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Relationships among symptom severity, coping styles, and quality of life in community-dwelling women with urinary incontinence: a multiple mediator model

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Abstract

Purpose

To investigate the relationships among symptom severity, coping styles, and quality of life (QOL) in community-dwelling women with urinary incontinence (UI).

Methods

A total of 592 women with UI participated in this cross-sectional study. Bivariate Pearson’s correlation was used to examine the correlations between symptom severity, coping styles, and QOL. Multivariate regression models and Sobel tests were used to test the mediating effect of coping styles. Additionally, a multiple mediator model was used to examine the mediating role of coping styles collectively. All regression models were adjusted for age, education, marital status, income, duration of UI, and type of UI.

Results

Participants tended to use avoidant and palliative coping styles and not use instrumental coping style. Avoidant and palliative coping styles were associated with poor QOL, and partially mediated the association between symptom severity and QOL. Nearly 73 % of the adverse effect of symptom severity on QOL was mediated by avoidant and palliative coping styles.

Conclusions

The use of avoidant and palliative coping styles was higher with more severe urine leakage, and QOL tended to be poorer. Coping styles should be addressed in UI management. It may be of particular value to look closely at negative coping styles and implement education and training of patients in improving their coping skills related to managing UI, which will in turn improve their QOL.

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Acknowledgments

This study was financed by the National Social Science Foundation in China (14CSH063) and Humanities and Social Sciences of Ministry of Education Planning Fund in China (14YJAZH076). The authors would like to acknowledge all the participants, research assistants, and community nurses who helped with the data collection. We are grateful to Yuan Zhang and Emily Long from the University of Massachusetts Lowell (USA) and Edanz Group for their editing of the manuscript.

Author contributions

Dongjuan Xu and Kefang Wang were responsible for the study design. Nana Liu, Haili Qu, and Liqin Chen performed the data collection. Dongjuan Xu and Nana Liu were responsible for the data analysis and drafting of the manuscript. Kefang Wang supervised the study and made critical revisions to the paper for important intellectual content.

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    Authors and Affiliations

    1. School of Nursing, Shandong University, No. 44, Wenhua Xi Road, Jinan, Shandong, China

      Dongjuan Xu, Nana Liu, Liqin Chen & Kefang Wang

    2. Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China

      Haili Qu

    3. School of Public Health, University of Minnesota, Minneapolis, MN, USA

      Dongjuan Xu

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    1. Dongjuan Xu
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    Correspondence to Kefang Wang.

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    Dongjuan Xu and Nana Liu have contributed equally to this work.

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    Xu, D., Liu, N., Qu, H. et al. Relationships among symptom severity, coping styles, and quality of life in community-dwelling women with urinary incontinence: a multiple mediator model. Qual Life Res 25, 223–232 (2016). https://doi.org/10.1007/s11136-015-1070-z

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