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Gümüşsoy S, Dönmez S. Investigation of social isolation and depression in female employees with urinary incontinence during the COVID-19 pandemic period. Work 2024:WOR240028. [PMID: 39031424 DOI: 10.3233/wor-240028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2024] Open
Abstract
BACKGROUND Urinary incontinence (UI) affects almost one-third of adult women. This is often taken as a section of the aging process and incurable In general, women perceive UI as more of a social issue and a taboo rather than a medical problem; they are reluctant to discuss the matter or seek assistance. OBJECTIVE This research was conducted to investigate the level of social isolation and depression in female employees with UI during the COVID-19 pandemic period. METHODS The study was done with 533 paticipant. The study data were done using the Nottingham Health Profile Social Isolation Scale (NHPSIS), and Beck Depression Inventory (BDI). RESULTS The total scores of the NHPSIS and BDI were found to be 18.55±3.3 (minimum = 5, maximum = 25) and 49.22±11.4 (minimum = 12, maximum = 60), respectively. In the Pearson correlation analysis, a strong, statistically significant, and positive correlation was discovered between NHPSIS and the average BDI total scores among women. CONCLUSION The level of depression and social isolation were obtained to be high among UI women who had a mix UI, high frequencies of UI, belong to higher age groups, singles, and high body mass index. It was showed that the levels of depression and social isolation scores were showed to be high in women had UI.
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Affiliation(s)
- Süreyya Gümüşsoy
- Ege University, Atatürk Health Care Vocational School, Bornova/Izmir/Turkey
| | - Sevgül Dönmez
- Department of Nursing, Muğla Sitki Koçman University, Institute of Health Sciences, Muğla-Turkey
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Buck J, Fromings Hill J, Collins R, Booth J, Fleming J. Effectiveness of non-pharmacological interventions delivered at home for urinary and faecal incontinence with homebound older people: systematic review of randomised controlled trials. Age Ageing 2024; 53:afae126. [PMID: 38941119 PMCID: PMC11212545 DOI: 10.1093/ageing/afae126] [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: 11/10/2023] [Indexed: 06/29/2024] Open
Abstract
INTRODUCTION Incontinence is a common, distressing condition, most prevalent in older people. There is an unmet need for effective interventions to support continence. This review focuses on non-pharmacological interventions to reduce incontinence among homebound older people. Aim: to identify interventions with potential to be delivered by care workers, nurses or family members in a person's home. METHODS Multiple databases were searched until 15 September 2023 for randomised controlled trials reporting home-based interventions for incontinence for older people (≥65 years) living at home. Two reviewers independently screened titles, abstracts and papers against inclusion criteria, then assessed for the Risk of Bias (RoB2). A third reviewer resolved the discrepancies. Primary data were extracted and synthesised. RESULTS A full-text review of 81 papers identified seven eligible papers (1996-2022, all USA), including n = 636 participants (561 women and 75 men). Two studies focusing on multicomponent behavioural interventions showed benefit, as did one study of transcutaneous tibial nerve stimulation self-administered through electrode-embedded socks. Three, which included cognitively impaired people, reported improvement with toileting assistance programmes, but the effects were not all significant. Results were inconclusive from a study examining the effects of fluid intake adjustments. Interventions were delivered by nurses, three in collaboration with family caregivers. No faecal incontinence interventions met the criteria. CONCLUSION There is scant evidence for continence supporting interventions delivered in older people's own homes. With an ageing population often reliant on family or social care workers well-placed to support continence promotion and policy drives for services to support older people remaining at home, this evidence gap needs addressing.
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Affiliation(s)
- Jackie Buck
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
- St Bartholomew’s Hospital, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK
| | - Julia Fromings Hill
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Rachael Collins
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Joanne Booth
- Research Centre for Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Jane Fleming
- Cambridge Public Health Interdisciplinary Research Centre, University of Cambridge, Cambridge, UK
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Pan T, Zhang Z, He T, Zhang C, Liang J, Wang X, Di X, Hong Y, Bai P. The association between urinary incontinence and suicidal ideation: Findings from the National Health and Nutrition Examination Survey. PLoS One 2024; 19:e0301553. [PMID: 38781254 PMCID: PMC11115289 DOI: 10.1371/journal.pone.0301553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/15/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Urinary incontinence (UI) might be linked to suicidal ideation, but we do not yet have all the relevant details. This study aimed to dig deeper into the connection between UI and suicidal ideation using data from the National Health and Nutrition Examination Survey (NHANES). METHODS We examined 31,891 participants aged ≥ 20 years from NHANES 2005-2018 who provided complete information. We used standardized surveys to check for UI and signs of suicidal ideation. To better understand this relationship, we used statistical tools such as multivariable logistic regression, subgroup analysis, and sensitivity analyses. RESULTS Among the 31,891 participants, 28.9% reported UI and 10.7% reported suicidal ideation. Those with UI exhibited a significantly greater incidence of suicidal ideation (15.5%) than did those without UI (8.8%, P < 0.001). After adjusting for various factors, including age, sex, marital status, socioeconomic status, educational level, lifestyle factors, and chronic comorbidities, UI remained significantly associated with suicidal ideation (OR:1.54, 95% CI = 1.39-1.7, P < 0.001). Among all types of UI, MUI participants were more likely to experience suicidal ideation. Compared with no UI, higher odds of suicidal ideation suffered from MUI (OR:2.11, 95%CI:1.83-2.44, P < 0.001), SUI (OR:1.4, 95%CI:1.19-1.65, P < 0.001), UUI(OR:1.37,95%CI:1.16-1.62, P < 0.001) after full adjustment. With the exception of individuals living with a partner, the remaining subgroups exhibited a positive correlation between urinary incontinence and suicidal ideation, considering that factors such as age, sex, and prevalent comorbidities such as hypertension, depression, and diabetes did not reveal any statistically significant interactions (all P > 0.05). Sensitivity analyses, incorporating imputed missing covariates, did not substantially alter the results (OR: 1.53, 95% CI: 1.4-1.68, P < 0.001). CONCLUSION Urinary incontinence may correlate with increased suicidal ideation risk, priority screening for suicidal ideation and timely intervention are essential for individuals with urinary incontinence, but prospective studies are needed to verify the results.
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Affiliation(s)
- Ting Pan
- Department of Acupuncture, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, 100029, China
| | - Zhiguo Zhang
- China Academy of Chinese Medical Sciences Institute of Basic Theory in Chinese Medicine, Beijing, 100700, China
| | - Tiantian He
- Department of Acupuncture, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, 100029, China
| | - Chongyang Zhang
- Department of Acupuncture, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, 100029, China
| | - Junjie Liang
- Department of Acupuncture, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, 100029, China
| | - Xinru Wang
- Department of Acupuncture, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, 100029, China
| | - Xueshi Di
- Department of Acupuncture, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, 100029, China
| | - Yuying Hong
- Department of Acupuncture, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, 100029, China
| | - Peng Bai
- Department of Acupuncture, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, 100029, China
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Zhang Y, Fang D, Luo Y, Wang C, Wan L, Cao Y, Xin H, Ding H. A large cross sectional study on diaper utilization and beneficial role in outdoor activity and emotions among incontinence elderly people. Sci Rep 2024; 14:6358. [PMID: 38491120 PMCID: PMC10943191 DOI: 10.1038/s41598-024-57055-5] [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: 01/26/2024] [Accepted: 03/13/2024] [Indexed: 03/18/2024] Open
Abstract
This study was designed based on a cross-sectional investigation conducted Shanghai, China. Demographic characteristics, diaper utilization, Activities of Daily Living (ADL) and emotion were collected by Unified Needs Assessment Form for Elderly Care Questionnaire. Cognition function was assessed by Mini-mental State Examination (MMSE) scale. Multivariate logistic regression was used for statistical analysis. The diaper utilization rate was 31.2%. Female, higher level of education, poorer ADL and cognition, more severe incontinence and financial dependence on others were facilitating factors for diaper usage (P < 0.05). The possibility of using diaper differed according to the intimacy of caregivers. Among incontinent individuals with relatively good ADL and cognition level, diaper utilization can significantly decrease the risk of going out only once a month (OR: 2.63 vs 4.05), and going out less than once a month (OR: 5.32 vs 6.53). Incontinence people who going out at least once a week had a lower risk of some negative emotion. Significantly, diaper utilization further decreased this risk. In conclusion, for incontinence elderly people with relatively independent ability, proper use of diaper may improve the frequency of outdoor activity and emotion. Nevertheless, diaper utilization should be decided based on elderly people's own will.
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Affiliation(s)
- Yunwei Zhang
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, 200031, People's Republic of China
| | - Dawei Fang
- Department of Cardiology, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, Fujian, People's Republic of China
| | - Yashuang Luo
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, 200031, People's Republic of China
| | - Changying Wang
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, 200031, People's Republic of China
| | - Lingshan Wan
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, 200031, People's Republic of China
| | - Yifan Cao
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, 200031, People's Republic of China
| | - Hongyun Xin
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, 200031, People's Republic of China
| | - Hansheng Ding
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, 200031, People's Republic of China.
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Abe T, Matsumoto S, Kunimoto M, Hachiro Y, Ota S, Ohara K, Inagaki M, Saitoh Y, Murakami M. Prevalence of Double Incontinence and Lower Urinary Tract Symptoms in Patients with Fecal Incontinence: A Single-center Observational Study. J Anus Rectum Colon 2024; 8:30-38. [PMID: 38313750 PMCID: PMC10831982 DOI: 10.23922/jarc.2023-040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/05/2023] [Indexed: 02/06/2024] Open
Abstract
Objectives Double incontinence (DI), which is the co-occurrence of fecal incontinence (FI) and urinary incontinence (UI), increases with age and has a greater negative impact on the quality of life (QOL) than either incontinence alone. We aimed to assess lower urinary tract symptoms (LUTS) in patients with FI to elucidate the prevalence and characteristics of DI. Methods This study enrolled consecutive patients who visited our hospital with FI symptoms. FI was evaluated using the Cleveland Clinic Florida Fecal Incontinence Score (CCFIS). LUTS were assessed using the International Prostate Symptom Score (IPSS), QOL score (IPSS-QOL) and Overactive Bladder Symptom Score (OABSS). Results This study evaluated 140 patients (96 women [mean age: 70.7 years] and 44 men [mean age: 74.4 years]). The mean IPSS was significantly higher in men than in women (12.0 vs. 7.5, p = 0.003). A positive correlation was found between IPSS and CCFIS in women (r = 0.256, p = 0.012) but not in men. For both sexes, the older group (aged ≥70 years) had higher OABSS scores and more urge UI instances than the younger group (aged ≤69 years). Of the 140 patients with FI, 78 (55.7%) had DI, and DI was more common in women than in men (63.5% vs. 38.6%, p = 0.006). Conclusions The characteristics of LUTS and UI in patients with FI were comparable to those in the general population for both sexes; however, the prevalence of DI was much higher among patients with FI than that in the general population.
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Affiliation(s)
- Tatsuya Abe
- Department of Proctology, Kunimoto Hospital, Asahikawa, Japan
| | - Seiji Matsumoto
- Headquarters for Research Promotion, Asahikawa Medical University, Asahikawa, Japan
| | - Masao Kunimoto
- Department of Proctology, Kunimoto Hospital, Asahikawa, Japan
| | | | - Shigenori Ota
- Department of Proctology, Kunimoto Hospital, Asahikawa, Japan
| | - Kei Ohara
- Department of Proctology, Kunimoto Hospital, Asahikawa, Japan
| | | | - Yusuke Saitoh
- Department of Gastroenterology, Kunimoto Hospital, Asahikawa, Japan
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Akobundu UN, Onuzulu MS, Obiekwe SJ, Akosile CO, Daniel JA, Nwankwo MJ, Ochiabuto OMT. Prevalence of urinary incontinence and knowledge of pelvic floor muscle training among older women in a Nigerian suburban community. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241276255. [PMID: 39245961 PMCID: PMC11382240 DOI: 10.1177/17455057241276255] [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: 09/10/2024]
Abstract
BACKGROUND Urinary incontinence (UI) is a highly prevalent condition in women with a profound influence on their well-being and quality of life. Pelvic floor muscle training (PFMT) is a widely accepted conservative management of incontinence. Adequate knowledge of PFMT can enhance the ability of individuals to perform them effectively unsupervised. OBJECTIVES This study aimed to determine the prevalence of UI and knowledge of PFMT among older women in a selected suburban community in Nigeria. DESIGN A cross-sectional design. METHODS This study consecutively recruited 121 older women (65 years and above) with a mean age of 68.59 ± 4.94 years in Nnewi North LGA Anambra state, Nigeria. The International Consultation on Incontinence Questionnaire Short Form and an adopted pre-tested questionnaire were used to assess the prevalence of UI and knowledge of PFMT. Data was analyzed using Statistical Package of Social Sciences (SPSS) version 26 Descriptive statistics, and the chi-square test was utilized with significance determined at an alpha level of 0.05. RESULTS The results revealed that 33.88% of the respondents experience UI, and 3.3% of them have heard about PFMT. There was significant association between prevalence of UI and number of pregnancies (χ2 = 11.16, p = 0.03) and children (χ2 = 9.77, p = 0.04). There was no significant association between the prevalence of UI and level of education (χ2 = 4.20, p = 0.12) and knowledge of PFMT (χ2 = 0.48, p = 0.42). There was no significant association between knowledge of PFMT and number of pregnancies (χ2 = 04.25, p = 0.37), and number of children (χ2 = 4.02, p = 0.40). There was a significant association between knowledge of PFMT and level of education among the participants (χ2 = 7.46, p = 0.02). CONCLUSION The study showed a significant prevalence of UI and poor knowledge of PFMT in older women. Health professionals should sensitize older women in hospitals and care homes on the benefits of PFMT to improve their knowledge of PFMT.
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Affiliation(s)
| | | | - Sochima Johnmark Obiekwe
- Department of Medical Rehabilitation, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
- Department of Public Health, Lomo University of Research, Freesias, Kinshasa, DR Congo
| | | | - Jovita Ada Daniel
- Department of Prosthetics and Orthotics, Federal University of Technology, Owerri, Imo State, Nigeria
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Nishimoto K, Tsutsumimoto K, Doi T, Kurita S, Kiuchi Y, Shimada H. Urinary incontinence and life-space activity/mobility additively increase the risk of incident disability among older adults. Maturitas 2024; 179:107870. [PMID: 37939451 DOI: 10.1016/j.maturitas.2023.107870] [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] [Received: 06/06/2023] [Revised: 10/19/2023] [Accepted: 10/22/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES To examine the associations of a combination of urinary incontinence (UI) and life-space activity/mobility with the risk of incident disability among community-dwelling older adults. STUDY DESIGN The participants were 12,808 older adults for the cross-sectional study and 12,516 older adults who completed the follow-up assessment. MAIN OUTCOME MEASURES UI was assessed using a questionnaire. Life-space activity/mobility was evaluated using total, physical, and social scores on the Active Mobility Index (AMI). Participants were classified into four groups (high AMI total score + no UI; high AMI total score + UI; low AMI total score + no UI; low AMI total score + UI). Incident disability was extracted from the Japanese Long-Term Care System. RESULTS During the 24-month follow-up, 562 participants (4.5 %) developed disability. Those with a low AMI score + no UI (hazard ratio, 1.35; 95 % confidence interval, 1.07-1.71) and those with a low AMI score + UI (hazard ratio, 2.00; 95 % confidence interval, 1.56-2.56) had a higher risk of incident disability than those with a high AMI score + no UI in the follow-up analysis. CONCLUSIONS A combination of UI and low AMI score was associated with an increased risk of incident disability, whereas having UI but a high AMI score was not associated with an increased risk of incident disability. Our findings may help identify older adults at high risk of developing disabilities.
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Affiliation(s)
- Kazuhei Nishimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan; Medical Science Division, Department of Medical Sciences, Graduate School of Medicine, Science and Technology, Shinshu University, Matsumoto, Japan.
| | - Kota Tsutsumimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Takehiko Doi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Satoshi Kurita
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Yuto Kiuchi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan; Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
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Kalata U, Pomian A, Jarkiewicz M, Kondratskyi V, Lippki K, Barcz E. Influence of Stress Urinary Incontinence and Pelvic Organ Prolapse on Depression, Anxiety, and Insomnia-A Comparative Observational Study. J Clin Med 2023; 13:185. [PMID: 38202192 PMCID: PMC10779935 DOI: 10.3390/jcm13010185] [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: 11/09/2023] [Revised: 12/06/2023] [Accepted: 12/26/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Among pelvic floor disorders (PFDs), overactive bladder is a well-recognized condition affecting mental health. The aim of this study was to assess whether there is a correlation between stress urinary incontinence (SUI), pelvic organ prolapse (POP), and mental health in comparison to control subjects and whether objective or subjective aspects of diseases are responsible for the aforementioned symptoms. METHODS 192 patients with SUI, 271 with symptomatic prolapse (>2 in the POPQ scale), and 199 controls without pelvic floor disorders were included in this study. Patients completed questionnaires assessing levels of depression, anxiety, and insomnia. The 1-h pad test and IIQ-7 questionnaires were collected in SUI. The pelvic organ prolapse quantification scale and the POPDI6, UDI6, and CRADI-8 questionnaires were used in POP patients. RESULTS Higher scores in psychiatric scales were observed in SUI (p < 0.05) and POP (p < 0.05) compared to control. There were no correlations between the objective severity of PFDs and psychological symptoms, while subjective complaints correlated with psychological health. In conclusion, we showed that subjective perceptions of SUI and POP are factors that augment psychiatric symptoms, while objective severity is not correlated with mental status. CONCLUSIONS Our findings suggest that patients with PFDs necessitate multidisciplinary attention, including psychiatric care.
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Affiliation(s)
- Urszula Kalata
- Chair of Gynecology and Obstetrics, Medical Faculty, Collegium Medicum, Cardinal Stefan Wyszynski University, 01-938 Warsaw, Poland; (U.K.); (A.P.); (V.K.); (K.L.)
| | - Andrzej Pomian
- Chair of Gynecology and Obstetrics, Medical Faculty, Collegium Medicum, Cardinal Stefan Wyszynski University, 01-938 Warsaw, Poland; (U.K.); (A.P.); (V.K.); (K.L.)
| | - Michał Jarkiewicz
- 3rd Department of Psychiatry, Institute of Psychiatry and Neurology, 02-957 Warsaw, Poland;
| | - Vitalii Kondratskyi
- Chair of Gynecology and Obstetrics, Medical Faculty, Collegium Medicum, Cardinal Stefan Wyszynski University, 01-938 Warsaw, Poland; (U.K.); (A.P.); (V.K.); (K.L.)
| | - Krzysztof Lippki
- Chair of Gynecology and Obstetrics, Medical Faculty, Collegium Medicum, Cardinal Stefan Wyszynski University, 01-938 Warsaw, Poland; (U.K.); (A.P.); (V.K.); (K.L.)
| | - Ewa Barcz
- Chair of Gynecology and Obstetrics, Medical Faculty, Collegium Medicum, Cardinal Stefan Wyszynski University, 01-938 Warsaw, Poland; (U.K.); (A.P.); (V.K.); (K.L.)
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Kelly AM. A holistic approach to assessing an individual with urinary incontinence. Br J Community Nurs 2023; 28:445-454. [PMID: 37638755 DOI: 10.12968/bjcn.2023.28.9.445] [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: 08/29/2023]
Abstract
Urinary incontinence can have an overwhelmingly negative impact on an individual's quality of life. The personal, physical, psychosocial and sexual implications of urinary incontinence can affect health and well-being. This can increase the risk of falls, depression, anxiety, social isolation alongside a greater need for long-term care from a individual's own home. Statically, the prevalence rates of urinary incontinence increases with age; however, incontinence is not an inevitable or acceptable part of ageing-symptoms can be improved and managed effectively for suffers of this common condition. Urinary incontinence can be challenging to assess, address and overcome for individuals. However health professionals need to have the expertise and experience to undertake a comprehensive continence assessment. When assessment is completed evidence-based interventions can be recommended, implemented and subsequently evaluated.
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Affiliation(s)
- Anne Marie Kelly
- Clinical Nurse Specialist-Continence, Dublin South, Kildare and West Wicklow CHO, Elinor Lyons Building, Meath Campus, Heytesbury Street, Dublin 8
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Min EE, Thomas J. Urinary incontinence prevalence and factors associated with patients talking with doctors about urine control. J Family Med Prim Care 2023; 12:1555-1570. [PMID: 37767451 PMCID: PMC10521848 DOI: 10.4103/jfmpc.jfmpc_1955_22] [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: 10/04/2022] [Revised: 11/09/2022] [Accepted: 03/29/2023] [Indexed: 09/29/2023] Open
Abstract
Objectives Patient perceptions of their doctors may influence talking to them about urinary incontinence (UI). We estimated prevalence of UI among Medicare beneficiaries and assessed association between beneficiaries' demographic and clinical characteristics and whether they spoke to their doctor about UI and association between beneficiaries' perceptions of their doctor and whether they spoke to their doctor about UI. Methods This study was approved by the Purdue University Institutional Review Board (IRB) and determined exempt, category 4 (protocol number 1907022503, approval on August 5th, 2019). Medicare Current Beneficiary Survey (MCBS) 2016 data were analyzed. Beneficiaries who indicated that they lost urine control 2-3 times a month or above were classified as experiencing UI. An 11-item patient perception of their physician scale was created based on MCBS items. Perceptions were categorized as favorable or unfavorable. SAS version 9.4 for Unix was used for all analyses. PROC LOGISTIC was used to assess multi-variable association between beneficiaries' perceptions of their doctors and talking to their doctor about UI. Results Among 7466 persons meeting inclusion criteria, 1856 (24.9%) had UI. The perception of doctor scale scores ranged from 15 to 44, with mean score = 36.57 (standard deviation = 5.29). The scale Cronbach alpha reliability was 0.93. Using sensitivity and receiver operating characteristic analysis, a cutoff of 30 or higher was identified as a favorable perception. Beneficiaries with favorable perceptions of their doctor were more likely to speak to their doctor about experiencing UI than beneficiaries with unfavorable perceptions (odds ratio = 1.55, 95% confidence interval = 1.03 to 2.35, P-value = 0.038). Conclusion Overall, the more favorable the perception of their physicians, the more likely beneficiaries were to speak to them about their UI.
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Affiliation(s)
- Elissa E. Min
- Department of Pharmacy Practice, College of Pharmacy, Purdue University, West Lafayette, Indiana
| | - Joseph Thomas
- Department of Pharmacy Practice, College of Pharmacy, Purdue University, West Lafayette, Indiana
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Mat S, Jaafar MH, Razack AHA, Lim J, Ong TA, Khong SY, Kamaruzzaman SB, Chin AV, Abbas AA, Chan CK, Hairi NN, Othman S, Tan MP. Gender differences in the associations between knee pain and urinary incontinence in older adults: Cross-sectional analysis from the Malaysian Elders Longitudinal Research Study (MELoR). Neurourol Urodyn 2023; 42:641-649. [PMID: 36728321 DOI: 10.1002/nau.25136] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/30/2022] [Accepted: 01/16/2023] [Indexed: 02/03/2023]
Abstract
INTRODUCTION The common assumption that urinary incontinence occurs in osteoarthritis (OA) due to poor mobility is supported by limited evidence. The influence of gender in such associations is also yet to be elucidated. OBJECTIVE This study, therefore, identified any potential associations between knee OA symptoms and urinary incontinence and further explore sex differences in the associations. DESIGN Cross-sectional study. SETTING University Hospital. PARTICIPANTS This was a cross-sectional study from a longitudinal research study comprising 1221 community-dwelling older persons (57% women), mean age (SD) 68.95 (7.49) years. MAIN OUTCOME MEASURE(S) Presence of urinary incontinence: mixed, stress and urge symptoms. Physical performance and C-reactive protein levels were also assessed. RESULTS Two hundred and seventy-seven (22.83%) individuals reported the presence of urinary incontinence: mixed (41.5%), stress (30%), and urge (28.5%) symptoms. In an unadjusted analysis, stratified by gender, the association between knee pain and urinary incontinence was only present in women with mixed symptoms. After further adjustment of demographics differences and body mass index, the association between knee pain with any urinary incontinence and mixed symptoms remained significant with the odds ratios (95% confidence interval): 1.48 (1.02-2.15) and 1.73 (1.06-2.83), respectively. This relationship was attenuated after further adjustment for waist circumference and impaired lower limb mobility. CONCLUSION Our study refutes previous assumptions that urinary incontinence in individuals with OA is attributed to impaired mobility alone, but introduces the role of abdominal obesity in this relationship, particularly in women. Future studies should assess the temporal relationship between body fat distribution and OA with urinary incontinence.
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Affiliation(s)
- Sumaiyah Mat
- Physiotherapy Program and Center for Healthy Ageing and Wellness (H-CARE), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.,Ageing and Age-Associated Disorders Research Group, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mohamad Hasif Jaafar
- Academy of Contemporary Islamic Studies (ACIS), University of Technology Mara Negeri Sembilan Branch, Kuala Pilah, Negeri Sembilan, Malaysia
| | - Azad H A Razack
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Jasmine Lim
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Teng Aik Ong
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Su-Yen Khong
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Shahrul Bahyah Kamaruzzaman
- Ageing and Age-Associated Disorders Research Group, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ai-Vyrn Chin
- Ageing and Age-Associated Disorders Research Group, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Azlina Amir Abbas
- Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence in Research and Learning (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chee Ken Chan
- Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence in Research and Learning (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Noran Naqiah Hairi
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sajaratulnisah Othman
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Maw Pin Tan
- Ageing and Age-Associated Disorders Research Group, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Bandar Sunway, Malaysia
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Sex-specific impacts of social isolation on loneliness, depressive symptoms, cognitive impairment, and biomarkers: Results from the social environment and biomarker of aging study. Arch Gerontol Geriatr 2023; 106:104872. [PMID: 36493576 DOI: 10.1016/j.archger.2022.104872] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/03/2022] [Accepted: 11/19/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To investigate sex-specific associations between social isolation and psychological outcomes and biomarkers among community-dwelling middle-aged and older adults using a nationally representative population-based cohort study. METHODS Data from 757 participants from the Social Environment and Biomarkers of Aging Study (SEBAS) were retrieved for analysis, and all participants were stratified by sex. The associations between social isolation and psychological outcomes (loneliness, depressive symptoms, and cognitive impairment) at the 4-year follow-up were examined by multivariate logistic regression models, and associations between social isolation and biomarkers at the 4-year follow-up were examined by multivariate generalized linear models (GLMs). RESULTS For men, social isolation was not associated with the development of loneliness. However, being married (adjusted odds ratio (aOR) 0.32 [95% confidence interval (CI) 0.13-0.74], p<0.001) was associated with a lower risk of loneliness, indicating potential protective effects of marriage for men. On the other hand, social isolation was associated with a 2-fold higher risk of loneliness in women (aOR 2.26 [1.01-5.09], p<0.001). Social isolation was not associated with depressive symptoms after adjusting for other demographics. For men, being married (aOR 0.51 [0.26-0.99], p<0.05) or having good self-reported health (aOR 0.44 [0.21-0.92], p<0.05) was protective against depressive symptoms. For women, only good self-reported health (aOR 0.30 [0.13-0.70], p<0.01) provided protective effects against depressive symptoms. Similarly, other demographic factors (being married and having a higher educational level) but not social isolation were associated with lower risks of cognitive impairment. No significant associations were noted between social isolation and selected biomarkers. CONCLUSIONS Sex-different associations between social isolation and loneliness were noted; the effects of demographic factors, such as being married, self-reported health status, and high education levels, on subsequent loneliness, depression, and cognitive function were also sex-different. Further intervention studies are needed to explore sex-specific approaches to deal with the interplay of social isolation, loneliness, psychological outcomes and other demographic factors.
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Zhang Y. The effect of incontinence on depression among older adults: a longitudinal study in China. Public Health 2022; 212:58-65. [DOI: 10.1016/j.puhe.2022.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/09/2022] [Accepted: 08/30/2022] [Indexed: 11/11/2022]
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Anderson D, Kumar D, Divya D, Zepeda JL, Razzak AN, Hasoon J, Viswanath O, Kaye AD, Urits I. Mental Health in Non-Oncologic Urology Patients. Health Psychol Res 2022; 10:38352. [PMID: 36168643 PMCID: PMC9501847 DOI: 10.52965/001c.38352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
This article is a literature review of mental health concerns in non-oncologic urology patients. Pathologies represented in this review include Peyronie's Disease (PD), erectile dysfunction (ED), urinary incontinence and urinary tract infections (UTI), infertility, benign prostatic hyperplasia (BPH), kidney stones, and urinary retention. While there has been great interventional focus as of late for urogenitary malignancies (i.e. prostate cancer awareness with the Movember campaign), literature studies and intervention focused on non-oncologic urology patients has been limited. As such, we conducted a review on urology patients with non-oncologic pathologies as an effort to increase clinician awareness of mental health concerns among such patients, increase the comfort level for clinician communication on socially sensitive topics surrounding pathologies, and review ongoing interventions conducted within these pathologies. We outlined different ongoing Mental Health Illness (MHI) needs and treatments for various pathologies. Patients with non-cancerous urologic pathologies had lower quality of life and higher incidence of MHI than the general population. As such, in line with the American Urological Association recommendations, psychological and social support from peers, therapists, and healthcare providers further prove to be crucial for some subpopulations. The review also yielded pathology specific interventions such as group therapy for ED patients. Given the higher incidence of MHI in the patient population after the Covid-19 pandemic, MHI awareness in the sphere of non-oncologic urology treatment continues to be crucial when creating a collaborative treatment platform for patients.
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Affiliation(s)
| | - Devesh Kumar
- School of Medicine, Medical College of Wisconsin
| | - Divya Divya
- School of Medicine, University of Missouri- Kansas City
| | | | | | - Jamal Hasoon
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School
| | - Omar Viswanath
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School; Valley Anesthesiology and Pain Consultants, Envision Physician Services; Department of Anesthesiology, University of Arizona College of Medicine Phoenix; Department of Anesthesiology, Creighton University School of Medicine
| | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University Health Shreveport
| | - Ivan Urits
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School; Department of Anesthesiology, Louisiana State University Health Shreveport
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Kessler M, Volz PM, Bender JD, Nunes BP, Machado KP, Saes MDO, Soares MU, Facchini LA, Thumé E. Efeito da incontinência urinária na autopercepção negativa da saúde e depressão em idosos: uma coorte de base populacional. CIENCIA & SAUDE COLETIVA 2022; 27:2259-2267. [DOI: 10.1590/1413-81232022276.10462021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 08/16/2021] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivou-se medir a prevalência de autopercepção negativa da saúde e sintomas depressivos em idosos segundo a presença de incontinência urinária, após nove anos de acompanhamento. Trata-se de um estudo de coorte prospectivo de base populacional intitulado Saúde do Idoso Gaúcho de Bagé, no Rio Grande do Sul. Foram entrevistados 1.593 idosos no estudo de linha de base (2008) e 735 entre setembro de 2016 e agosto de 2017. A exposição “incontinência urinária (IU)” foi avaliada no estudo de linha de base e os desfechos “autopercepção negativa da saúde” e “sintomas depressivos” em 2016/17. A razão de odds e o intervalo de confiança de 95% foram calculados com regressão logística bruta e ajustada para variáveis demográficas, sociais, comportamentais e de condições de saúde. A prevalência de IU foi 20,7% em 2008 e 24,5% em 2016/17; a incidência foi de 19,8%, sendo 23,8% entre as mulheres e 14,6% entre os homens (p = 0,009). Idosos com IU no estudo de linha de base apresentaram chances 4,0 (IC95%:1,8-8,8) e 3,4 (IC95%:1,8-6,2) vezes maior de desenvolver autopercepção negativa da saúde e sintomas depressivos, respectivamente, após nove anos de acompanhamento, comparados àqueles sem IU. Os resultados evidenciam maior chance de problemas mentais entre idosos com IU.
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Affiliation(s)
- Marciane Kessler
- Universidade Regional Integrada do Alto Uruguai e das Missões, Brazil
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16
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Javanmardifard S, Gheibizadeh M, Shirazi F, Zarea K, Ghodsbin F. Psychosocial Experiences of Older Women in the Management of Urinary Incontinence: A Qualitative Study. Front Psychol 2022; 13:785446. [PMID: 35350738 PMCID: PMC8957818 DOI: 10.3389/fpsyg.2022.785446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/14/2022] [Indexed: 11/14/2022] Open
Abstract
Introduction Urinary incontinence is a prevalent disorder amongst older women. Identifying the psychosocial experiences of older women in disease management can improve the patient care process. Hence, the present study aimed to determine the psychosocial experiences of older women in the management of urinary incontinence. Methods This qualitative study was conducted using conventional content analysis. The study data were collected via unstructured in-depth face-to-face interviews with 22 older women suffering from urinary incontinence selected via purposive sampling. Sampling and data analysis were done simultaneously and were continued until data saturation. The interviews were recorded, transcribed, and analyzed using the method proposed by Graneheim and Lundman. Results The results indicated that the older people with urinary incontinence had various psychosocial experiences while living with and managing this disease. Accordingly, four main themes were extracted from the data as follows: “problem incompatibility with the disease,” “mental impasse,” “facing social restrictions,” and “concealment and social escapism.” Conclusion The findings demonstrated that older people with urinary incontinence experienced significant psychosocial pressures while living with this disorder, which affected their psychosocial well-being. Thus, paying attention to these psychosocial experiences while supporting and taking care of these patients can positively impact their psychosocial health and quality of life.
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Affiliation(s)
- Sorur Javanmardifard
- Student Research Committee, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahin Gheibizadeh
- Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fatemeh Shirazi
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kourosh Zarea
- Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fariba Ghodsbin
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Prevalence and clinical correlates for depression in women with urinary incontinence: a cross-sectional study. Int Urogynecol J 2022; 33:1303-1309. [DOI: 10.1007/s00192-022-05169-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 03/01/2022] [Indexed: 10/18/2022]
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Urinary Incontinence and Its Association with Physical and Psycho-Cognitive Factors: A Cross-Sectional Study in Older People Living in Nursing Homes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031500. [PMID: 35162524 PMCID: PMC8835480 DOI: 10.3390/ijerph19031500] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 02/01/2023]
Abstract
Urinary incontinence (UI) is a common geriatric syndrome affecting bladder health and is especially prevalent in nursing homes (NHs). The aim of the study was to determine the prevalence of UI and its associated factors in five Spanish NHs. UI (measured with Minimum Data Set 3.0), sociodemographic, and health-related variables were collected. Chi-square (or Fisher's) or Student's t-test (or Mann Whitney U) for bivariate analysis were used, with Prevalence Ratio (PR) as an association measure. The prevalence of UI was 66.1% (CI:95%, 53.6-77.2) in incontinent (n = 45, mean age 84.04, SD = 7.7) and continent (n = 23, mean age 83.00, SD = 7.7) groups. UI was significantly associated with frailty (PR = 1.84; 95%CI 0.96-3.53), faecal incontinence (PR = 1.65; 95%CI 1.02-2.65), anxiety (PR = 1.64; 95%CI 1.01-2.66), physical performance (PR = 1.77; 95%CI 1.00-3.11), and cognitive state (PR = 1.95; 95%CI 1.05-3.60). Statistically significant differences were found between incontinent and continent NH residents for limitations in activities of daily living (ADL), mobility, quality of life, sedentary behaviour, and handgrip strength. It can be concluded that two out of three of the residents experienced UI, and significant associated factors were mainly physical (sedentary behaviour, frailty, physical performance, ADL limitations, mobility, faecal incontinence, and handgrip strength) followed by psycho-cognitive factors (cognition, anxiety, and quality of life).
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Saldanha MF, Moraes END, Santos RRD, Jansen AK. Incidência de fragilidade e fatores associados à piora funcional na pessoa idosa longeva durante pandemia da covid-19: Estudo de Coorte. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2022. [DOI: 10.1590/1981-22562022025.220077.pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Avaliar a incidência de fragilidade na pessoa idosa longeva, durante a pandemia da covid–19 e identificar as associações entre os domínios do Índice de Vulnerabilidade Clínico Funcional (IVCF -20) e a fragilização. Métodos Estudo de coorte com 64 pessoas idosas longevas previamente não frágeis, avaliados em dois momentos: na linha de base, até um ano antes do início da pandemia e no seguimento, com uma média de intervalo entre os dois momentos de 15 meses. A fragilidade foi avaliada por meio do VS – Frailty (linha de base) e aplicação remota do IVCF-20 (seguimento). Resultados A idade média foi de 88,7±5 anos e a incidência de fragilidade de 20,6%. As pessoas idosas que fragilizaram apresentaram maior dependência em: deixar de fazer compras (p<0,001), deixar de controlar o próprio dinheiro (p<0,001) e deixar de fazer trabalhos domésticos (p=0,010), assim como em: deixar de tomar banho sozinho (p=0,041). A piora da cognição foi mais presente nos idosos que fragilizaram. A presença de desânimo, tristeza ou desesperança foi elevada (92,3%) e teve associação com a fragilização (p<0,001). Na análise multivariada, a fragilização esteve associada com piora do esquecimento (RR=2,39; IC95% 1,27-4,46), perda de interesse e prazer na realização de atividades (RR=4,94; IC95% 1,98-12,35) e incontinência esfincteriana (RR=2,40; IC95% 2.91-1,53). Conclusões A incidência de fragilização entre as pessoas idosas longevas durante a pandemia foi alta. Identificou-se que mais de um domínio foi afetado o que reforça a necessidade de avaliação da pessoa idosa em sua integralidade, sobretudo em períodos atípicos como o vivenciado.
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20
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Saldanha MF, Moraes END, Santos RRD, Jansen AK. Incidence of frailty and factors associated with functional deterioration in oldest old during the covid-19 pandemic: A cohort study. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2022. [DOI: 10.1590/1981-22562022025.220077.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Abstract Objective To assess the incidence of frailty in oldest old during the covid-19 pandemic and to evaluate the associations between the domains of the Clinical-Functional Vulnerability Index (IVCF -20) and frailty. Methods A cohort study of 64 non-frail oldest old was conducted. Participants were evaluated at two timepoints: at baseline up to one year before the onset of the pandemic; and at follow-up, with an average interval between the two timepoints of 15 months. Frailty was assessed using the VS – Frailty (baseline) and remote application of the IVCF-20 (follow-up). Results Mean participant age was 88.7±5 years and the incidence of frailty was 20.6%. Frail participants exhibited greater dependence shopping (p<0.001), controlling their own money (p<0.001) and doing housework (p=0.010), as well as bathing alone (p=0.041). Cognitive decline was more prevalent in the frail individuals. The presence of despondency sadness or hopelessness proved high (92.3%) and was associated with frailty (p<0.001). On the multivariate analysis, frailty was associated with worsening forgetfulness (RR=2.39; 95%CI 1.27-4.46), loss of interest and pleasure in performing activities (RR=4.94; 95%CI 1.98-12.35) and fecal/urinary incontinence (RR=2.40; 95%CI 2.91-1.53). Conclusions
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Mental Health and Quality of Life among Women with Incontinence. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2021. [DOI: 10.30621/jbachs.884403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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22
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Maguire T, Abdelrahman A, Maguire A. Pilot study exploring the incidence of lower urinary tract symptoms during pregnancy in a district general hospital in Northern Ireland: a prospective survey. Int Urogynecol J 2021. [PMID: 33666695 DOI: 10.1007/s00192-021-04718-w/published] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
INTRODUCTION AND HYPOTHESIS The objective of this study was to ascertain the prevalence of lower urinary tract symptoms (LUTS) during pregnancy with a prospective survey in the UK. MATERIALS AND METHODS Pregnant women over the age of 18 years booked for shared antenatal care at a district general hospital were asked to complete a validated 14-stem questionnaire enquiring about lower urinary tract symptoms. (ICIQ-FLUTS). Primary outcome measure was completion of the ICIQ-FLUTS questionnaire. Secondary analysis included the prevalence and odds ratios of individual symptoms that make up the ICIQ-FLUTS score. RESULTS In all, 383 women completed the questionnaire. The most common symptom reported was urgency with a prevalence of 80%. Urgency was over twice as likely to be reported in those with a BMI > 30. The next most common symptom reported was stress incontinence with 65% of participants reporting some leakage on exertion. The likelihood of reporting stress incontinence increased with parity, BMI > 30 and participants in the third trimester with odds ratios of 1.81, 2.07 and 2.09, respectively. Women were almost four times more likely to report any type of urinary incontinence if they had had a vaginal birth in their first pregnancy compared to those who had a caesarean section and women who had a forceps delivery were seven times more likely to report incontinence. CONCLUSIONS The antenatal period may represent an important opportunity for health promotion and intervention. The high prevalence of LUTS in our antenatal population highlights the need to educate women on bladder care.
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Affiliation(s)
- Turlough Maguire
- Northern Health and Social Care Trust, Women's, Children's and Families Division Antrim Area Hospital, Bush Road, Antrim, BT41 2RL, UK.
| | - Abdelmageed Abdelrahman
- Northern Health and Social Care Trust, Women's, Children's and Families Division Antrim Area Hospital, Bush Road, Antrim, BT41 2RL, UK
| | - Aideen Maguire
- Queen's University Belfast, Centre for Public Health, Belfast, UK
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Muermann MM, Wassersug RJ. Prostate Cancer From a Sex and Gender Perspective: A Review. Sex Med Rev 2021; 10:142-154. [PMID: 34108132 DOI: 10.1016/j.sxmr.2021.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/06/2021] [Accepted: 03/08/2021] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Factors influencing patient behavior regarding risk of prostate cancer (PCa) and outcomes of PCa treatments are poorly understood. Similarly, how PCa treatments affect patient sexual function and sense of their masculinity has not been fully investigated. A better understanding of the relationship between sex and gender for patients with PCa could significantly improve their care and quality of life. OBJECTIVES To review how concerns about sex and gender influence men's attitudes toward PCa screening, diagnosis, and treatment. To explore how PCa influences sexual function and self-perceived masculine identity. To examine contexts for PSA screening for transgender individuals. METHODS We reviewed biomedical and sociological literature exploring the impact of PCa on patient sexual function and self-perceived masculinity using OVID, PubMed, and other databases. We similarly reviewed how masculine gender norms influence patient willingness to engage with PCa screening, diagnoses, and treatment. RESULTS Gender norms and sexual function concerns influence patient engagement in all aspects of PCa care. This includes PSA screening, digital rectal examinations, active surveillance, and androgen deprivation therapy (ADT) amongst others. ADT is particularly challenging to sexual function, self-esteem, and masculine identity. Our research suggests that sex and gender are not separate concepts, but rather tightly intertwined, particularly when dealing with the realities experienced by patients with PCa. CONCLUSION Interventions to help patients deal with the challenges of PCa and its treatment are likely to be most effective if they concurrently address patients' sexual needs and understanding of gender norms. PSA screening should be considered for transgender individuals who are at greater risk of cancer and on long-term hormone therapy. More research is needed on how concerns over sex and gender influence PCa screening, diagnosis, and treatment. There is also a need for long term data on the oncological outcomes of prolonged exposure to hormone therapy for patients who are transgender. Muermann MM, Wassersug RJ. Prostate Cancer From a Sex and Gender Perspective: A Review. Sex Med Rev 2021;XX:XXX-XXX.
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Affiliation(s)
- Martin M Muermann
- School of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Richard J Wassersug
- Cellular & Physiological Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
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Lee HY, Rhee Y, Choi KS. Urinary incontinence and the association with depression, stress, and self-esteem in older Korean Women. Sci Rep 2021; 11:9054. [PMID: 33907278 PMCID: PMC8079410 DOI: 10.1038/s41598-021-88740-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 04/15/2021] [Indexed: 11/09/2022] Open
Abstract
The objectives were to investigate the prevalence of urinary incontinence (UI) and its relationships with depression, stress, and self-esteem in older Korean women from the Korean Study of Women's Health Related Issues (K-Stori), a nationally representative cross-sectional survey. A total of 3000 women between 65 and 79 years were the final study subjects. We applied multiple linear regression models to analyze associations with depression, stress, and self-esteem levels in relation to UI types. Types of urinary incontinence included stress, urge, and mixed UI. UI affects at least one in two older Korean women (52.2%). The prevalences of SUI, UUI, and MUI were 45.7%, 39.6%, and 33.1%, respectively. UI was found to be adversely associated with depression, stress, and self-esteem: women with UI reported significantly higher levels of depression and stress and lower levels of self-esteem than those without UI. Women with MUI reported significantly greater impairment than the women with SUI or UUI. Our results provide an evidence base for the evaluation of mental health in older women with incontinence. The prioritization of UI detection and the identification of psychological factors may help improve the diagnosis and management of UI and potentially yield significant economic and psychosocial benefits.
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Affiliation(s)
- Hoo-Yeon Lee
- Department of Social Medicine, College of Medicine, Dankook University, Chungnam, South Korea
| | - Yumie Rhee
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Kui Son Choi
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, South Korea.
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Batmani S, Jalali R, Mohammadi M, Bokaee S. Prevalence and factors related to urinary incontinence in older adults women worldwide: a comprehensive systematic review and meta-analysis of observational studies. BMC Geriatr 2021; 21:212. [PMID: 33781236 PMCID: PMC8008630 DOI: 10.1186/s12877-021-02135-8] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 03/07/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Urinary incontinence is a common condition in the general population and, in particular, the older adults population, which reduces the quality of life of these people, so this study aims to systematically examine and meta-analyse the overall prevalence of urinary incontinence in older women around the world and the related and influential factors. METHODS This report is a comprehensive systematic review and meta-analysis of the findings of research on urinary incontinence in older adults people across the world through looking for MEDLINE, Cochrane Library Sciencedirect, Embase, Scopus, ProQuest and Persian databases, namely iranmedex, magiran, and SID from January 2000 to April 2020, the heterogeneity of the experiments was measured using the I2 index and the data processing was done in the Systematic Meta-Analysis programme. RESULTS In 29 studies and the sample size of 518,465 people in the age range of 55-106 years, urinary incontinence in older adults' women in the world based on a meta-analysis of 37.1% (95% CI: 29.6-45.4%) was obtained. The highest prevalence of urinary incontinence was reported in older adults' women in Asia with 45.1% (95% CI: 36.9-53.5%). Meta-regression also showed that with increasing the sample size and year of the study, the overall prevalence of urinary incontinence in the older adults women of the world decreased and increased, respectively, which were statistically significant differences (P < 0.05). According to studies, the most important factors influencing the incidence of urinary incontinence in older women are women's age (p < 0.001), obesity (p < 0.001), diabetes (p < 0.001), women's education (p < 0.001), delivery rank (p < 0.001), hypertension (p < 0.001), smoking (p < 0.001). They also have urinary tract infections (p < 0.001). CONCLUSION Given the high prevalence of urinary incontinence in older women around the world, health policy makers must consider control and diagnostic measures in older women and prioritize treatment and rehabilitation activities.
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Affiliation(s)
- Sedighe Batmani
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Rostam Jalali
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Mohammadi
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shadi Bokaee
- Faculty of Health and Life Sciences, School of Life Sciences, Coventry University, Coventry, UK
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Maguire T, Abdelrahman A, Maguire A. Pilot study exploring the incidence of lower urinary tract symptoms during pregnancy in a district general hospital in Northern Ireland: a prospective survey. Int Urogynecol J 2021; 32:2807-2817. [PMID: 33666695 DOI: 10.1007/s00192-021-04718-w] [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: 11/24/2020] [Accepted: 02/04/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The objective of this study was to ascertain the prevalence of lower urinary tract symptoms (LUTS) during pregnancy with a prospective survey in the UK. MATERIALS AND METHODS Pregnant women over the age of 18 years booked for shared antenatal care at a district general hospital were asked to complete a validated 14-stem questionnaire enquiring about lower urinary tract symptoms. (ICIQ-FLUTS). Primary outcome measure was completion of the ICIQ-FLUTS questionnaire. Secondary analysis included the prevalence and odds ratios of individual symptoms that make up the ICIQ-FLUTS score. RESULTS In all, 383 women completed the questionnaire. The most common symptom reported was urgency with a prevalence of 80%. Urgency was over twice as likely to be reported in those with a BMI > 30. The next most common symptom reported was stress incontinence with 65% of participants reporting some leakage on exertion. The likelihood of reporting stress incontinence increased with parity, BMI > 30 and participants in the third trimester with odds ratios of 1.81, 2.07 and 2.09, respectively. Women were almost four times more likely to report any type of urinary incontinence if they had had a vaginal birth in their first pregnancy compared to those who had a caesarean section and women who had a forceps delivery were seven times more likely to report incontinence. CONCLUSIONS The antenatal period may represent an important opportunity for health promotion and intervention. The high prevalence of LUTS in our antenatal population highlights the need to educate women on bladder care.
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Affiliation(s)
- Turlough Maguire
- Northern Health and Social Care Trust, Women's, Children's and Families Division Antrim Area Hospital, Bush Road, Antrim, BT41 2RL, UK.
| | - Abdelmageed Abdelrahman
- Northern Health and Social Care Trust, Women's, Children's and Families Division Antrim Area Hospital, Bush Road, Antrim, BT41 2RL, UK
| | - Aideen Maguire
- Queen's University Belfast, Centre for Public Health, Belfast, UK
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Prevalence and predictors of continence containment products and catheter use in an acute hospital: A cross-sectional study. Geriatr Nurs 2021; 42:433-439. [PMID: 33684628 DOI: 10.1016/j.gerinurse.2021.02.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 02/10/2021] [Accepted: 02/12/2021] [Indexed: 01/02/2023]
Abstract
Although incontinence is common in hospital, the prevalence and predictors of continence aid use (continence wear and catheters) are poorly described. A one-day cross-sectional study was conducted in a large university hospital assessing consecutive inpatients (≥55) for their pre-admission and current use of continence aids. Barthel Index, Clinical Frailty Scale and Charlson Co-morbidity scores were recorded. Appropriateness was defined by local guidelines. 355 inpatients, median age 75±17 years, were included; 53% were male. Continence aid use was high; prevalence was 46% increasing to 58% for those ≥75. All-in-one pads were the most common, an overall prevalence of 31%. Older age, lower Barthel and higher frailty scores were associated with continence aid use in multivariate analysis. Inappropriate use of aids was high at 45% with older age being the only independent predictor. Continence aids are often used inappropriately during hospitalisation by older patients. Concerted efforts are required to address this issue.
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Urinary Incontinence in Climacteric Women With or Without Depressive Symptoms: A Cross-Sectional Study. Female Pelvic Med Reconstr Surg 2021; 27:e442-e447. [PMID: 32947552 DOI: 10.1097/spv.0000000000000958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to investigate whether the occurrence of urinary incontinence (UI) is associated with increased odds of depression in perimenopausal and postmenopausal women. METHODS This cross-sectional study included 208 women with depressive symptoms, confirmed by the Beck Depression Inventory, and 247 patients without depression. All participants were perimenopausal or postmenopausal women aged 35 to 65 years who attended an outpatient clinic from a tertiary-academic hospital in Northeastern Brazil. Urinary incontinence symptoms were assessed using patient's self-report and the validated versions of the International Consultation on Incontinence Questionnaire-Short Form and the Questionnaire for Urinary Incontinence Diagnosis. To investigate the severity of climacteric symptoms, the Blatt-Kupperman Index was used, and menopause-related quality of life was analyzed using the Utian Quality of Life Questionnaire. RESULTS In univariate analysis, the Beck Depression Inventory-II mean scores for UI and non-UI women were, respectively, 15.5 (95% confidence interval, 14.28-16.72) and 11.83 (10.52-13.13; P < 0.05). Patients with moderate and severe scores of depression reported higher International Consultation on Incontinence Questionnaire-Short Form and Questionnaire for Urinary Incontinence Diagnosis scores when compared with women with mild depression scores and women without depression (P < 0.001). Conversely, in multivariate analysis, having UI was not associated with having depression (odds ratio [OR], 0.85; 0.52-1.37; P = 0.50), after adjusting for confounders. Older age (>55 years) was associated with decreased odds of depression (OR, 0.43; 0.21-0.88; P = 0.02), whereas moderate (OR, 2.28; 1.40-3.71; P = 0.001) and severe (OR, 7.70; 2.79-21.23) intensities of menopause symptoms were associated with increased odds of depression. CONCLUSION Urinary incontinence was not associated with depression within climacteric women after multivariate analysis.
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Yu K, Wu S, Jang Y, Chou CP, Wilber KH, Aranda MP, Chi I. Longitudinal Assessment of the Relationships Between Geriatric Conditions and Loneliness. J Am Med Dir Assoc 2020; 22:1107-1113.e1. [PMID: 33071157 DOI: 10.1016/j.jamda.2020.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 08/27/2020] [Accepted: 09/01/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVES In response to the lack of longitudinal evidence, this study aims to disentangle time sequence and directionality between the severity of geriatric conditions (GCs) and loneliness. DESIGN Longitudinal panel study. SETTING AND PARTICIPANTS The working sample had 4680 participants of 2006, 2010, and 2014 waves of the Health and Retirement Study (HRS). All participants were at least 65 years old at baseline. Proxy responded cases and individuals who suffered from moderate to severe cognitive impairment were excluded from the analysis. METHODS Loneliness was measured with the 3-item UCLA loneliness scale. Five GCs were included: falls, incontinence, vision impairment, hearing impairment, and pain. Severity indicators were the number of times fallen in the past 2 years, number of days experiencing loss of bladder control in the past month, self-rated eyesight, self-rated hearing, and participants' perceived level of pain. RESULTS Random-intercept cross-lagged panel models were run to analyze the relationship between the severity of each individual GC and loneliness. All models were controlled for baseline demographics, social isolation, self-rated health, physical function, comorbidities, and hospitalization. The longitudinal association between loneliness and fall was bidirectional: a higher loneliness score predicted an increased number of falls and vice versa. Incontinence, vision impairment, hearing impairment, and pain were not significantly associated with loneliness longitudinally. The association between the random intercept of loneliness and some GCs (vision and pain) were significant, indicating the severity of these GCs were related to loneliness at the between-person level at baseline. CONCLUSION AND IMPLICATIONS Findings of the longitudinal analysis suggest a reciprocal relationship between fall and loneliness. Fall prevention programs could be integrated with social service for addressing loneliness, and alleviating loneliness might be beneficial for preventing falls. Results of this study highlight the importance of integrating clinical management of falls with social services addressing loneliness in long term care.
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Affiliation(s)
- Kexin Yu
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA; Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, CA.
| | - Shinyi Wu
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA; Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, CA; Viterbi School of Engineering, Daniel J. Epstein Department of Industrial and Systems Engineering, University of Southern California, Los Angeles, CA
| | - Yuri Jang
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA; Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, CA
| | - Chih-Ping Chou
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA; Department of Bio-Industry Communication & Development, National Taiwan University, Taipei, Taiwan
| | - Kathleen H Wilber
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA
| | - María P Aranda
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA; Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, CA
| | - Iris Chi
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA; Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, CA
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Quality of Life among Obstetric Fistula Patients at Kitovu Mission Hospital: A Health Facility-Based Cross-Sectional Study in Masaka District, Uganda. Obstet Gynecol Int 2020; 2020:7953915. [PMID: 32528539 PMCID: PMC7262733 DOI: 10.1155/2020/7953915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 04/28/2020] [Indexed: 11/18/2022] Open
Abstract
Background Obstetric fistula (OF) remains a silent neglected maternal challenge associated with devastating life consequences. Living with OF presents far-reaching physical, social, psychosocial, and emotional concerns, which negatively impact a woman's quality of life. This study evaluated the quality of life among obstetric fistula patients in Masaka district, Uganda. Method A cross-sectional study was conducted among 63 women diagnosed with OF at Kitovu Mission Hospital. Data were collected using a questionnaire, observation, in-depth interviews, and focus group discussions. Data were analyzed at univariate, bivariate, and multivariate levels, where the ordinal logistic regression model was applied. The qualitative data was transcribed and analyzed using qualitative content analysis. Results Majority (87%) of the women diagnosed with OF reportedly had a poor quality of life. Bivariate analysis indicated that level of education (P < 0.001), employment status (P < 0.001), energy for everyday life (P < 0.001), capacity to work (P < 0.001), satisfaction with personal relationships (P < 0.001), feelings of loneliness (P < 0.001), negative feelings (P = 0.002), and self-confidence (P < 0.001) were significantly associated with good QoL. Multivariate analysis showed increased odds of good QoL increased among women with self-confidence (OR = 32.320; CI = 2.019–517.467), formal education (OR = 9.9497; CI = 1.075–92.048), women who did not experience difficulties in mobility (OR = 19.144; CI = 0.149–2456.770), and women who were satisfied with their personal relationships (OR = 5.785; CI = 0.447–74.824). Conclusion A holistic fistula treatment approach is required that takes into consideration all aspects of life to address the consequences of obstetric fistula to realize improved quality of life among patients.
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Subrata SA. Health‐related quality of life in patients undergoing TURP: Translating evidence into urological nursing practice. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2020. [DOI: 10.1111/ijun.12216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Sumarno A. Subrata
- Doctoral Candidate in Doctor of Philosophy Program in NursingInternational and Collaborative Program with Foreign University Program, Mahidol University Nakhon Pathom Thailand
- Department of Nursing and Wound Research Center, Faculty of Health SciencesUniversitas Muhammadiyah Magelang Magelang Indonesia
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Vancampfort D, Hallgren M, Schuch F, Stubbs B, Smith L, Rosenbaum S, Firth J, Van Damme T, Koyanagi A. Sedentary behavior and depression among community-dwelling adults aged ≥50 years: Results from the irish longitudinal study on Ageing. J Affect Disord 2020; 262:389-396. [PMID: 31740113 DOI: 10.1016/j.jad.2019.11.066] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 10/17/2019] [Accepted: 11/09/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Sedentary behavior (SB) may be a risk factor for depression in middle- and old age adults. The aim of this study was to examine cross-sectional and longitudinal relationships between SB and depression in a large national sample of Irish people aged 50 and older taking into account a wide range of previously identified influential factors. METHODS Data from the Irish Longitudinal Study on Ageing survey were analyzed (wave 1: 2009-2011, wave 2: 2012-2013). Depression was assessed with the Center for Epidemiologic Studies Depression scale. Total weekday SB and control variables were self-reported. Multivariable logistic regression and mediation analysis were conducted to assess the associations. RESULTS The final sample consisted of 6903 individuals aged ≥50 years (63.6 ± 9.2years; 52.1% female). After full adjustment for age, gender, social class, current smoking, physical activity, mobility, pain, cognition, chronic physical conditions, disability, anxiety, loneliness, and social network, the association between SB and depression was not statistically significant (OR=1.06; 95%CI=0.60-1.89). Mediation analysis showed that the association is explained by social network (mediated percentage 23.1%), physical activity (20.3%), loneliness (13.2%), chronic physical conditions (11.1%), and disability (7.9%). Cross-sectional analysis showed that SB is significantly associated with depression even after full adjustment. LIMITATIONS SB was self-reported. CONCLUSIONS Factors closely linked with SB such as social isolation, loneliness, physical inactivity, chronic physical conditions, and disability may play a major role in depression among middle-aged and older people. Lifestyle interventions focusing on reductions in depression in this population need to consider these factors.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium.
| | - Mats Hallgren
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Felipe Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, Australia; Black Dog Institute, Prince of Wales Hospital, Sydney, Australia
| | - Joseph Firth
- NICM Health Research Institute, Western Sydney University, Westmead, Australia; Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, United Kingdom; Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Tine Van Damme
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, CIBERSAM, Barcelona, Spain; Catalan Institution for Research and Advanced Studies, ICREA, Barcelona, Spain
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Incontinence and loneliness among Chinese older adults with multimorbidity in primary care: A cross-sectional study. J Psychosom Res 2019; 127:109863. [PMID: 31689597 DOI: 10.1016/j.jpsychores.2019.109863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 10/24/2019] [Accepted: 10/24/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To evaluate the associations between incontinence and loneliness among the Chinese elderly with multimorbidity in primary care, with the specific aim to look into the relationship of incontinence with social and emotional subdomains of loneliness. METHODS This cross-sectional study included older patients with multimorbidity in public primary care clinics in Hong Kong. Loneliness was assessed by the De Jong Gierveld Loneliness Scale (DJGLS). Tobit models were used to evaluate the association between incontinence and loneliness before and after adjustment for socio-demographics, lifestyle behaviors, physical and psychological conditions, social support and living status. RESULTS A total of 741 patients were included. Before adjustment, incontinence was associated with higher levels of emotional loneliness (coefficient = 0.74, 95% CI = 0.43-1.06, p < .001) and higher levels of overall loneliness (coefficient = 0.81, 95% CI = 0.34-1.27, p = .001), but not social loneliness (coefficient = 0.34, 95% CI = -0.41 - 1.09, p = .38). After adjustment, incontinence was still significantly associated with higher levels of emotional loneliness (coefficient = 0.35, 95% CI = 0.07-0.64, p = .01). CONCLUSION Incontinence is independently associated with emotional loneliness. Healthcare professionals should pay special attention to emotional loneliness among older patients with incontinence. Further studies are needed to look into the potential mechanisms and interventions.
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Hernández B, Reilly RB, Kenny RA. Investigation of multimorbidity and prevalent disease combinations in older Irish adults using network analysis and association rules. Sci Rep 2019; 9:14567. [PMID: 31601959 PMCID: PMC6787335 DOI: 10.1038/s41598-019-51135-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 09/05/2019] [Indexed: 12/11/2022] Open
Abstract
Multimorbidity (the presence of multiple medical conditions) is well known to increase with age. People with multimorbidities often have higher physical and functional decline as well as increased mortality. Despite growing evidence that integrated and collaborative care improves many undesirable outcomes of multimorbidity, the majority of health systems are based around treating individual diseases. A pattern analysis of comorbidities using network graphs and a novel use of association rules was conducted to investigate disease associations on 6101 Irish adults aged 50+. The complex network of morbidities and differences in the prevalence and interactions of these morbidities by sex was also assessed. Gender specific differences in disease prevalence was found for 22/31 medical conditions included in this study. Females had a more complex network of disease associations than males with strong associations found between arthritis, osteoporosis and thyroid issues among others. To assess the strength of these associations we provide probabilities of being diagnosed with a comorbid condition given the presence of an index morbidity for 639 pairwise combinations. This information can be used to guide clinicians in deciding which comorbidities should be incorporated into comprehensive assessments in addition to anticipating likely future morbidities and thus developing prevention strategies.
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Affiliation(s)
- Belinda Hernández
- TILDA The Irish Longitudinal Study in Ageing, Trinity College, The University of Dublin, Dublin, Ireland.
- Mercer Institute for Successful Ageing, St. James Hospital, Dublin, Ireland.
- Dept of Medical Gerontology, School of Medicine, Trinity College, The University of Dublin, Dublin, Ireland.
| | - Richard B Reilly
- TILDA The Irish Longitudinal Study in Ageing, Trinity College, The University of Dublin, Dublin, Ireland
- Dept of Medical Gerontology, School of Medicine, Trinity College, The University of Dublin, Dublin, Ireland
- School of Engineering, Trinity College, The University of Dublin, Dublin, Ireland
- Trinity Centre for Biomedical Engineering, Trinity College, The University of Dublin, Dublin, Ireland
| | - Rose Anne Kenny
- TILDA The Irish Longitudinal Study in Ageing, Trinity College, The University of Dublin, Dublin, Ireland
- Mercer Institute for Successful Ageing, St. James Hospital, Dublin, Ireland
- Dept of Medical Gerontology, School of Medicine, Trinity College, The University of Dublin, Dublin, Ireland
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Perissinotto C, Holt-Lunstad J, Periyakoil VS, Covinsky K. A Practical Approach to Assessing and Mitigating Loneliness and Isolation in Older Adults. J Am Geriatr Soc 2019; 67:657-662. [PMID: 30762228 DOI: 10.1111/jgs.15746] [Citation(s) in RCA: 109] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 11/07/2018] [Accepted: 11/26/2018] [Indexed: 01/17/2023]
Abstract
Loneliness and social isolation are strongly associated with several adverse health outcomes in older persons including death and functional impairments. The strength of these associations has been compared with smoking. Accordingly, loneliness and isolation have significant public health implications. Despite the adverse impacts of loneliness and social isolation on quality of life, and their strong association with health outcomes, the evaluation of loneliness and isolation have not been integrated into medical care. The risks for loneliness may be of particular concern to persons with serious illness as patients and caregivers cope with the experience of loss, loss of independence, and increasing care needs. To date, there has been no uniform way of evaluating and documenting loneliness and social isolation as a part of a review of a patient's social determinants of health. This article provides a framework for healthcare systems, providers, and community members working with older adults to (1) understand loneliness, isolation, and its counterpart social connection; (2) describe the different ways loneliness affects health; and (3) create a framework for asking about and documenting these experiences. Finally, because the lack of studies assessing whether targeting loneliness can improve health outcomes is a major gap, we provide guidance on the future of interventions. J Am Geriatr Soc 67:657-662, 2019.
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Affiliation(s)
- Carla Perissinotto
- Department of Medicine, University of California, San Francisco, San Francisco, California
| | | | - Vyjeyanthi S Periyakoil
- Stanford Aging and Ethnogeriatrics Center.,Stanford University, School of Medicine, Palo Alto, California.,VA Palo Alto Health Care System, Palo Alto, California
| | - Ken Covinsky
- Department of Medicine, University of California, San Francisco, San Francisco, California
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Siddiqui NY, Wiseman JB, Cella D, Bradley CS, Lai HH, Helmuth ME, Smith AR, Griffith JW, Amundsen CL, Kenton KS, Clemens JQ, Kreder KJ, Merion RM, Kirkali Z, Kusek JW, Cameron AP. Mental Health, Sleep and Physical Function in Treatment Seeking Women with Urinary Incontinence. J Urol 2018; 200:848-855. [PMID: 29730202 PMCID: PMC6146022 DOI: 10.1016/j.juro.2018.04.076] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2018] [Indexed: 11/21/2022]
Abstract
PURPOSE We examined how mental health measures, sleep and physical function are associated with the presence and type of urinary incontinence and severity in women seeking treatment for lower urinary tract symptoms. MATERIALS AND METHODS This baseline cross-sectional analysis was performed in treatment seeking women with lower urinary tract symptoms. All participants completed the LUTS (Lower Urinary Tract Symptoms) Tool (Pfizer, New York, New York), which was used to classify women based on urinary incontinence symptoms and measure severity. The PROMIS (Patient-Reported Outcomes Measurement Information System) questionnaire for depression, anxiety, sleep disturbance and physical function, the PSS (Perceived Stress Scale) and the IPAQ-SF (International Physical Activity Questionnaire Short Form) were administered. Multivariable regression modeling was done to assess associations with urinary symptom presence, type and severity. RESULTS We studied 510 women with a mean ± SD age of 56 ± 14 years. Of the women 82% were Caucasian, 47% were obese and 14% reported diabetes. Urinary incontinence was reported by 420 women (82.4%), including stress urinary incontinence in 70, urgency urinary incontinence in 85, mixed urinary incontinence in 240 and other urinary incontinence in 25. On adjusted analyses there was no difference in any mental health, sleep or physical function measure based on the presence vs the absence of urinary incontinence. Among women with urinary incontinence PROMIS anxiety and sleep disturbance scores were higher in those with mixed urinary incontinence than stress urinary incontinence. Increasing urinary incontinence severity was associated with higher PROMIS depression and anxiety scores, and higher PSS scores. However, higher urinary incontinence severity was not associated with a difference in sleep or physical function. CONCLUSIONS Among treatment seeking women with lower urinary tract symptoms, increasing urinary incontinence severity rather than the presence or type of urinary incontinence was associated with increased depression, anxiety and stress.
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Affiliation(s)
- Nazema Y Siddiqui
- Division of Urogynecology and Reconstructive Surgery, Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina.
| | | | - David Cella
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
| | - Catherine S Bradley
- Departments of Obstetrics and Gynecology and Urology, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - H Henry Lai
- Departments of Surgery and Anesthesiology, Washington University School of Medicine, St. Louis, Missouri
| | | | - Abigail R Smith
- Arbor Research Collaborative for Health, Ann Arbor, Michigan
| | - James W Griffith
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
| | - Cindy L Amundsen
- Division of Urogynecology and Reconstructive Surgery, Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina
| | - Kimberly S Kenton
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | | - Karl J Kreder
- Departments of Obstetrics and Gynecology and Urology, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Robert M Merion
- Arbor Research Collaborative for Health, Ann Arbor, Michigan
| | - Ziya Kirkali
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland
| | - John W Kusek
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland
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Ivchenko A, Bödeker RH, Neumeister C, Wiedemann A. Anticholinergic burden and comorbidities in patients attending treatment with trospium chloride for overactive bladder in a real-life setting: results of a prospective non-interventional study. BMC Urol 2018; 18:80. [PMID: 30217174 PMCID: PMC6137886 DOI: 10.1186/s12894-018-0394-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 09/02/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Elderly people are representative for the patients most likely to be treated with anticholinergics for overactive bladder (OAB). They often receive further drugs with anticholinergic properties for concomitant conditions. This increases the risk for side effects, including central nervous system disorders. Data on comorbidities and baseline anticholinergic burden of OAB patients seen in urological practice is scarce. Therefore, we included an epidemiological survey on these issues in our study which assessed the effectiveness and tolerability of trospium chloride (TC) in established dosages under routine conditions. METHODS Outpatients (≥ 65 years of age), for whom treatment with TC was indicated, were eligible to participate in this non-interventional, prospective study performed in 162 urological practices in Germany. Epidemiological questions were evaluated by the Anticholinergic Burden (ACB) scale and the Cumulative Illness Rating Scale for Geriatrics (CIRS-G) at baseline. Efficacy was assessed by changes in symptom-related variables of OAB after treatment. Dosage regimen, duration of treatment, adverse events, withdrawals, and ease of subdivision of the prescribed SNAP-TAB tablet were documented. Patients and physicians rated efficacy and tolerability of treatment. Statistics were descriptive. RESULTS Four hundred fourty-five out of 986 (47.54%) patients in the epidemiological population had a baseline ACB scale score > 0, 100 (24.72%) of whom a score ≥ 3. The median CIRS-G comorbidity index score for all patients was 5. 78.55% (608/774) of patients in the efficacy population received a daily dose of 45 mg TC. 60.03% (365/608) of them took this dose by dividing the SNAP-TAB tablet in three equal parts. Before-after-comparisons of the core symptoms of OAB showed clear improvements. An influence of the dosage scheme (1 × 45 mg TC/d vs 3 × 15 mg TC/d) on clinical outcome could not be observed. Most urologists and patients rated TC treatment as effective and well tolerated. 44 (4.37%) out of 1007 patients in the safety collective ended their treatment prematurely, while 75 patients (7.45%) experienced adverse events. CONCLUSIONS Anticholinergic burden and comorbidities in elderly OAB patients are frequent. The acceptance of the SNAP-TAB tablet, which facilitates flexible dosing with TC, was high, which is supportive in ensuring adherence in therapy. TRIAL REGISTRATION This non-interventional study was registered on October 29, 2014 with the number DRKS00007109 at the German Register of Clinical Studies (DRKS).
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Affiliation(s)
- A. Ivchenko
- Department of Urology, Evangelisches KrankenhausWitten gGmbH, UniversityWitten/Herdecke, Pferdebachstrasse 27, 58455 Witten, Germany
| | - R.-H. Bödeker
- Department of Statistics, Institute of Medical Informatics, University Clinic Giessen, Rudolf-Buchheim-Strasse 6, 35392 Gießen, Germany
| | - C. Neumeister
- Department of Medical Science/Clinical Research, Dr. R. Pfleger GmbH, Dr.-Robert-Pfleger-Strasse 12, 96052 Bamberg, Germany
| | - A. Wiedemann
- Department of Urology, Evangelisches KrankenhausWitten gGmbH, UniversityWitten/Herdecke, Pferdebachstrasse 27, 58455 Witten, Germany
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Elmelund M, Klarskov N, Biering-Sørensen F. Prevalence of urinary incontinence in women with spinal cord injury. Spinal Cord 2018; 56:1124-1133. [DOI: 10.1038/s41393-018-0157-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 05/07/2018] [Accepted: 05/08/2018] [Indexed: 01/28/2023]
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