Tool was used for critical appraisal. Grading of Recommendations Assessment, Development and Evaluation - Confidence in Evidence from Reviews of Qualitative research for assessing certainty of review findings. RESULTS 86 studies representing over 20,000 women from 24 high income countries were included. Confidence was high that barriers to help-seeking were similar across all study types and pelvic symptoms: stigma, lack of knowledge, women's perception that clinicians dismissed their symptoms, and associated normalising and deprioritising of low bother symptoms. Supportive clinicians and increased knowledge were key facilitators. CONCLUSIONS Using the Common-Sense Model to explore women's help-seeking behaviour with stigmatised pelvic symptoms reveals problems with cognitive representation of symptom identity, emotional representations of embarrassment and shame, and a subjective norm that women believe their symptoms will be trivialised by clinicians. Together these barriers frustrate women's identification of their candidacy for healthcare. Addressing these issues through behavioural change interventions for women and clinicians, will help to achieve universal access to pelvic healthcare services (United Nations Sustainable Development Goal 3.7). SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021256956.
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Affiliation(s)
- Clare Jouanny
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland.
| | - Purva Abhyankar
- Department of Psychology, University of Stirling, Stirling, Scotland
| | - Margaret Maxwell
- The Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, Scotland
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Liang S, Li J, Chen Z, Li Y, Hao F, Cai W. Prevalence and Influencing Factors of Help-Seeking Behavior Among Women with Urinary Incontinence: A Systematic Review and Meta-Analysis. J Womens Health (Larchmt) 2023; 32:1363-1379. [PMID: 37870774 DOI: 10.1089/jwh.2022.0482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023] Open
Abstract
Purpose: This systematic review and meta-analysis aimed to investigate the mean (weighted) prevalence of help-seeking behavior among women with urinary incontinence (UI) in relevant subgroups and the related influencing factors. Materials and Methods: Six English and four Chinese databases were systematically searched between 1996 and July 10, 2022. Two researchers independently screened the literature, extracted data, and evaluated the quality of the included studies. All statistical analyses were conducted using RevMan 5.4. Results: The mean (weighted) prevalence of help-seeking behavior based on the 41 included studies, including a total of 32,640 women with UI, was 28% (95% confidence interval [CI]: 22%-34%). We performed a subgroup analysis based on UI type, population, region, publication time, case definition of help-seeking, and use of validated tools to determine UI. The results of the subgroup analysis showed that the pooled prevalence of help-seeking behavior was 23% (95% CI: 14%-32%) among pregnant and maternity women, 27% (95% CI: 19%-35%) among menopausal women, 24% (95% CI: 14%-35%) among 20- to 50-year-old women, 31% (95% CI: 25%-36%) among those older than 50 years, 24% (95% CI: 17%-30%) in Asia, and 33% (95% CI: 22%-44%) in Europe. Meanwhile, the pooled odds ratio showed that education level, UI type, UI severity, and quality of life significantly influenced help-seeking behavior among women with UI. Conclusions: This systematic review revealed that the pooled prevalence of help-seeking behaviors among women with UI is 28%. These influencing factors have important implications for adapting to health care and social care systems.
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Affiliation(s)
- Surui Liang
- Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Jie Li
- Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, China
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhaoying Chen
- Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, China
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Yan Li
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Fengming Hao
- Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, China
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Wenzhi Cai
- Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, China
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
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Dmochowski RR, Newman DK, Rovner ES, Zillioux J, Malik RD, Ackerman AL. Patient and Clinician Challenges with Anticholinergic Step Therapy in the Treatment of Overactive Bladder: A Narrative Review. Adv Ther 2023; 40:4741-4757. [PMID: 37725308 PMCID: PMC10567877 DOI: 10.1007/s12325-023-02625-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/21/2023] [Indexed: 09/21/2023]
Abstract
Anticholinergics have been used in the treatment of overactive bladder (OAB), but their use is limited by poor tolerability and anticholinergic-related side effects. Increasingly, providers are discontinuing anticholinergic prescribing because of growing evidence of the association of anticholinergic use with increased risk of cognitive decline and other adverse effects. Newer medications for OAB, the β3-adrenergic receptor agonists mirabegron and vibegron, do not have anticholinergic properties and are typically well tolerated; however, many insurance plans have limited patient access to these newer OAB medications by requiring step therapy, meaning less expensive anticholinergic medications must be trialed and/or failed before a β3-agonist will be covered and dispensed. Thus, many patients are unable to easily access these medications. Step therapy and other drug utilization strategies (e.g., prior authorization) are often used to manage the growing costs of pharmaceuticals, but these policies do not always follow treatment guidelines and may harm patients as a result of treatment delays, discontinuations, or related increases in adverse events. Medical professionals have called for reform of drug utilization strategies through partnerships that include clinicians and policymakers. This narrative review discusses prescribing patterns for OAB treatment and the effect of switching between drugs, as well as the costs of step therapy and prior authorization on patients and prescribers.
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Affiliation(s)
- Roger R Dmochowski
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Diane K Newman
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Eric S Rovner
- Department of Urology, Medical University of South Carolina, Charleston, SC, USA
| | - Jacqueline Zillioux
- Department of Urology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Rena D Malik
- Division of Urology, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - A Lenore Ackerman
- Departments of Urology and Obstetrics and Gynecology, Division of Pelvic Medicine and Reconstructive Surgery, David Geffen School of Medicine, University of California, Los Angeles, 10833 Le Conte Avenue, Box 951738, Los Angeles, CA, 90095-1738, USA.
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Burgio KL, Cunningham SD, Newman DK, Low LK, Nodora J, Lipman TH, Klusaritz H, James AS, Rickey L, Gahagan S, Hebert-Beirne J, Kenton KS, Williams BR. Preferences for Public Health Messaging Related to Bladder Health in Adolescent and Adult Women. J Womens Health (Larchmt) 2023; 32:1120-1135. [PMID: 37610853 PMCID: PMC10541935 DOI: 10.1089/jwh.2022.0463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023] Open
Abstract
Objective: The purpose of this analysis was to explore adolescent and adult women's preferences for the content and delivery of public health messaging around bladder health. Materials and Methods: This was a directed content analysis of focus group data from the Study of Habits, Attitudes, Realities, and Experiences, which explored adolescent and adult women's experiences, perceptions, beliefs, knowledge, and behaviors related to bladder health and function across the life course. This article reports an analysis of the "Public Health Messaging" code, which includes participants' views on what information is needed about bladder health, attributes of messaging, and preferred locations and delivery methods. Results: Forty-four focus groups were conducted with 360 participants (ages 11-93 years) organized into six age groups. Across age groups, participants wanted messaging on maintaining bladder health and preventing bladder problems. They offered suggestions for a wide variety of methods to deliver bladder health information. Ideas for delivery methods fell into three broad categories: (1) traditional in-person modes of delivery, which included individual communication with providers in clinical settings and group-based methods in schools and other community settings where adolescent and adult women naturally gather; (2) internet-based website and social media delivery methods; and (3) static (noninteractive) modes of delivery such as pamphlets. Participants recommended the development of multiple delivery methods to be tailored for specific audiences. Conclusions: These findings can inform development of broad ranging public health messaging tailored to audiences of all ages with a goal of engaging adolescent and adult women across the bladder health risk spectrum.
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Affiliation(s)
- Kathryn L Burgio
- Department of Medicine, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA
- Department of Veterans Affairs, Geriatric Research, Education, and Clinical Center, Birmingham, Alabama, USA
| | - Shayna D Cunningham
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Diane K Newman
- Department of Surgery, Division of Urology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lisa Kane Low
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Jesse Nodora
- Behavioral Medicine, Herbert Wertheim School of Public Health, University of California-San Diego, La Jolla, California, USA
| | - Terri H Lipman
- Department of Surgery, Division of Urology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Heather Klusaritz
- Department of Surgery, Division of Urology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Aimee S James
- Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Leslie Rickey
- Departments of Urology and Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Shelia Gahagan
- Department of Pediatrics, University of California, San Diego, La Jolla, California, USA
| | - Jeni Hebert-Beirne
- Division of Community Health Services, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA
| | - Kimberly S Kenton
- Department of Obstetrics and Gynecology, Northwestern University, Evanston, Illinois, USA
| | - Beverly Rosa Williams
- Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA
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Lane GI, Erekson E, Austin A, Carmichael D, Minassian VA, Grodstein F, Bynum JP. Treatment for Urinary Incontinence in Women Older Than 65 Years. UROGYNECOLOGY (PHILADELPHIA, PA.) 2023; 29:687-695. [PMID: 37490708 DOI: 10.1097/spv.0000000000001335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
IMPORTANCE Urinary incontinence (UI) is common among women older than 65 years and negatively affects quality of life. However, the prevalence of UI treatment and determinants of treatment are largely unknown. OBJECTIVES The aim of this study was to identify rates of UI treatment and factors associated with treatment in older women with self-reported UI. STUDY DESIGN This is a retrospective cohort analysis of a data set linking UI symptoms from the Nurses' Health Study to Medicare claims. We evaluated use of pharmacotherapy, noninvasive, and procedural treatments for UI within 1 year before symptom survey. For pharmacotherapy, we used multivariable logistic regression to estimate odds ratios (ORs) of UI treatment. RESULTS Of the 67,587 Nurses' Health Study respondents, 15,088 had linkage to Medicare, subscribed to part D, and answered UI questions. Of these, 8,332 (55.2%) women reported UI, and 10.9% with UI had a Medicare claim for treatment; pharmacotherapy represented 94.6% of all treatments.On regression analysis, women with more severe and longer-term UI had higher odds of treatment (severe vs slight UI: OR, 3.1; 95% confidence interval [CI], 2.2-4.3) (longer vs new UI: OR, 1.9; 95% CI, 1.5-2.3). Women with mixed (OR, 2.5; 95% CI, 1.9-3.2) or urgency UI (OR, 3.0; 95% CI, 2.2-3.9) had greater odds of treatment compared with women with stress UI. CONCLUSIONS We estimate that only approximately 1 in 9 older women with self-reported UI underwent treatment within the year before reporting symptoms, of which pharmacotherapy was the most common UI intervention, and women with more severe and longer duration of symptoms were most often treated.
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Affiliation(s)
- Giulia I Lane
- From theDepartment of Urology, University of Michigan Medical School, Ann Arbor, MI
| | - Elisabeth Erekson
- Department of Obstetrics and Gynecology at Maine Medical Center, Portland, ME
| | - Andrea Austin
- The Dartmouth Institute for Health Policy and Clinical Practice at the Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Donald Carmichael
- The Dartmouth Institute for Health Policy and Clinical Practice at the Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Vatche A Minassian
- Division of Urogynecology, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA
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Sharifiaghdas F, Narouie B, Taheri M, Jalali S, Shalbafan B, Azadvari M, Dadpour M, Rouientan H, Ahmadzade M, Hanafi Bojd H. Multiple sclerosis and lower urinary tract symptoms: A survey of prevalence, characteristic and urological evaluations. SAGE Open Med 2023; 11:20503121231178047. [PMID: 37384196 PMCID: PMC10293526 DOI: 10.1177/20503121231178047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 05/09/2023] [Indexed: 06/30/2023] Open
Abstract
Objective Most multiple sclerosis patients have urological complications such as lower urinary tract symptoms. This study was conducted to evaluate the prevalence of these symptoms and whether they result in a urological evaluation. Methods A cross-sectional study of 517 multiple sclerosis patients at Tehran's referral multiple sclerosis center and neurology clinics between 2018 and 2022 was performed. Data were collected through interviews after patients completed informed consent forms. Urological examinations, including urine analysis and ultrasonography, were evaluated as final assessments. The data were analyzed using descriptive and inferential statistical tests in Statistical Package for Social Science. Results Among all participants, the prevalence of lower urinary tract symptoms was 73% (n = 384), with urgency (44.8% n = 232) being the most common symptom. The prevalence of intermittency was significantly higher among women (p = 0.004). There was no gender-significant difference in terms of the prevalence of other symptoms (p > 0.050). Lower urinary tract symptoms were significantly correlated with age, clinical course, disease duration, and disability (p < 0.001). Additionally, 37.3% and 18.7% of patients with lower urinary tract symptoms, as well as 17.9% and 37.5% of patients with multiple sclerosis attacks, respectively, had undergone urine analysis and ultrasonography. Conclusion Multiple sclerosis patients rarely undergo urological evaluations during the course of their disease. Proper assessment is essential as these symptoms are among the most detrimental manifestations of this disease.
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Affiliation(s)
- Farzaneh Sharifiaghdas
- Department of Urology, Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Behzad Narouie
- Department of Urology, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Maryam Taheri
- Department of Urology, Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saba Jalali
- Faculty of land and food systems, University of British Colombia Vancouver, Vancouver, Canada
| | - Bita Shalbafan
- Clinical Research Development Unit of Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohaddeseh Azadvari
- Department of Physical Medicine and Rehabilitation, Urology Research Center, Sina & Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Dadpour
- Department of Urology, Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamidreza Rouientan
- Department of Urology, Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohadese Ahmadzade
- Department of Urology, Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamideh Hanafi Bojd
- Department of Urology, Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Burgio KL, Cunningham SD, Newman DK, Low LK, Nodora J, Lipman TH, Gahagan S, Klusaritz H, James AS, Rickey L, Kenton KS, Hebert-Beirne J, Williams BR. Need for Public Health Messaging Related to Bladder Health from Adolescence to Advanced Age. J Womens Health (Larchmt) 2023; 32:224-238. [PMID: 36454206 PMCID: PMC9940805 DOI: 10.1089/jwh.2022.0185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective: The purpose of this analysis was to explore adolescent and adult women's interest in public health messaging around bladder health and perceptions of its usefulness. Materials and Methods: Directed content analysis of focus group data from the Study of Habits, Attitudes, Realities, and Experiences, which explored adolescent and adult women's experiences, perceptions, beliefs, knowledge, and behaviors related to bladder health across the life course. This article reports an analysis of the "Public Health Messaging" code, which included participants' desire or need for information about bladder health and recommendations for appropriate priority audiences. Results: Forty-four focus groups were conducted with 360 participants organized into six age groups (11-93 years). There was consensus across age groups that more information about the bladder is wanted and needed throughout the life course, as there is currently a lack of reliable educational resources. Information on bladder health was seen as useful and important because it enables people to anticipate negative changes in bladder health and act to prevent these. Several priority audiences were identified based on their risk of developing symptoms, but participants also saw value in educating the general public regardless of risk status. They also recommended education for parents and teachers who are in positions to control bathroom access. Conclusions: Results indicate a uniform desire for information on women's bladder health and a need for more research to develop individual prevention strategies and public health messaging for women of all ages, as well as guidance for organizations with a role in supporting bladder health.
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Affiliation(s)
- Kathryn L. Burgio
- Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA
- Department of Veterans Affairs, Geriatric Research, Education, and Clinical Center (GRECC), Birmingham, Alabama, USA
- 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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Yan F, Xiao LD, Zhou K, Li Z, Tang S. Perceptions and help-seeking behaviours among community-dwelling older people with urinary incontinence: A systematic integrative review. J Adv Nurs 2022; 78:1574-1587. [PMID: 35150161 DOI: 10.1111/jan.15183] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/05/2021] [Accepted: 01/04/2022] [Indexed: 12/30/2022]
Abstract
AIM To synthesize research evidence on perceptions and help-seeking behaviours in community-dwelling older people with urinary incontinence based on the Capability-Opportunity-Motivation-Behaviours model. BACKGROUND Urinary incontinence is highly prevalent in community-dwelling older people, yet only a small proportion seek help from health professionals. Untreated urinary incontinence has a detrimental impact on older people's quality of life and distresses their caregivers. DESIGN Systematic integrative review. DATA SOURCES Ten databases were searched systematically between 9 November 2020 and 17 December 2020 including Medline (PubMed), CINAHL, Ageline, Web of Science, Scopus, ProQuest, Psyclnfo, CNKI, Wanfang and Vip. REVIEW METHODS Quality appraisal was applied to assess the quality of selected articles. Data relevant to the review aim were extracted from included articles for analysis. Convergent qualitative synthesis was used to synthesize findings. RESULTS Twenty articles were included and two main themes with six sub-themes were identified. Theme one described three common perceptions including urinary incontinence as a part of normal ageing, a stigma and a health problem. Each perception had a profound impact on older people's motivation to self-report the problem to health professionals. Theme two revealed three main help-seeking approaches comprising self-help, help from friends and help from health professionals. Of these, self-help was the dominant approach used to conceal urinary incontinence and contributed to social isolation. CONCLUSION Improving urinary incontinence management in community-dwelling older people requires the development of their capability and motivation, and increased opportunities to access and gain help from skilled health professionals. IMPACT Findings can facilitate resource development to improve health literacy for the general public pertinent to urinary incontinence and associated stigma. Moreover, findings can inform a user-friendly reporting and referral system for the problem. In addition, findings can inform education and skill training for health professionals, older people and their caregivers to effectively manage the problem.
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Affiliation(s)
- Fang Yan
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Lily D Xiao
- College of Nursing and Health Science, Adelaide, South Australia, Australia
| | - Keyi Zhou
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Zeen Li
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
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