Urinary Incontinence in Women Under 65: Quality of Life, Stress Related to Incontinence and Patterns of Seeking Health Care
10.1023/B:QURE.0000040794.77438.cf Cite this article as: Margalith, I., Gillon, G. & Gordon, D. Qual Life Res (2004) 13: 1381. doi:10.1023/B:QURE.0000040794.77438.cf Abstract Objective: We sought to describe quality of life, psychological stress and patterns of seeking health care (PSHC) among young and middle-aged women experiencing urinary stress incontinence (USI). Reasons and variables associated with delay in seeking care were also investigated. Methods: A sample of 131 patients, aged 22–65, filled out a questionnaire consisted of: SF-36, stress related to incontinence, patterns of seeking health care questionnaires and a 10 cm visual analogue scale (VAS) measuring perceived suffering from USI (0 indicating absence of suffering while 10 indicating most severe suffering). Results: Scores on eight domains of SF-36 were lower, compared to 405 Israeli healthy women ( p < 0.001). Forty-one percent reported impairment in performing work and other activities. Mean scores on the VAS was 5.04 (SD: 2.59), 30% marked 7 cm and higher and 12.6% reported most severe suffering due to USI (scored 10 cm). Psychological stress related to incontinence was higher among the younger women and those with severe impairment to sexual activity. The majority of the sample (74%) delayed seeking help for at least a year, 46% delayed it for 3 years. Common reasons for delay were lack of time (36.3%), shame (15.7%) and fear of surgery (14.7%). Age, psychological stress, perceived suffering and social functioning (SF) were associated with patterns of seeking care. Conclusions: USI causes suffering and impaired quality of life among young women. Reluctance to seek help highlights the need to promote women's knowledge of treatment options and cure prospects. Patterns of seeking care Quality of life Stress related to incontinence Urinary incontinence Young adults References
Valerius AJ.The psychosocial impact of urinary incontinence on women aged 25–45 years.Urol Nurs 1997;17(3): 96–103.
Bush TA, Castellini DT, Phillips C.Exploring women's beliefs regarding urinary incontinence.Urol Nurs 2001;21: 211–218.
Bates F, Porter G.The role of the nurse continence advisor in a urology wellness clinic.Urol Nurs 2002;22(1):23–26.
Roberts RO, Jacobsen SJ, Rhodes T,et al.Urinary incontinence in a community-based cohort:Prevalence of health care seeking.J Am Geriatr Soc 1998;46:467–472.
Vinker S, Kaplan B, Nakar S, Samuels G, Shapira G, Kitai E.Urinary incontinence in women:Prevalence,characteristics and effect on quality of life.A primary care clinic study.Isr Med Assoc J 2001;3(9):663–666.
Abrahams N, Jewkers R, Mvo Z.Health care seeking practices of pregnant women and the role of midwife in Cape Town,South Africa.J Midwifery Women's Health 2001;46(4):240–247.
Burgess C, Hunter MS, Ramirez AJ.A qualitative study of delay among women reporting symptoms of breast cancer. Br J Gen Prac 2001;51(473):967–971.
Cote P, Cassidy,JD, Carroll L.The treatment of back and low back pain:Who seeks care?Who goes where?Med Care 2001;39(9):956–967.
Kolosky NA, Talley NJ, Boyce PM.Predictors of health care seeking for irritable bowel syndrome and nonulcer dyspepsia:A critical review of the literature on symptom and psychosocial factors.Am J Gastroenterol 2001;96(5): 1340–1439.
Margalith I, Shapiro A.Anxiety and patient participation in clinical decision making:The case of patients with urinary calculi.Soc Sci Med 1997;45(3):419–427.
Fortenberry JD, McFarlane M, Bleakely A,et al.Relationship of stigma and shame to gonorrhea and HIV screening.Am J Public Health 2002;92(3):371–378.
Facione NC, Giancarlo C, Chan L.Perceived risk and help seeking behavior for breast cancer.A Chinese American perspective.Cancer Nurs 2000;23(4):258–267.
NIH Consensus Statements.Urinary incontinence in adults 1998;71:1–24.
Abrams P, Blaivas JG, Stanton SL, Anderson JT.The standardization of terminology of lower urinary tract function.Scand J Urol Nephrol 1988;114(Suppl.):5–19.
Valvane J, Juva K, Erkinjuntti T, Tilvas R.Major depression in the elderly:A population study in Helsinki. Int Psychogeriatr 1996;8(3):437–443.
Berglund AL, Eiseman M, Lalos O.Personality characteristics of stress incontinent women:A pilot study.J Psychosom Obstet Gynaecol 1994;15(3):165–170.
Herzog AR, Fultz NH, Brock BM, Brown MB, Diokono AC.Urinary incontinence and psychological distress among older adults.Psychol Aging 1988;3(2):115–121.
Grimby A, Milsom I, Molander U, Wiklund I, Eklund P. The influence of urinary incontinence on the quality of life of elderly women.Age Ageing 1993;22:82–29.
Skoner MM.Self management of urinary incontinence among women 31–50 years of age.Rehab Nurs 1994;19(6): 339–343.
Thom D.Variation of estimates of urinary incontinence prevalence in the community:Effects of differences in definition,population characteristics and study type.J Am Geriatr Soc 1998;46(4):473–480.
Burgio KL, Matthews KA, Engel BT.Prevalence,incidence and correlates of urinary incontinence in healthy middleaged women.J Urol 1991;146:1255–1259.
Wyman JF, Harkins SW, Fantl JA.Psychosocial impact of urinary incontinence in the community-dwelling population.J Am Geriatr Soc 1990;38(3):282–288.
Yu LC.Incontinence stress index:Measuring psychosocial impact.J Gerontol Nurs 1987;13(7):18–25.
Yu LC, Rohner TJ, Katreider DL, Hu TW, Igou JF, Dennis PJ.Profile of urinary incontinent elderly in longterm care institutions.J Am Geriatr Soc 1990;38(4):433–439.
Kim JI.Continence efficacy intervention program for community residing women with stress urinary incontinence in Japan.Public Health Nurs 2001;18(1):64–72.
Peyrat L, Hailott F, Bruyere JM, Bontin P, Bertrand P, Lanson Y.Prevalence and risk factors of urinary incontinence in young and middle-aged women.Br J Urol Int 2002;89:61–66.
Ware JE, Sherbourn CD.The MOS 36-Item Short-Form Health Survey (SF-36).Med Care 1992;30(6):473–483.
Lewin-Epstein N, Sagiv-Schiter T, Shabtai EL, Shmueli A. Validation of the 36-Item Short Form Health Survey (Hebrew version)in adult population in Israel.Med Care 1998; 36(9):1361–1370.
McHorney CA, Ware JE, Lu R, Sherbourne CD.The MOS 36 item Short-Form Health Survey (SF-36):Tests of data quality,scaling assumptions and reliability across diverse patient groups.Med Care 1994;32(1):40–46.
Bodden-Heidrich R, Berckmann MN, Libra B, Rechenberger I, Bender HG.Psychosomatic aspects of urinary incontinence.Arch Gynecol Obstet 1999;262(3–4):151–158.
Vierhout ME, Gianotten WL.Mechanisms of urine loss during sexual activity.Eur J Obstet Gynecol Reprod Biol 1993;52(1):45–47.
Guttormsen V, Hunskaar S.Distress associated with urinary incontinence,as measured by a visual analogue scale. Scand J Caring Sci 1991;5(1):57–61.
Frazer MI, Haylen BT, Sutherst JR.The severity of urinary incontinence in women.Comparison of subjective and objective tests.Br J Urol 1989;63:14–15.
Parkin DE, Davis JA.Use of a visual analogue scale in the diagnosis of urinary incontinence.Br Med J 1986;293:365–366.
Yu LC, Kaltreider DL, Hu T, Igou, JF, Craighead WE. Measuring stress associated with incontinence:The ISQ-P tool.J Gerontol Nurs 1989;15(2):9–15.
Hagglund D, Walker-Engstrom ML, Larsson G. Leppert J. Quality of life and seeking help in women with urinary incontinence.A population-based study.Acta Obstet Gynecol Scand 2001;80:1051–1055.
Ueda T, Tamakai M, Kageyama S, Yoshimura N, Yoshida O.Urinary incontinence among community-dwelling people aged 40 years or older in Japan:Prevalence,risk factors, knowledge and self-perception.Int J Urol 2000;7(3):95–103.
Google Scholar Copyright information
© Kluwer Academic Publishers 2004