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Akan N, Sancar B. Frequency of urinary incontinence and attitudes towards urinary incontinence of women in Mersin, Turkey. Pak J Med Sci 2024; 40:1448-1453. [PMID: 39092057 PMCID: PMC11255790 DOI: 10.12669/pjms.40.7.8134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/30/2023] [Accepted: 03/27/2024] [Indexed: 08/04/2024] Open
Abstract
Objectives Urinary incontinence (UI) is the involuntary loss of urine or the inability to control urination. The International Continence Society defines UI as any complaint of involuntary loss of urine. UI is a very important health problem that affects women's quality of life. It can lead to a decrease in women's self-confidence and prevent them from participating in social activities. This study was conducted to investigate the prevalence of UI in women living in Turkey, the factors affecting it, and women's attitudes toward UI. Methods This descriptive and cross-sectional study included 903 women who applied to 17 family health centers in Mersin, Turkey, between May 10th to June 10th 2019 for any reason. The data of the study were obtained using the descriptive information form and the Urinary Incontinence Attitude Scale (UIAS). Data analysis was performed with SPSS-21 using percentiles, mean±standard deviation, and Pearson chi-square tests. Results According to the results obtained, 28.9% of the women had UI problems, more than half (54.6%) of the women with UI did not present to a health institution for this problem, and 54.8% did not receive any treatment. In addition, the frequency of experiencing UI was higher in those with a chronic disease (59.2%) than in those without any chronic disease, and the difference was significant. Conclusion The demographic and fertility characteristics of the women influenced the frequency of experiencing UI. In addition, among the women participating in the study, those with negative attitudes toward UI experienced more UI problems. There should be greater efforts to raise awareness among women on this subject.
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Affiliation(s)
- Nazife Akan
- Nazife Akan, Assistant Professor, Department of Nursing, Faculty of Health Sciences, Toros University, 45 Evler Campus, Mersin, Turkey
| | - Behire Sancar
- Behire Sancar, Assistant Professor, Department of Nursing, Faculty of Health Sciences, Toros University, 45 Evler Campus, Mersin, Turkey
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Yount-Tavener SM, Fay RA. Maintaining A Long-Term Practice of Daily Pelvic Floor Muscle Exercises: What Do Childbearing Women Think? J Midwifery Womens Health 2024; 69:567-576. [PMID: 38520694 DOI: 10.1111/jmwh.13626] [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] [Revised: 01/02/2024] [Indexed: 03/25/2024]
Abstract
INTRODUCTION To be effective, pelvic floor muscle therapy (PFMT) exercises should be intense, be practiced consistently, and include clinical support. Many women do not adhere to a consistent PFMT program, compromising the resolution or prevention of urinary incontinence (UI). This study aimed to answer 2 key questions: What prevents women from performing PFMT long term, and what can health care providers do to support women to perform them? METHODS Postpartum women from 4 sites in the United States completed a questionnaire about experiences with PFMT or Kegel exercises during and after pregnancy. This study focused on one of the 7 open-ended questions: What would prevent you from performing Kegels lifelong? Thematic analysis was implemented via an inductive approach using Braun and Clarke's 6-phase process. RESULTS Three salient themes emerged that help explain factors that prevent women from adhering to a daily PFMT routine: (1) life gets in the way, (2) inadequate PFMT education and instruction, and (3) disconnect exists about long-term consequences. The sample included 368 participants. DISCUSSION The themes were congruent with the limited body of qualitative literature on experience with PFMT exercises. This study was able to identify areas of need in the US maternal health care system to help childbearing people adopt daily PFMT, such as (1) inadequate parental leave and childcare support, (2) no formalized education related to UI and PFMT and a lack of pelvic health promotion, (3) lacking prioritization of long-term PFMT, and (4) the need to dispel the acceptance that UI postbirth is normal. Health care providers should prioritize interactive education, emphasizing how to correctly perform PFMT and the importance and effectiveness of integrating clinical support. To adequately encompass pelvic floor health care and education up to one year postbirth, changes are needed to the US perinatal health care system, providing sufficient insurance reimbursement and parental social support programs.
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Affiliation(s)
- Susan M Yount-Tavener
- Department of Midwifery and Women's Health, Frontier Nursing University, Lexington, Kentucky
| | - Rebecca A Fay
- Department of Midwifery and Women's Health, Frontier Nursing University, Lexington, Kentucky
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Jouanny C, Abhyankar P, Maxwell M. A mixed methods systematic literature review of barriers and facilitators to help-seeking among women with stigmatised pelvic health symptoms. BMC Womens Health 2024; 24:217. [PMID: 38570870 PMCID: PMC10993589 DOI: 10.1186/s12905-024-03063-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 03/29/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Women's pelvic health is a globally important subject, included in international and United Kingdom health policies, emphasising the importance of improving information and access to pelvic health services. Consequences of pelvic symptoms are intimate, personal, and varied, often causing embarrassment and shame, affecting women's quality of life and wellbeing. AIM To understand the experience of seeking healthcare for stigmatised pelvic health symptoms by synthesising all types of published primary research and mapping the results to behavioural theory, to identify potential targets for intervention. METHODS Systematic search of MEDLINE, CINAHL, PsycINFO, SocINDEX, PubMED databases, CDSR and CENTRAL registers, from inception to May 2023 for all types of research capturing women's views and experiences of seeking help with stigmatised urogenital and bowel symptoms. Studies only reporting prevalence, predictors of help-seeking, non-health related help-seeking, or written in languages other than English, German, French, Spanish and Swedish were excluded. Reference checking and forward citation searching for all included studies was performed. A results-based synthesis approach was used to integrate quantitative and qualitative data. Themes were mapped to the Common-Sense model and Candidacy framework. The Mixed Methods Appraisal Tool was used for critical appraisal. Grading of Recommendations Assessment, Development and Evaluation - Confidence in Evidence from Reviews of Qualitative research for assessing certainty of review findings. RESULTS 86 studies representing over 20,000 women from 24 high income countries were included. Confidence was high that barriers to help-seeking were similar across all study types and pelvic symptoms: stigma, lack of knowledge, women's perception that clinicians dismissed their symptoms, and associated normalising and deprioritising of low bother symptoms. Supportive clinicians and increased knowledge were key facilitators. CONCLUSIONS Using the Common-Sense Model to explore women's help-seeking behaviour with stigmatised pelvic symptoms reveals problems with cognitive representation of symptom identity, emotional representations of embarrassment and shame, and a subjective norm that women believe their symptoms will be trivialised by clinicians. Together these barriers frustrate women's identification of their candidacy for healthcare. Addressing these issues through behavioural change interventions for women and clinicians, will help to achieve universal access to pelvic healthcare services (United Nations Sustainable Development Goal 3.7). SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021256956.
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Affiliation(s)
- Clare Jouanny
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland.
| | - Purva Abhyankar
- Department of Psychology, University of Stirling, Stirling, Scotland
| | - Margaret Maxwell
- The Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, Scotland
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Mjelde LME, Litherland AT, Beisland EG. Women's experiences of assessment for urinary incontinence: a qualitative study. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:168-174. [PMID: 38386533 DOI: 10.12968/bjon.2024.33.4.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
BACKGROUND One in four women experience urinary incontinence. A woman's medical history, a physical examination and certain tests can guide specialists in diagnosing and offering treatment. Despite the high prevalence, little is known about women's experience of urinary incontinence assessment. AIM To explore the experience of a group of women undergoing an assessment for urinary incontinence. METHODS Individual semi-structured interviews were conducted with 10 women who had been assessed for urinary incontinence. A thematic reflective analysis method was used. FINDINGS The women experienced a lot of shame and worry related to their urinary incontinence and the assessment. Having a safe relationship with the urotherapist was very important, and being given information about treatment options gave hope for a better life. CONCLUSION Urinary incontinence and its assessment are associated with shame and anxiety. A good patient-urotherapist relationship is paramount and learning that treatments are available made women feel more optimistic about the future.
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Affiliation(s)
| | | | - Elisabeth Grov Beisland
- Associate Professor, Department of Health and Caring sciences, Western Norway University of Applied Sciences, Bergen, Norway
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Gao G, Vaughan CP, Markland AD, Reinicke K, Annavaram N, Burningham Z. Leveraging A Clinical Dashboard and Process Mappings to Improve Treatment Access and Outcomes for Women Veterans with Urinary Incontinence. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2024; 2023:359-368. [PMID: 38222400 PMCID: PMC10785906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
In support of the Improving Primary Care Understanding of Resources and Screening for Urinary Incontinence to Enhance Treatment initiative with the Veterans Health Administration, we developed a clinical dashboard to support primary care providers in identifying underdiagnosed, undertreated women Veterans with urinary incontinence. This paper describes our dashboard development and evaluation. We employed a user-centered design in determining dashboard requirements, interface design, and functionality. We invited early users at three pilot sites to formal usability reviews. We quantified the dashboard usability using the System Usability Scale and administered surveys and interviews for insights on performance. We employed process maps to uncover processes of end-users' dashboard engagements within local environments. User evaluations demonstrated the dashboard as a helpful instrument in identifying women Veterans with good to excellent usability performance. User feedback offers a user-driven pathway to develop our dashboard that supports clinicians to better care for women Veterans with urinary incontinence.
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Affiliation(s)
- Grace Gao
- Atlanta VA Healthcare System, Atlanta, GA
| | - Camille P Vaughan
- Birmingham/Atlanta VA Geriatric Research Education and Clinical Center, Atlanta, GA
- Emory University, Atlanta, GA
| | - Alayne D Markland
- Birmingham/Atlanta VA Geriatric Research Education and Clinical Center, Birmingham, AL
- University of Alabama at Birmingham, AL
| | | | | | - Zachary Burningham
- Informatics, Decision-Enhancement and Analytic Sciences Center of Innovation, Salt Lake City, UT
- Veterans Affairs Medical Center, Salt Lake City, UT
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Klein AJ, Eisenhauer C, Mollard E, Alappattu M, Shade MY, Struwe L, Berger AM. "The constant worry": Urinary incontinence self-management in rural women: A qualitative study. Res Nurs Health 2023; 46:603-615. [PMID: 37792276 DOI: 10.1002/nur.22341] [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: 04/25/2023] [Revised: 09/01/2023] [Accepted: 09/17/2023] [Indexed: 10/05/2023]
Abstract
Urinary incontinence (UI) is experienced by approximately 60% of women in the United States and has a negative impact on self-esteem, sexual function, social participation, and quality of life. Rural women, who are underrepresented in the UI literature, face many health disparities and unique barriers to accessing care. The purpose of this qualitative descriptive study was to explore UI self-management behaviors in rural women with UI, including the contextual factors that influence their approach to self-management. This study recruited rural women, ages 30-60 years, using purposive sampling via social media. Demographic information was collected. A semi-structured interview guide was used to conduct individual, in-depth interviews via Zoom. Interview data were analyzed using qualitative description. Sections of interview text were coded using a priori and emergent codes, grouped into categories, and distilled into themes. A total of 31 participants (mean age = 47.2 years) met inclusion/exclusion criteria, enrolled, and completed the study. Qualitative analysis revealed rural as a cross-cutting theme and five major themes: self-management behaviors, familial influence, medical encounters, talking about UI, and resource scarcity. Participants described the rural environment as having a substantial impact on their approach to UI self-management. Specifically, rural social enmeshment made seeking care for UI in rural communities challenging. Findings shed light on how the rural environment influences various aspects of UI self-management in midlife women. Diverse perspectives in UI self-management are needed to advance knowledge in this field.
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Affiliation(s)
- Abbey Jo Klein
- University of Nebraska Medical Center, College of Nursing, Omaha, Nebraska, USA
| | - Christine Eisenhauer
- Nebraska Total Care Clinical Advisory Board, Centene Corporation, Omaha, Nebraska, USA
| | - Elizabeth Mollard
- University of Nebraska Medical Center, College of Nursing, Lincoln, Nebraska, USA
| | - Meryl Alappattu
- Department of Physical Therapy, University of Florida, Gainesville, Florida, USA
| | - Marcia Y Shade
- University of Nebraska Medical Center, College of Nursing, Omaha, Nebraska, USA
| | - Leeza Struwe
- Niedfelt Nursing Research Center, University of Nebraska Medical Center, Lincoln, Nebraska, USA
| | - Ann M Berger
- University of Nebraska Medical Center, College of Nursing, Omaha, Nebraska, USA
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Blanco Gutiérrez V, Hundley VA, Way S. The Experience of Women From Underrepresented Groups With Urinary Incontinence: A Systematic Review. J Transcult Nurs 2023; 34:288-300. [PMID: 37199465 PMCID: PMC10265309 DOI: 10.1177/10436596231172205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023] Open
Abstract
INTRODUCTION Urinary incontinence (UI) in women is a global public health issue. However, there is a limited understanding of the experience of women from underrepresented groups suffering from UI. The purpose of this systematic review was to examine current evidence regarding the experience of women with UI from these groups. METHODOLOGY A systematic search was undertaken to retrieve research studies that answered the research question. Four qualitative research studies were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided this review. RESULTS Four themes emerged from this review: the perceived origin of UI, the physical, psychological, and social impact of UI, the impact of culture and religion on UI, and vice versa, and the interaction of women with health services. DISCUSSION Social determinants of health, such as religion and culture, need to be considered by professionals providing care if women from underrepresented groups experiencing UI are to receive optimal care.
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Xu P, Jin Y, Guo P, Xu X, Wang X, Zhang W, Mao M, Feng S. Barriers and enablers of pelvic floor rehabilitation behaviours in pregnant women with stress urinary incontinence: a qualitative analysis using the theoretical domains framework. BMC Pregnancy Childbirth 2023; 23:300. [PMID: 37118702 PMCID: PMC10148524 DOI: 10.1186/s12884-023-05633-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 04/21/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Stress urinary incontinence during pregnancy is closely related to the occurrence of postpartum and long-term urinary incontinence. Early pelvic floor management is of great significance in promoting the recovery of pelvic floor tissues in pregnant women. However, effective management of urinary incontinence is far from achievable owing to the low adherence of pregnant women in partaking in pelvic floor rehabilitation. As a comprehensive framework for behavioural theory, the Theoretical Domain Framework allows for comprehensive identification of behavioural determinants. Using Theoretical Domain Framework, this study aimed to identify barriers and enablers of pelvic floor rehabilitation behaviours in pregnant women with stress urinary incontinence. METHODS A descriptive, qualitative design was used in this study. Face-to-face semi-structured interviews were conducted with pregnant women with stress urinary incontinence based on the Theoretical Domain Framework. The data were analysed using a combination of inductive and deductive methods. RESULTS Twenty pregnant women with stress urinary incontinence were interviewed. Seven themes were summarised and used to explain the pelvic floor rehabilitation behaviours of pregnant women with stress urinary incontinence. The seven themes were (1) individual knowledge and experience of pelvic floor management, (2) judgments about expected outcomes, (3) interactions of interpersonal situations, (4) environment, resources, and decision-making processes, (5) personal goal-setting and efforts towards behaviour change, (6) emotional influences on decision-making, and (7) personal characteristics. Besides the "Optimism" domain, 13 of the 14 Theoretical Domains Framework domains were found to influence pregnant patients' pelvic floor rehabilitation behaviours after deductive mapping of themes to the Theoretical Domains Framework. In addition, the inductive analysis generated a theme of personal characteristics that did not map to any of the Theoretical Domains Framework domains. CONCLUSIONS The pelvic floor rehabilitation behaviours of pregnant women with stress urinary incontinence are complex and are affected by many factors. The findings confirm the need for multiple interventions to support pelvic floor management in pregnant women with stress urinary incontinence, focusing on enhancing knowledge and skills in pelvic floor care and using appropriate behaviour change techniques (such as prompts) to provide a supportive environment.
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Affiliation(s)
- Ping Xu
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Women's Hospital, Zhejiang University School of Medicine, No.1 Xue Shi Road, Hangzhou, Zhejiang Province, 310006, People's Republic of China
| | - Ying Jin
- Women's Hospital, Zhejiang University School of Medicine, No.1 Xue Shi Road, Hangzhou, Zhejiang Province, 310006, People's Republic of China
| | - Pingping Guo
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Women's Hospital, Zhejiang University School of Medicine, No.1 Xue Shi Road, Hangzhou, Zhejiang Province, 310006, People's Republic of China
| | - Xuefen Xu
- Women's Hospital, Zhejiang University School of Medicine, No.1 Xue Shi Road, Hangzhou, Zhejiang Province, 310006, People's Republic of China
| | - Xiaojuan Wang
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Women's Hospital, Zhejiang University School of Medicine, No.1 Xue Shi Road, Hangzhou, Zhejiang Province, 310006, People's Republic of China
| | - Wei Zhang
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Women's Hospital, Zhejiang University School of Medicine, No.1 Xue Shi Road, Hangzhou, Zhejiang Province, 310006, People's Republic of China
| | - Minna Mao
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Women's Hospital, Zhejiang University School of Medicine, No.1 Xue Shi Road, Hangzhou, Zhejiang Province, 310006, People's Republic of China
| | - Suwen Feng
- Women's Hospital, Zhejiang University School of Medicine, No.1 Xue Shi Road, Hangzhou, Zhejiang Province, 310006, People's Republic of China.
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Evidence-Informed, Interdisciplinary, Multidimensional Action Plan to Advance Overactive Bladder Research and Treatment Initiatives: Directives From State-of-the-Science Conference on Overactive Bladder and Cognitive Impairment. UROGYNECOLOGY (HAGERSTOWN, MD.) 2023; 29:S20-S39. [PMID: 36548637 DOI: 10.1097/spv.0000000000001274] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
ABSTRACT This article outlines an evidence-informed, interdisciplinary, multidimensional, comprehensive action plan for the American Urogynecologic Society to improve care of women with overactive bladder (OAB) while minimizing treatment-related adverse events, including cognitive impairment. It is a "call to action" to advance basic, translational, and clinical research and summarizes initiatives developed at the State-of-the-Science Conference on OAB and Cognitive Impairment to (1) develop framework for a new OAB treatment approach in women, (2) define research gaps and future research priorities, (3) champion health equity and diversity considerations in OAB treatment, (4) foster community and promote education to remove stigma surrounding OAB and urinary incontinence, and (5) elevate visibility and impact of OAB, by creating partnerships through education and engagement with health care professionals, industry, private and public payers, funding agencies, and policymakers.
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Reddy D, Zulfeen M, Pandey D. Stress incontinence combined score (SICS): A novel combined grading system to assess the severity of stress urinary incontinence in women. Eur J Obstet Gynecol Reprod Biol 2022; 278:57-65. [PMID: 36115261 DOI: 10.1016/j.ejogrb.2022.09.002] [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: 07/11/2022] [Revised: 08/24/2022] [Accepted: 09/02/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Natural history of urinary incontinence (UI) in women is a less understood domain. Stratifying severity of stress urinary incontinence (SUI) can be an important tool to understand the natural history, prognosticate the disease and plan optimal management. Present study was aimed to test a novel score (Stress Incontinence Combined score: SICS) with the currently popular tools International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and Incontinence Symptom Index (ISI) scores. MATERIAL AND METHODS This was a prospective study conducted at a university teaching hospital, over a period of 2 years. After screening women for SUI, SICS was administered. The novel SICS score was then compared with ICIQ-UI SF and ISI. RESULTS A total of 1750 women, attending various OPDs in a tertiary care hospital, were screened for urinary incontinence. The prevalence of UI and SUI was 26.6% and 12.8% respectively. The agreement between ISI and SICS was 81.7%, while the ICIQ- UI SF agreed with the SICS in 80.8% of the cases. AUROC analysis done showed that a score of 10 or more on the SICS (total score 16) could diagnose high-grade SUI with a sensitivity of 97%, specificity of 96% (Reference: ISI), and a sensitivity of 100%, and specificity of 93% (Reference: ICIQ- UI SF) CONCLUSION: SICS is the first of its kind tool, developed to specifically grade the severity of SUI, while incorporating both subjective and objective measures, with excellent reliability and reproducibility.
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Affiliation(s)
- Deepa Reddy
- KMC Manipal, Manipal Academy of Higher Education, Manipal (MAHE), India
| | | | - Deeksha Pandey
- KMC Manipal, Manipal Academy of Higher Education, Manipal (MAHE), India.
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Phthalate exposure enhances incidence of urinary incontinence: US NHANES, 2003-2004 and 2005-2006. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:64692-64703. [PMID: 35474427 DOI: 10.1007/s11356-022-20307-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 04/13/2022] [Indexed: 02/05/2023]
Abstract
The aim of this study is to investigate the associations between phthalate exposure and UI in a nationally representative sample of US adults. Cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) database was used for analysis. In total, 2,818 participants with measurements for phthalate metabolites and complete UI questionnaire data were enrolled in our study. Furthermore, seven phthalate metabolites were measured, which were obtained from urine samples and creatinine-standardized in the subsequent analyses. After dividing these phthalate metabolites into three groups, multivariable regression models were performed to evaluate the association between phthalate metabolites and UI rates. Moreover, interaction analyses and subgroup analyses stratified by gender were performed. In these seven phthalate metabolites, high level of mono-carboxynonyl phthalate (MCNP), mono-carboxyoctyl phthalate (MCOP), mono-isobutyl phthalate (MiBP), mono-n-butyl phthalate (MBP), and mono-3-carboxypropyl phthalate (MCPP) showed increased risk of UI (odds ratio (OR) = 1.52, 1.42, 1.43, 1.50, 1.51, respectively, all p value < 0.05). Trend test showed that incidence of UI increased significantly with concentration. A higher incidence of UI among participants was observed in the maximal tertile of phthalate when comparing with the lowest tertile. Subgroup analysis found that different phthalates have varying influence for different types of UI. Moreover, the analyses stratified for sex indicated that the high concentrations of MCNP and median concentrations of MCCP were associated with increase of the odds of UI in women and in men, respectively. Overall, the exposure to phthalates was positively associated with UI among US adults. Notably, different phthalates have varying influence for different types of UI, and male and female exposure to phthalate could result in the different prevalence of UI.
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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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Jaffar A, Tan CE, Mohd-Sidik S, Admodisastro N, Goodyear-Smith F. Persuasive Technology in an mHealth App Designed for Pelvic Floor Muscle Training Among Women: Systematic Review. JMIR Mhealth Uhealth 2022; 10:e28751. [PMID: 35315777 PMCID: PMC8984823 DOI: 10.2196/28751] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 06/03/2021] [Accepted: 02/02/2022] [Indexed: 02/06/2023] Open
Abstract
Background Pelvic floor muscle training (PFMT) is one of the first-line treatments for stress urinary incontinence among pregnant women. Mobile health (mHealth) technology is potentially effective for delivering PFMT to pregnant women. Persuasive technology in the development of such mobile apps may facilitate behavior change by improving adherence to the exercises. The Capability, Opportunity, and Motivation–Behavior (COM-B) model is potentially useful in selecting the appropriate interventions to be incorporated into the apps. Objective This review of mHealth apps for PFMT aims to describe the principles of persuasion used for each app and to propose mHealth app design features based on the COM-B model. Methods A systematic literature search was conducted to answer three main research questions: what are the available mHealth apps for PFMT in the published literature, what persuasive strategies were used in their studies how were they mapped to the COM-B model, and how effective were the selected persuasive strategies for PFMT adherence? We searched PubMed, CINAHL, Web of Science, Scopus, and local Malaysian databases such as MyCite and MyMedR for articles reporting mHealth apps used for the delivery of PFMT. We included original articles reporting experimental and cross-sectional studies, including pilot or feasibility trials. Systematic and narrative reviews were excluded. Narrative and thematic syntheses were conducted on the eligible articles based on the research questions. The Cochrane risk of bias tool and the Risk of Bias Assessment Tool for Non-randomized Studies were used to assess study bias. Results Of the 169 records from the initial search, 10 (5.9%) articles meeting the selection criteria were included in this review. There were 8 mHealth apps designed for the delivery of PFMT. The Tät, which used 3 categories of persuasive system design, improved PFMT adherence and was cost-effective. Only 1 app, the iBall app, used all categories of persuasive system design, by including social support such as "competition" in its design. The Diário Saúde app was the only app developed using operant conditioning. All apps incorporated Tailoring and Expertise as part of their PSD strategies. Only 3 apps, the Diário Saúde, Tät, and Pen Yi Kang demonstrated improved PFMT adherence. Conclusions Persuasive technology used in mobile apps may target desired behavior change more effectively. The persuasive system design can be mapped to the COM-B model to explain its effectiveness on behaviour change outcomes.
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Affiliation(s)
- Aida Jaffar
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia.,Primary Care Unit, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia, Kuala Lumpur, Malaysia
| | - Chai-Eng Tan
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia.,Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Sherina Mohd-Sidik
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Novia Admodisastro
- Software Engineering & Information System Department, Faculty of Computer Science & Information Technology, Universiti Putra Malaysia, Selangor, Malaysia
| | - Felicity Goodyear-Smith
- Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
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Torres-Lacomba M, Navarro-Brazález B, Yuste-Sánchez MJ, Sánchez-Sánchez B, Prieto-Gómez V, Vergara-Pérez F. Women’s Experiences with Compliance with Pelvic Floor Home Exercise Therapy and Lifestyle Changes for Pelvic Organ Prolapse Symptoms: A Qualitative Study. J Pers Med 2022; 12:jpm12030498. [PMID: 35330497 PMCID: PMC8950721 DOI: 10.3390/jpm12030498] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/01/2022] [Accepted: 03/17/2022] [Indexed: 02/04/2023] Open
Abstract
In this study, we aimed to investigate women’s experiences with compliance with prescribed pelvic floor muscle exercises (PFMEs) and lifestyle changes 6–12 months after completing an individual pelvic floor physiotherapy program. This study was targeted to understanding factors affecting adherence to PFMEs and lifestyle changes to deal with pelvic organ prolapse (POP) symptoms. We designed this research as a descriptive qualitative study. We conducted this study from December 2016 to September 2017 in Madrid, Spain. Twenty-six women with symptomatic POP selected using a purposive sampling method participated in six focus groups and three one-to-one semi-structured interviews. Three authors coded and inductively analyzed transcript contents with iterative theme development. A thematic analysis revealed three main themes: (1) symptoms change; (2) PFMEs and lifestyle changes performance; and (3) a health practitioner–patient relationship. Women identified as adherent reported improvement in physical symptoms and emotional and general state as a result of the new knowledge achieved. Fear also promoted compliance with performing PFMEs and adopting lifestyle changes. Likewise, PFMEs preference and routine, integration of PFMEs and lifestyle changes into activities of daily living, support guides, therapeutic alliance, individual supervision, follow-up, and feedback were also identified as adherence facilitators. One of the biggest barriers that we identified was responsibility. Compliance with prescribed PFMEs and lifestyle changes can be improved with effective individual, women-centered, and supervised physiotherapy programs reducing symptoms, including exercises aligned with women’s preferences that are easy to integrate in daily living, promoting knowledge and awareness of their condition, providing written or electronic guidelines, with routine follow-up visits offering both positive feedback and clear and consistent messages, and enhancing therapeutic alliance.
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15
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Yakit Ak E, Oskay U. Evaluation of incontinence women aged 20 or older living in Diyarbakir. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2022. [DOI: 10.1111/ijun.12313] [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)
- Eda Yakit Ak
- Atatürk Health Services Vocational School Dicle University Diyarbakır Turkey
| | - Umran Oskay
- Department of Women's Health and Gynecological Nursing, Florence Nightingale Faculty of Nursing Istanbul University‐Cerrahpasa Istanbul Turkey
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Murphy C, de Laine C, Macaulay M, Avery M, Fader M. A qualitative study and preliminary model of living with dementia and incontinence at home: beyond containment. Age Ageing 2022; 51:afab221. [PMID: 34888621 PMCID: PMC8753012 DOI: 10.1093/ageing/afab221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 08/10/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND most people living with dementia (PLWD) will develop incontinence problems with associated harmful consequences. Well-contained incontinence is often the main treatment goal. It would therefore be expected that poorly contained incontinence would have a negative impact. AIM to investigate differences in how well-contained or poorly contained incontinence impacts on the experience of living with incontinence for PLWD at home and their carers. DESIGN secondary analysis of a qualitative study. METHODS semi-structured interviews were undertaken with PLWD, carers and healthcare professionals (continence or dementia nurses). PLWD and carers were recruited via www.joindementiaresearch.nihr.ac.uk and via dementia/carer groups. Nurses were recruited via their employers. Interviews were recorded and transcribed verbatim. Framework analysis was used. RESULTS forty-five people (twenty-six carers, two PLWD, nine continence nurses and eight dementia nurses) participated. Despite poorly contained incontinence, some PLWD/carer dyads appeared relatively unaffected by incontinence. Conversely, one or both members of some dyads who achieved good containment found incontinence care highly challenging. Four themes were identified, together forming a preliminary model of incontinence containment and impact, as follows. CONCLUSION reliable containment is an important goal for PLWD living at home and their carers, but it is not the only goal. Other factors, such as behaviours that challenge or carer coping strategies, can mean that even well-contained incontinence can have a negative impact. This paper proposes a preliminary model for evaluation.
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Affiliation(s)
- Catherine Murphy
- School of Health Sciences, University of Southampton, Southampton, UK
| | | | - Margaret Macaulay
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Miriam Avery
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Mandy Fader
- School of Health Sciences, University of Southampton, Southampton, UK
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Méndez LMG, Moura ACRD, Cunha RMD, Figueiredo VBD, Moreira MA, Nascimento SLD. Behavioral therapy in the treatment of urinary incontinence: quality of life and severity. FISIOTERAPIA EM MOVIMENTO 2022. [DOI: 10.1590/fm.2022.356014] [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
Abstract Introduction: Behavioral therapy (BT) is an association of techniques that aim to minimize or abolish urinary symptoms, including urinary incontinence (UI), through education about the health condition, changes in lifestyle and nutritional habits, and bladder training. Objective: To analyze whether there is a change in the quality of life and severity of UI after group behavioral therapy in women with UI. Methods: Prospective observational study conducted in a pelvic physical therapy public service. Women with UI of any etiology, over 18 years of age, who completed a protocol of four weekly group BT meetings as the first treatment option for UI were included. Outcomes (impact of UI on QoL and classification of UI severity) were assessed before, immediately after, and one month after BT using the King's Health Questionnaire (KHQ) and the Incontinence Severity Index (ISI). Results: Sample of 146 participants. A reduction in the impact of UI on QoL was observed in the KHQ domains: impact of UI, physical limitations, personal relationships, emotions, general health perception (p < 0.05) immediately after BT. After one month, there was a reduction in the UI impact domains, daily activity limitations, physical limitations, general health perception, emotions, and sleep (p < 0.05). In addition, there was a reduction in the classification of UI severity assessed by the ISI (p < 0.001). Conclusion: There was an improvement in QoL and a decrease in UI severity in women with UI who completed a BT group as the first treatment option.
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Méndez LMG, Moura ACRD, Cunha RMD, Figueiredo VBD, Moreira MA, Nascimento SLD. Terapia comportamental no tratamento da incontinência urinária: qualidade de vida e gravidade. FISIOTERAPIA EM MOVIMENTO 2022. [DOI: 10.1590/fm.2022.356014.0] [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 Introdução: A terapia comportamental (TC) é uma associação de técnicas que visam minimizar ou abolir sintomas urinários, incluindo a incontinência urinária (IU), por meio da educação sobre a condição de saúde, mudanças em hábitos de vida e alimentares e treinamento vesical. Objetivo: Analisar se existe alteração da qualidade de vida e da gravidade da IU após terapia comportamental em grupo de mulheres com IU. Métodos: Estudo observacional prospectivo realizado em um serviço público de fisioterapia pélvica. Mulheres com IU de qualquer etiologia e maiores de 18 anos foram submetidas a um protocolo de quatro encontros de TC em grupo, semanalmente, como primeira opção de tratamento para IU. Os desfechos, impacto da IU na qualidade de vida (QV) e classificação da gravidade da IU foram avaliados antes, imediatamente após e um mês depois da TC pelos questionários King's Health Questionnaire (KHQ) e Incontinence Severity Index (ISI). Resultados: Amostra de 146 participantes. Observou-se redução do impacto da IU na QV nos domínios do KHQ: impacto da IU, limitações físicas, relações pessoais, emoções, percepção geral de saúde (p < 0,05) imediatamente após a TC. Após um mês, observou-se redução nos domínios de impacto da IU nas limitações de atividades diárias, limitações físicas, percepção geral de saúde, emoções e sono (p < 0,05), além da redução na classificação de gravidade da IU avaliada pelo ISI (p < 0,001). Conclusão: Houve melhora da QV e diminuição da gravidade da IU em mulheres com IU submetidas à TC em grupo como primeira opção de tratamento.
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Listening to Learn: A Qualitative Analysis of Women's Experiences with Mesh Mid-urethral Sling Surgery. Urology 2021; 161:36-41. [PMID: 34929240 DOI: 10.1016/j.urology.2021.12.006] [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: 09/09/2021] [Revised: 12/05/2021] [Accepted: 12/07/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To improve women's experiences with mesh mid-urethral sling (MUS) surgery for treatment of stress urinary incontinence (SUI), we sought to qualitatively examine patient perspectives of MUS surgery, organize resulting patient-derived themes, and present our findings as potential springboards for future research and quality improvement efforts. METHODS We conducted semi-structured focus groups and interviews of patients who had undergone mesh MUS surgery at a single tertiary referral institution. Discussions were recorded, transcribed, de-identified, and analyzed using deductive and inductive content analysis. Two researchers independently performed line-by-line coding which was verified by two additional researchers. RESULTS Eleven women participated. Most sought SUI care after becoming frustrated with their symptoms. However, some participants experienced barriers to care or dismissal of their symptoms by their physicians. While participants expected improvements in SUI symptoms after MUS surgery, some expected improvement or resolution of other pelvic floor-related issues such as bowel symptoms. Despite having improved SUI symptoms, participants described non-SUI symptoms as negative outcomes from their MUS surgery. Overall, participants wished SUI-associated embarrassment could be lessened and suggested public service announcements to help normalize discussion of SUI symptoms. CONCLUSIONS Obtaining first-hand information from SUI patients who have undergone MUS surgery provides insights into what matters to patients. Information from this study can help support further investigation into barriers to care for SUI patients and further study into improving counseling on goals and expectations of MUS surgery. The themes complement the current knowledge on MUS by providing insights that can only be collected through open-ended inquiry.
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20
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What Influences Women to Adhere to Pelvic Floor Exercises after Physiotherapy Treatment? A Qualitative Study for Individualized Pelvic Health Care. J Pers Med 2021; 11:jpm11121368. [PMID: 34945840 PMCID: PMC8706048 DOI: 10.3390/jpm11121368] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/07/2021] [Accepted: 12/10/2021] [Indexed: 12/29/2022] Open
Abstract
Conservative treatment of pelvic floor dysfunction (PFD) includes therapeutic exercise for pelvic floor muscle (PFM) training or other complementary exercise modalities, such as hypopressive exercises. However, the long-term effectiveness of the conservative treatment depends on a patient's adherence to the exercises and the integration of professional health advice into their daily life. The objective of this study was to establish the adherence experience of women with diagnosed PFD in home-based exercises after an intensive face-to-face physiotherapy treatment. A qualitative study from an interpretive paradigm was developed. Semi-structured individual and group interviews were performed 6 months after finishing individual physiotherapy treatment. The interviews were recorded, fully transcribed and analyzed thematically by creating categories. Thirty-one women were interviewed. The women reported that their adherence to home PFM exercises depended on the exercise program itself, its efficacy, their personal experiences with the exercises, intrinsic factors such as self-awareness or beliefs, and extrinsic factors, such as professional or instrumental feedback. Thus, therapeutic adherence could be more likely with effective physiotherapy programs that include mutually agreed home exercises and simple movements women can build into their daily lives. Improving awareness and knowledge of the pelvic region and the importance of PFM treatment as well as consideration for potential worsening of PFD will also encourage women to adhere to the exercises.
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21
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Quality of Life of Physically Active and Inactive Women Who Are Older after Surgery for Stress Urinary Incontinence Using a Transobturator Tape (TOT). J Clin Med 2021; 10:jcm10204761. [PMID: 34682882 PMCID: PMC8537612 DOI: 10.3390/jcm10204761] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/29/2021] [Accepted: 10/15/2021] [Indexed: 12/13/2022] Open
Abstract
Urinary incontinence is a major health problem. According to various authors, it concerns 30–40% of the population and grows with age, affecting approximately 50% of women aged over 70. According to the recommendations of the International Continence Society, the treatment of urinary incontinence should commence with conservative treatment and, above all, with physiotherapy. If the conservative treatment fails or the level of urinary incontinence is too high, surgery is recommended. With regard to female patients examined at work, the TOT method was applied. The aim of this study was to assess the relationship between regular physical activity and the quality of life of women aged 65–87 who underwent surgical treatment for stress urinary incontinence (SUI) using the TOT method. The study group involved 60 postmenopausal women, patients of the Department of Gynaecology of the Hospital of Ministry of the Interior and Administration in Wroclaw, with SUI diagnosed during ultrasonography. The female patients were surveyed before and 12 months after the surgery using standardised IPAQ and WHOQOL-BREF.FL questionnaires. Significant positive relationships between quality of life and physical activity before and 12 months after the surgery were demonstrated in the somatic and social domains. Physically active postmenopausal women presented higher values in all domains and total quality of life according to the WHOQOL-BREF compared with physically inactive women, both before and 12 months after the procedure using the TOT method.
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22
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Rada MP, Jones S, Betschart C, Falconi G, Haddad JM, Doumouchtsis SK. A meta-synthesis of qualitative studies on stress urinary incontinence in women for the development of a Core Outcome Set: A systematic review. Int J Gynaecol Obstet 2021; 158:3-12. [PMID: 34534366 DOI: 10.1002/ijgo.13934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/04/2021] [Accepted: 09/15/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Given the high variation of perceptions of women with stress urinary incontinence (SUI), qualitative meta-synthesis in this field appears warranted. We aimed to synthesize evidence on women's experiences of SUI by analyzing qualitative data. METHODS A literature search of Medline, Embase, Scopus, PsycInfo, and CINAHL databases was performed by a CHORUS Working Group, from inception to August 2020. Qualitative studies on women's perspectives on SUI were included. Thematic analysis was used as a conceptual approach to analyze the data and develop a set of overarching themes. The quality of studies was assessed based on the Critical Appraisal Skills Program tool. RESULTS Seven studies were included. Six themes encompassing women's perspectives on SUI emerged: experiencing SUI, awareness of SUI, treatments for SUI, sexuality, communication, and psychosocial effects. The quality appraisal of the studies showed good coherence. CONCLUSION This study revealed six overarching themes, of which treatment had the highest prevalence. Assessment of women's perceptions of SUI in the context of a qualitative meta-synthesis may inform policy and practice around this condition, may guide and help set research priorities, and will ideally contribute to the development of a Core Outcome Set for SUI.
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Affiliation(s)
- Maria Patricia Rada
- 2nd Department of Obstetrics and Gynaecology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Stephanie Jones
- School of Medicine, American University of the Caribbean, Pembroke Pines, FL, USA
| | - Cornelia Betschart
- Department of Gynecology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Gabriele Falconi
- Complex Operative Unit of Gynecology, Department of Surgical Sciences, Fondazione PTV Policlinico Tor Vergata University Hospital, Rome, Italy
| | - Jorge Milhem Haddad
- Urogynecology Division, Department of Obstetrics and Gynecology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Stergios K Doumouchtsis
- School of Medicine, American University of the Caribbean, Pembroke Pines, FL, USA.,Department of Obstetrics and Gynecology, Epsom and St Helier University Hospitals NHS Trust, Epsom, UK.,Laboratory of Experimental Surgery and Surgical Research N S Christeas, University of Athens, Medical School, Athens, Greece.,St George's University of London, London, UK.,School of Medicine, Ross University, Miramar, FL, USA
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Stoddard MD, Russell D, McDonald MV, Dignam R, Bowles KH, Prigerson HG, Chughtai B. Nurse Perspectives on Urinary Incontinence in the Home Hospice Setting. J Pain Symptom Manage 2021; 62:383-390. [PMID: 33271313 DOI: 10.1016/j.jpainsymman.2020.11.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/19/2020] [Accepted: 11/21/2020] [Indexed: 01/08/2023]
Abstract
CONTEXT To date, no studies have characterized the impacts of urinary incontinence (UI) at the end of life in the home hospice (HH) setting. UI is highly prevalent at the end of life and adversely affects quality of life. OBJECTIVES To characterize HH nurses' perspectives on UI in HH patients. METHODS We conducted a qualitative descriptive study of interviews between HH nurses and the study investigator. Thirty-two interviews with HH nurses were transcribed and analyzed. Nurses were mostly female, college-educated, and had several years of experience in HH nursing. RESULTS We identified findings in four major themes: 1) HH nurses' definition and identification of UI, 2) the absence of formal guidelines for diagnosing UI in HH patients, 3) UI's adverse effect on HH patients and their families, and 4) the lack of standardized guidelines for the management of UI in the HH setting. We found that there was a general lack of clarity on the subtypes of UI and no standardized guidelines for management of UI in the HH setting. Nurses reported that UI was bothersome to HH patients and their caregivers, citing patient discomfort, loss of dignity, and additional labor burden as reasons for this. Management strategies for UI lacked standardization. CONCLUSION UI is a prevalent and debilitating condition in HH patients. There is a need for studies to further characterize the impacts of UI on HH patients and their caregivers. Formal training on UI subtypes and management is needed to facilitate proper documentation, research, and improve patient outcomes.
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Affiliation(s)
- Michelina D Stoddard
- Department of Urology, Weill Cornell Medicine/New York Presbyterian, New York, New York, USA; Weill-Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD Program, New York, New York, USA
| | - David Russell
- Center for Home Care Policy & Research, Visiting Nurse Service of New York, New York, New York, USA; Department of Sociology, Appalachian State University, Boone, North Carolina, USA
| | - Margaret V McDonald
- Center for Home Care Policy & Research, Visiting Nurse Service of New York, New York, New York, USA
| | - Ritchell Dignam
- Visiting Nurse Service of New York Hospice, New York, New York, USA
| | - Kathryn H Bowles
- Center for Home Care Policy & Research, Visiting Nurse Service of New York, New York, New York, USA; Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Holly G Prigerson
- Department of Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Bilal Chughtai
- Department of Urology, Weill Cornell Medicine/New York Presbyterian, New York, New York, USA.
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Fernandes ACNL, Palacios-Ceña D, Hay-Smith J, Pena CC, Sidou MF, de Alencar AL, Ferreira CHJ. Women report sustained benefits from attending group-based education about pelvic floor muscles: a longitudinal qualitative study. J Physiother 2021; 67:210-216. [PMID: 34147398 DOI: 10.1016/j.jphys.2021.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 03/17/2021] [Accepted: 06/07/2021] [Indexed: 10/21/2022] Open
Abstract
QUESTION Among women who have participated in group-based education about the pelvic floor, what are their perceptions of the program and the group format? DESIGN Exploratory longitudinal qualitative study. PARTICIPANTS Community-dwelling women aged ≥ 18 years who participated in three or four sessions of pelvic floor education in a group format at a university clinic. DATA EXTRACTION AND ANALYSIS Semi-structured group or individual interviews were conducted at three time points: 1 week, 3 months and ≥ 5 months after the education activity. Data were inductively content analysed and independently coded, with iterative theme development. RESULTS Women considered the content and delivery appropriate and useful. New knowledge was assimilated and shared with others, and many tried to adopt pelvic floor muscle training in daily life. The women felt that the education sessions might benefit other women, with and without pelvic floor dysfunction symptoms, and that such education would ideally be more widely available. A perception of the value of the education persisted over time, even though maintenance of some health-promoting behaviours, such as pelvic floor muscle training, decreased. CONCLUSION The pelvic floor group education sessions appeared to fulfil the purpose of increasing knowledge about pelvic floor (dys)function and applying this in daily life. Overall, the participants, who had completed three or four of the four sessions, found the program to be useful. A unique feature of this study was longitudinal data collection and it seemed that the perception of value persisted over time.
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Affiliation(s)
| | - Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Research Group of Humanities and Qualitative Research in Health Science, Universidad Rey Juan Carlos, Madrid, Spain
| | - Jean Hay-Smith
- Physiotherapist Rehabilitation Teaching and Research Unit, University of Otago, Wellington, New Zealand
| | | | - Mayra Feltrin Sidou
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
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Jaffar A, Mohd-Sidik S, Abd Manaf R, Foo CN, Gan QF, Saad H. Quality of life among pregnant women with urinary incontinence: A cross-sectional study in a Malaysian primary care clinic. PLoS One 2021; 16:e0250714. [PMID: 33909678 PMCID: PMC8081257 DOI: 10.1371/journal.pone.0250714] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 04/13/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Pregnant women have an increased risk of urinary incontinence (UI), affecting their quality of life (QoL). This study aims to determine UI and its relationship with QoL among incontinent pregnant women. METHODS This was a cross-sectional study in a semi-urban primary care clinic in Selangor, Malaysia, among pregnant women aged 18 years old and above. The validated study instruments consisted of questions on socio-demography, the International Consultation on Incontinence Questionnaire-UI Short Form (ICIQ-UI SF) to determine UI and the International Consultation on Incontinence Questionnaire Lower Urinary Tract Symptoms Quality of Life Module (ICIQ-LUTSQoL) to assess their QoL. A generalised linear model was used to determine the association between the continent and incontinent pregnant women with QoL. RESULTS Of the approached 610 respondents, 440 consented to participate in the study, resulting in a response rate of 72.1%. The mean age was 29.8 years old (SD 4.69) with 82.2% (n = 148) having stress UI. Significant independent factors related to the decreased QoL were mid to late trimester (OR 3.06, 95% CI 1.48-6.32), stress UI, (OR 6.94, 95%CI 4.00-12.04) and urge UI (OR3.87, 95%CI 0.48-31.28). Non-Malay improved QoL (OR 0.29, 95% CI 0.16-0.52). CONCLUSIONS All types of UI significantly affecting pregnant women's QoL. This information is useful in enhancing antenatal management at the primary care level, whereby they should be screened for UI and provided with effective early intervention to improve their QoL.
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Affiliation(s)
- Aida Jaffar
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Primary Care Unit, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia, Sg Besi, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Sherina Mohd-Sidik
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- * E-mail:
| | - Rosliza Abd Manaf
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Chai Nien Foo
- Department of Population Medicine, Universiti Tunku Abdul Rahman, Cheras, Kajang, Selangor, Malaysia
| | - Quan Fu Gan
- Pre-clinical Department, Universiti Tunku Abdul Rahman, Cheras, Kajang, Selangor, Malaysia
| | - Hamimah Saad
- Klinik Kesihatan Kajang, Jalan Semenyih, Kajang, Selangor, Malaysia
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Choi EPH, Huang J, Chau PH, Wan EYF. Health-related quality of life among Chinese primary care patients with different lower urinary tract symptoms: a latent class analysis. Qual Life Res 2021; 30:1305-1315. [PMID: 33447962 DOI: 10.1007/s11136-020-02731-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE No previous study has used a data-driven approach to explore symptom subclasses among patients with lower urinary tract symptoms (LUTS). The objectives of this study were to use latent class analysis (LCA) to identify distinct classes of LUTS among primary care patients and to assess the class differences in health-related quality of life (HRQOL). METHODS In this cross-sectional study, 500 patients were randomly recruited, and 18 symptoms according to the International Continence Society 2002 criteria were assessed. Classes were identified by LCA. Patient HRQOL was measured using the 12-item Short Form Health Survey (version 2), the modified Incontinence Impact Questionnaire-Short Form and the HRQOL item from the International Prostate Symptom Score. RESULTS Six distinct LUTS classes were identified: "asymptomatic" (26.0%), "mild symptoms" (22.6%), "moderate multiple symptoms" (17.0%), "urgency symptoms" (13.8%), "urinary incontinence" (12.0%) and "severe multiple symptoms" (8.6%). Multinomial regression analysis found differences in the gender distribution and prevalence of heart diseases across classes, and multiple linear regression found that patients with "severe multiple symptoms" and "urinary incontinence" had the poorest HRQOL. CONCLUSION Almost three quarters of the primary care patients in this study were suffering from varying degrees of LUTS. The poor HRQOL in "severe multiple symptoms" and "urinary incontinence" implies that patients in these classes require additional attention and treatments.
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Affiliation(s)
- Edmond Pui Hang Choi
- School of Nursing, University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong.
| | - Jing Huang
- School of Nursing, University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Pui Hing Chau
- School of Nursing, University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Eric Yuk Fai Wan
- Department of Family Medicine and Primary Care, University of Hong Kong, Pokfulam, Hong Kong.,Department of Pharmacology and Pharmacy, University of Hong Kong, Pokfulam, Hong Kong
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Costantino C, Casuccio A, Restivo V. Potential Risks and Factors of Women's Health Promotion. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249555. [PMID: 33371190 PMCID: PMC7767262 DOI: 10.3390/ijerph17249555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 12/18/2020] [Indexed: 06/12/2023]
Abstract
In addition to diseases shared by both sexes, there are a number of illnesses and injuries that are primarily associated with women [...].
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Erkal Aksoy Y, Akın B, Dereli Yılmaz S. Urinary incontinence experiences of pregnant women: A qualitative study. Urologia 2020; 88:140-147. [PMID: 33245027 DOI: 10.1177/0391560320974880] [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: 11/17/2022]
Abstract
OBJECTIVE The research was carried out to determine the life experiences of pregnant women who have urinary incontinence problems. METHODS The type of the research is of qualitative type. Views of pregnant women were coded according to repeating frequencies; then thematic grouping was done. Both common views and individual repetitions of the pregnant women were coded. During the study, 52 pregnant women stated that they had urinary incontinence problems. However, five pregnant women did not want to participate in the study and six pregnant women wanted to leave during the interview. Interviews ended with 41 pregnant women. RESULTS In the study, the mean age of the pregnant women was determined as 29.75 ± 4.83, and the mean gestational week was 27.85 ± 5.60. The views of pregnant women are divided into five main themes and 16 sub-themes. The main themes for the urinary incontinence life experiences of pregnant women were determined as "strategies to take precautions, psychological effects, pregnancy and baby-specific effects, physical effects and changes in their relationship with the spouse." CONCLUSION As a result, it was determined that urinary incontinence problem negatively affected the life experience of pregnant women.
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Affiliation(s)
- Yasemin Erkal Aksoy
- Department of Midwifery, Health Sciences Faculty of Selcuk University, Konya, Turkey
| | - Bihter Akın
- Department of Midwifery, Health Sciences Faculty of Selcuk University, Konya, Turkey
| | - Sema Dereli Yılmaz
- Department of Midwifery, Health Sciences Faculty of Selcuk University, Konya, Turkey
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Williams BR, Vargo K, Newman DK, Yvette Lacoursiere D, Mueller ER, Connett J, Low LK, James AS, Smith AL, Schmitz KH, Burgio KL. It's About Time: The Temporal Burden of Lower Urinary Tract Symptoms Among Women. UROLOGIC NURSING 2020; 40:10.7257/1053-816x.2020.40.6.277. [PMID: 33642840 PMCID: PMC7906293 DOI: 10.7257/1053-816x.2020.40.6.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This secondary analysis studied 50 transcripts of women who shared day-to-day experiences of lower urinary tract symptoms (LUTS) and characterized temporal (time-associated) features of living with LUTS. Findings revealed two overarching time-associated themes: The Complexity of LUTS and The Quest for Empowerment over LUTS. Findings suggest that the temporal burden of LUTS is the accumulated impact of symptoms and symptom management on women's daily lives within multiple contexts across the life course. Increasing nurses' knowledge of the temporal context of LUTS may heighten awareness and improve symptom detection and management.
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Affiliation(s)
- Beverly Rosa Williams
- University of Alabama at Birmingham School of Medicine, Department of Veterans Affairs, Birmingham, AL
| | - Keith Vargo
- University of Minnesota School of Public Health
| | - Diane K Newman
- Division of Urology, Department of Surgery, University of Pennsylvania, Perelman School of Medicine
| | | | | | | | | | - Aimee S James
- Washington University in St. Louis School of Medicine
| | | | | | - Kathryn L Burgio
- University of Alabama at Birmingham School of Medicine, Department of Veterans Affairs, Birmingham, AL
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