Culture, teams, and organizations: A qualitative exploration of female nurses’ and midwives’ experiences of urinary symptoms at work

Stressors and bathroom behaviors associated with urinary incontinence in nurses working during the COVID-19 pandemic: A mixed-methods study

An inability to take breaks contributed to premature and delayed voiding with a high prevalence of stress and urge incontinence. Nurse leaders can implement policies to promote healthy toileting behaviors.

Examining workplace behaviors in adult women with urinary incontinence: A pilot study

BACKGROUND

Urinary incontinence is a growing issue among adult women globally. Limited data exist examining the impact of occupational, environmental, and behavioral factors on urinary incontinence.

OBJECTIVE

This quantitative, cross-sectional pilot study examined the workplace behaviors of adult women experiencing urinary incontinence. It was hypothesized that specific jobs and work environments would be associated with increased urinary incontinence and urgency based on identified behaviors and work-related conditions.

DESIGN

This study is a quantitative, cross-sectional survey.

METHODS

Adult women (18 years and older) with a history of urinary incontinence were recruited from August 2022 to February 2023 to complete a one-time survey consisting of multiple-choice and short answer questions identifying specific workplace behaviors and symptoms of urinary incontinence. Descriptive statistics and data categorization were used to observe outcomes and examine relationships between urinary incontinence and particular professions.

RESULTS

Urinary incontinence and urgency-related symptoms affected healthcare and business professionals at a higher prevalence. The most commonly reported behaviors across all professions consisted of withholding urine and utilizing absorbance products.

CONCLUSION

The results of this study will help guide women's health practitioners in exploring current workplace behaviors that may contribute to urinary incontinence in adult women. With this knowledge, practitioners can provide meaningful education to employers and employees to prioritize toileting behaviors in the workplace.

Sex differences in lower urinary tract symptoms of Korean workers: Prevalence, mental health, and associated factors

Objectives

Lower urinary tract symptoms (LUTS) in workers can aggravate mental health, lower quality of life, and decrease work productivity. We aimed to examine the prevalence of LUTS, sex-related differences in LUTS, mental health of workers with LUTS, and factors associated with LUTS in Korean workers.

Methods

This cross-sectional study included 192 workers from D city and the Gyeongbuk province of South Korea. LUTS were measured using self-reported questionnaires, and mental health was assessed for anxiety, depression, and perceived stress. Differences in characteristics between workers with and without LUTS were analyzed using the chi-square test or independent t-test. Multiple logistic regression analysis was performed to identify factors associated with LUTS.

Results

Urinary urgency (UU) was significantly more prevalent in men than in women; however, stress urinary incontinence (SUI) was more prevalent in women than in men. The average anxiety and perceived stress scores were significantly higher in men with UU than in men without UU. Men with hypertension or nocturia were more likely to have UU than those without hypertension or nocturia. The anxiety scores significantly increased the odds of UU in men. Advanced age significantly increased the odds of SUI in women. Blue-collar female workers were more likely to develop SUI than their white-collar counterparts.

Conclusions

Our study highlighted the prevalence and burden of LUTS among workers. Occupational health providers need to regularly assess workers' bladder storage problems and provide manageable interventions for UU in men and SUI in women.

Identifying occupational health inequities in the absence of suitable data: are there inequities in access to adequate bathrooms in US workplaces?

OBJECTIVES

Our research questions are often chosen based on the existence of suitable data for analysis or prior research in the area. For new interdisciplinary research areas, such as occupational health equity, suitable data might not yet exist. In this manuscript, we describe how we approached a research question in the absence of suitable data using the example of identifying inequities in adequate bathrooms in US workplaces.

METHODS

We created a conceptual model that hypothesises causal mechanisms for occupational health inequities, and from this model we identified a series of questions that could be answered using separate data sets to better understand inequities in adequate workplace bathrooms. Breaking up the analysis into multiple steps allowed us to use multiple data sources and analysis methods, which helped compensate for limitations in each data set.

RESULTS

Using the conceptual model as a guide, we were able to identify some jobs that likely have inadequate bathrooms as well as subpopulations potentially at higher risk for inadequate bathrooms. We also identified specific data gaps by reflecting on the challenges we faced in our multistep analysis. These gaps, which indicated future data collection needs, included difficulty finding data sources for some predictors of inadequate bathrooms that prevented us from fully investigating potential inequities.

CONCLUSIONS

We share our conceptual model and our example analysis to motivate researchers to avoid letting availability of data limit the research questions they pursue.

Prevalence and influencing factors of lower urinary tract symptoms in female nurses: a cross-sectional study based on TARGET

Background

Even though occupational women have a high incidence of lower urinary tract symptoms (LUTS), which seriously affect their daily work life, few large scale sample studies have provided empirical evidence to support this phenomenon among female nurses in China. Consequently, this article investigated female nurses who was presupposed to have a high prevalence of LUTS, which adversely exposes their health and patient safety to these risks. Additionally, it is considered important to explore the factors associated with LUTS in female nurses for patient care safety and nurse bladder health practice.

Objectives

The purpose of this study was to assess the incidence of LUTS and symptoms-related risk factors among female nurses, to provide evidence for the prevention and control of LUTS.

Methods

An online survey recruiting 23,066 participants was carried out in a multicenter cross-sectional study in 42 hospitals from December 2020 to November 2022. Stepwise multivariate logistic regression analysis and nomogram were used to identify the factors associated with lower urinary tract symptoms. Besides, SPSS version 26.0, R version 4.2.2, and GraphPad Prism Version 8.3 software packages were used for statistical analysis.

Results

Based on the completion rate of the questionnaire which was 84.1% (n = 19,393), it was found that among 19,393 female nurses, the prevalence of LUTS was 67.71% and this rate was influenced by age, Body Mass Index (BMI), marital status, years of working, menstrual status, mode of delivery, history of breastfeeding, history of miscarriage, history of alcohol and coffee or tea consumption (p < 0.05). Interestingly, we also find that in addition to the above mentioned factors, anxiety, depression, and perceived stress were also related to LUTS in female nurses (p < 0.05).

Conclusion

Given the high prevalence of LUTS among female nurses and their potential influencing factors, female nurses should focus on their reproductive health and develop good lifestyle habits. Thus, nursing managers should provide a warm and harmonious work environment and sensitize female nurses to increase their awareness about the importance of drinking clean water and urinating during work in a hygienic environment.

Women's Health and Working Life: A Scoping Review

Women's health matters for participation in working life. The objective of this study was to explore female physiology in a work-life context and to investigate possible associations between women's health, sickness absence and work ability. A scoping review was conducted to develop a systematic overview of the current research and to identify knowledge gaps. The search strategy was developed through a population, concept and context (PCC) model, and three areas of women's health were identified for investigation in the context of work. A total of 5798 articles were screened by title and abstract and 274 articles were screened by full text; 130 articles were included in the review. The material included research from 19 countries; the majority of the studies used quantitative methods. The results showed an impact on the occupational setting and an association between sickness absence, work ability and all three areas of women's health, but a holistic and overall perspective on female biology in the work context is missing. This review calls for more knowledge on health and work and possible gender differences in this regard. Women's health and working life involve a complex connection that has the potential to develop new knowledge.

Humans peeing: Justice-involved women's access to toilets in public spaces

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.

Working Alone, Limited Restroom Accessibility, and Poor Menstrual Health Among Cosmetics Saleswomen in South Korea

Menstrual hygiene management (MHM) at work has been neglected in occupational health research despite its importance for female workers' health. This study investigated the association between hours of working alone and poor menstrual health among 740 cosmetics saleswomen in South Korea. Hours of working alone in a day were classified into 4 categories. MHM was measured by asking "Over the past six months, have you ever experienced that you could not change your sanitary pad when you need to change it at work?" We also measured the experience of dermatopathy due to unchanged sanitary pads. Cosmetics saleswomen who worked alone for 3 h or more in a day reported a higher prevalence of ever being unable to change the sanitary pads (prevalence ratio [PR] 1.84, 95% confidence interval [CI]: 1.37-2.46) and dermatopathy due to unchanged sanitary pads (PR 2.06, 95% CI: 1.18-3.59) than those who worked alone less than 1 h in a day.

A mixed-methods pilot study exploring midwives' job satisfaction: Is being of service to women the key?

INTRODUCTION

The purpose of this research project was to investigate midwives' job satisfaction in Australian maternity care settings.

METHODS

A mixed methods pilot study using the convergent parallel design, and a mixed-methods approach was used for this study. The Nursing Workplace Satisfaction questionnaire was used to collect data online via social media platforms, and consisted of Likert Scale responses, and both closed and opened ended questions.

RESULTS

The quantitative results noted an overall positive result to participants' job satisfaction, however there were areas that participants reported as problematic. These areas were delved into further via the results of the qualitative data which highlighted eight themes that explored the participants' perception of the worst things that impacted upon their job satisfaction, and also the best things which impacted in relation to their current jobs.

CONCLUSIONS

This study revealed factors including staff shortages, being time-poor, missing basic human rights like meals and comfort breaks which were linked to midwives' dissatisfaction with their jobs in Australia. The study also identified that midwives valued being of service to women, and that this factor was a driving force in job satisfaction.

Female nurses have a higher prevalence of urinary tract symptoms and infection than other occupations in dialysis units

Introduction:

Urinary tract symptoms and infection have been associated with occupational factors that impact hydration habits particularly in women. We compared self-reported urinary symptoms and infection and hydration habits between nurses and other occupations in dialysis units.

Methods:

Cross-sectional study. Participants worked in five nephrology centers in Brazil and answered an online questionnaire comprising questions regarding urinary tract symptoms and infection episodes in the preceding year; data on usual daily beverage intake, urine frequency, and urine color according to a urine color chart were also collected, as well as perceptions of water access and toilet adequacy at work.

Results:

We included 133 women (age=36.9±9.5 years). The self-reported usual daily beverage intake was 6.6±2.9 cups/day (~1320 mL), daily urine frequency was 5.4±2.1, and urine color chart score: 3.0±1.2. Nurses (N=66/49.6%) reported higher prevalence of burning sensation (50 versus 27%; P<0.001), urinary urgency (42 versus 21%; P<0.001), and infection (42% versus 25%; P=0.04) as well as lower liquid intake (6.0±2.6 versus 7.3±3.0 cups/day; P=0.01) than controls. Forty four percent of nurses reported being able to drink when thirsty "always" and "most of the time" versus 93% of the control group.

Conclusion:

Dialysis female nurses reported lower beverage intake and higher prevalence of symptoms and infection than other occupations in the same environment. Interventions to improve hydration can potentially decrease urinary problems in this population.

Toileting Behaviors Related to Urination in Women: A Scoping Review

This scoping review explores the state of science regarding women’s toileting behaviors, gaps in knowledge, and areas for future research. Online databases were searched to identify papers published in English between January 2010 through July 2019; the search identified 25 articles. The Toileting Behaviors–Women’s Elimination Behaviors scale has been published in four validated language versions and used in 17 of the 25 studies. The most frequent behaviors include concern about public toilet cleanliness, delaying urination when busy or away from home, and using different toileting postures at and away from home. Determinants of toileting behaviors include environmental factors, chronic health conditions, and cognitive/psychological factors. Associations were found between toileting behaviors and lower urinary tract symptoms and between toileting postures and uroflowmetric parameters and post-void residual volume. Strategies that address modifiable determinants of toileting behaviors should be developed and tested in future research. Furthermore, little is known about the toileting behaviors and bladder health in older women and women from developing countries. Rigorous studies are needed to better understand the underlying mechanisms of toileting behaviors, the nature of associations between toileting behaviors and lower urinary tract symptoms, and effects of the environment on women’s toileting behaviors.

U.S. Adolescent and Adult Women's Experiences Accessing and Using Toilets in Schools, Workplaces, and Public Spaces: A Multi-Site Focus Group Study to Inform Future Research in Bladder Health

The World Health Organization recognizes access to clean and safe toilets as crucial for public health. This study explored U.S. adolescent and adult cisgender women's lived experiences accessing toilets in schools, workplaces, and public spaces. As part of the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium, we conducted 44 focus groups with female participants (n = 360; ages 11-93). Focus groups were stratified by age (11-14, 15-17, 18-25, 26-44, 45-64, 65+) and conducted across 7 geographically diverse U.S. sites from July 2017-April 2018. Using a transdisciplinary approach, we conducted conventional qualitative coding informed by our PLUS conceptual framework and used content analysis processes to identify salient themes. Across settings, toilet access was restricted by "gatekeepers" (i.e., individuals who control access to toilets). In contrast, self-restricting toilet use (deciding not to use the toilet despite biologic need to urinate) was based on internalized norms to prioritize school and job responsibilities over urination. In public spaces, self-restricting use was largely in response to lack of cleanliness. Across the life course, participants perceived gender disparities in the ability to easily access public toilets. Further research is needed to determine if and how these factors impact bladder health across the life course.

Delaying voiding, limiting fluids, urinary symptoms, and work productivity: A survey of female nurses and midwives

AIM

To examine the relationships between workplace bladder practices, urinary symptoms, and work productivity.

DESIGN

Cross-sectional observational survey.

METHODS

Surveys were distributed June-November 2016 to at least 600 female nurses and midwives at three urban hospitals in New South Wales, Australia. Nurses self-reported restricted workplace access to toilets, delaying voiding, limiting of fluid intakes and urinary symptoms at work. Logistic modelling was used to examine whether nurses' bladder practices impaired their time management, ability to concentrate or perform physical demands.

RESULTS

Of 353 useable surveys, one in five nurses (22.4%; N = 79) reported restricted access to toilets at work, most (77.1%; N = 272) delayed voiding and one in four (26.9%; N = 95) limited fluid intakes to delay voiding at work. Almost half the sample had urinary symptoms at work (46.7%; N = 165); delaying voiding increased the likelihood of impaired mental concentration and limiting fluid intakes increased the likelihood of impaired time management.

CONCLUSION

As workplace access to toilets and related bladder practices are modifiable, associated urinary symptoms and productivity loss may be preventable.

IMPACT

Nurses' often experience restricted accesses to amenities due to job demands and workplace environments. The impact of nurses' poor bladder practices in the workplace is not known. In this study most nurses delayed voiding and many purposefully limited fluid intakes at work. These behaviours impacted a nurse's ability to manage time and/or concentrate at work. Results have implications for nurses' personal health, the design of workplace environments, workforce management, occupational health policy, and patient care.