Skip to main content

Advertisement

SpringerLink
Log in

Predictors and reasons for help-seeking behavior among women with urinary incontinence

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

The aim of the study was to evaluate the predictors and reasons for help-seeking behavior among women with urinary incontinence (UI) in Germany and Denmark.

Methods

This international postal survey was conducted in 2014. In each country, 4,000 women of at least 18 years of age were randomly selected. The questionnaires included validated items regarding help-seeking behavior and the ICIQ-UI SF. UI was defined as any involuntary loss of urine. Binary logistic regression analysis was used to assess factors predicting help-seeking behavior. Reasons for seeking or not seeking help were evaluated in terms of the severity of UI and as the most frequently reported.

Results

Of 1,063 Danish women with UI, 25.3% had consulted a physician compared with 31.4% of 786 German women with UI (p = 0.004). The severity and duration of UI, and actively seeking information regarding UI, were significant independent predictors of help-seeking behavior. Women with slight/moderate UI did not seek help because they did not consider UI as a problem, whereas of women with severe/very severe UI, German women reported that other illnesses were more important and Danish women reported that they did not have enough resources to consult a physician.

Conclusions

Only a small proportion of women with UI had consulted a physician, and the driving forces for help-seeking behavior were severity and duration of UI and actively seeking information regarding UI. Public information campaigns might enhance consultation rates providing that passively receiving and actively seeking information have the same effects on help-seeking behavior. We show for the first time that reasons for not consulting a physician for UI vary depending on the severity of the UI.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Haylen B, Ridder DD, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. 2010;21:5–26. doi:10.1007/s00192-009-0976-9.

    Article  PubMed  Google Scholar 

  2. Hunskaar S, Arnold EP, Burgio K, et al. Epidemiology and natural history of urinary incontinence. Int Urogynecol J. 2000;11:301–19. doi:10.1007/s001920070021.

    Article  CAS  Google Scholar 

  3. Buckley BS, Lapitan MC; Epidemiology Committee of the Fourth International Consultation on Incontinence, Paris, 2008. Prevalence of urinary incontinence in men, women, and children – current evidence: findings of the Fourth International Consultation on Incontinence. Urology. 2010;76:265–70. doi:10.1016/j.urology.2009.11.078.

    Article  PubMed  Google Scholar 

  4. Schreiber Pedersen L, Lose G, Høybye MT, et al. Prevalence of urinary incontinence among women and analysis of potential risk factors in Germany and Denmark. Acta Obstet Gynecol Scand. 2017;96:939–48. doi:10.1111/aogs.13149.

    Article  PubMed  Google Scholar 

  5. O’Donnell M, Lose G, Sykes D, et al. Help-seeking behaviour and associated factors among women with urinary incontinence in France, Germany, Spain and the United Kingdom. Eur Urol. 2005;47:385–92. doi:10.1016/j.eururo.2004.09.014.

    Article  PubMed  Google Scholar 

  6. Hannestad Y, Rortveit G, Hunskaar S. Help-seeking and associated factors in female urinary incontinence. The Norwegian EPINCONT Study. Epidemiology of Incontinence in the County of Nord-Trøndelag. Scand J Prim Health Care. 2002;20:102–7. doi:10.1080/713796408.

    Article  PubMed  Google Scholar 

  7. Hägglund D, Walker-Engström ML, Larsson G, Leppert J. Reasons why women with long-term urinary incontinence do not seek professional help: a cross-sectional population-based cohort study. Int Urogynecol J Pelvic Floor Dysfunct. 2003;14:296–304. doi:10.1007/s00192-003-1077-9.

    Article  PubMed  Google Scholar 

  8. Kinchen KS, Burgio K, Diokno AC, et al. Factors associated with women’s decisions to seek treatment for urinary incontinence. J Womens Health. 2003;12:687–98.

    Article  Google Scholar 

  9. Yu H-J, Wong W, Chen J, Chie W-C. Quality of life impact and treatment seeking of Chinese women with urinary incontinence. Qual Life Res. 2003;12:327–33. doi:10.1023/a:1023250632395.

    Article  PubMed  Google Scholar 

  10. Abrams P, Cardozo L, Khoury S, Wein A. Incontinence, 5th International Consultation on Incontinence, Paris, February 2012. 5th ed. Paris: ICUD-EAU; 2013.

    Google Scholar 

  11. Papanicolaou S, Hunskaar S, Lose G, Sykes D. Assessment of bothersomeness and impact on quality of life of urinary incontinence in women in France, Germany, Spain and the UK. BJU Int. 2005;96:831–8. doi:10.1111/j.1464-410X.2005.05722.x.

    Article  PubMed  Google Scholar 

  12. Monz B, Chartier-Kastler E, Hampel C, et al. Patient characteristics associated with quality of life in European women seeking treatment for urinary incontinence: results from PURE. Eur Urol. 2007;51:1073–82. doi:10.1016/j.eururo.2006.09.022.

    Article  PubMed  Google Scholar 

  13. Ebbesen MH, Hunskaar S, Rortveit G, Hannestad YS. Prevalence, incidence and remission of urinary incontinence in women: longitudinal data from the Norwegian HUNT study (EPINCONT). BMC Urol. 2013;13:27. doi:10.1186/1471-2490-13-27.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Miller YD, Brown WJ, Smith N, Chiarelli P. Managing urinary incontinence across the lifespan. Int J Behav Med. 2003;10:143–61.

    Article  PubMed  Google Scholar 

  15. Berger MB, Patel DA, Miller JM, et al. Racial differences in self-reported healthcare seeking and treatment for urinary incontinence in community-dwelling women from the EPI study. Neurourol Urodyn. 2011;30:1442–7.

    Article  PubMed Central  PubMed  Google Scholar 

  16. OECD/Eurostat/UNESCO Institute for Statistics. ISCED 2011 Operational Manual: Guidelines for classifying national education programmes and related qualifications. Paris: OECD Publishing; 2015.doi:10.1787/9789264228368-en

    Google Scholar 

  17. Creswell JW, Clark VLP. Designing and conducting mixed methods research. 2nd ed. Los Angeles: Sage; 2011.

    Google Scholar 

  18. Jürgensen M, Elsner S, Schreiber Pedersen L, et al. "I really thought nothing could be done": help-seeking behaviour among women with urinary incontinence. Int J Res Med Sci. 2015;3:826–35. doi:10.5455/2320-6012.ijrms20150402.

    Article  Google Scholar 

  19. Harkness JA, van de Vijver FJ, Mohler PP. Cross-cultural survey methods. New York: Wiley; 2003.

  20. de Vet HC, Terwee CB, Mokkink LB, Knol DL. Measurement in medicine, 1st ed. New York: Cambridge University Press; 2011.

    Book  Google Scholar 

  21. Willis GB. Cognitive interview: a tool for improving questionnaire design. Thousand Oaks: Sage; 2005.

    Book  Google Scholar 

  22. Avery KN, Bosch JL, Gotoh M, et al. Questionnaires to assess urinary and anal incontinence: review and recommendations. J Urol. 2007;177:39–49. doi:10.1016/j.juro.2006.08.075.

    Article  CAS  PubMed  Google Scholar 

  23. Avery K, Donovan J, Peters TJ, et al. ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourol Urodyn. 2004;23:322–30. doi:10.1002/nau.20041.

    Article  PubMed  Google Scholar 

  24. Espuña-Pons M, Dilla T, Castro D, et al. Analysis of the value of the ICIQ-UI SF questionnaire and stress test in the differential diagnosis of the type of urinary incontinence. Neurourol Urodyn. 2007;26:836–41.

    Article  PubMed  Google Scholar 

  25. Klovning A, Avery K, Sandvik H, Hunskaar S. Comparison of two questionnaires for assessing the severity of urinary incontinence: the ICIQ-UI SF versus the incontinence severity index. Neurourol Urodyn. 2009;28:411–5.

    Article  PubMed  Google Scholar 

  26. Hansen BB, Svare J, Viktrup L, et al. Urinary incontinence during pregnancy and 1 year after delivery in primiparous women compared with a control group of nulliparous women. Neurourol Urodyn. 2012;31:475–80. doi:10.1002/nau.21221.

    Article  PubMed  Google Scholar 

  27. World Medical Association. Declaration of Helsinki. Ethical principles for medical research involving human subjects. Jahr Wiss Ethik. 2014;18(1):363–8. doi:10.1515/jwiet-2014-0117.

    Google Scholar 

  28. Xu D, Wang X, Li J, Wang K. The mediating effect of “bothersome” urinary incontinence on help-seeking intentions among community-dwelling women. J Adv Nurs. 2015;71:315–25. doi:10.1111/jan.12514.

    Article  PubMed  Google Scholar 

  29. Doshi AM, Van Den Eeden SK, Morrill MY, et al. Women with diabetes: understanding urinary incontinence and help seeking behavior. J Urol. 2010;184:1402–7. doi:10.1016/j.juro.2010.06.014.

    Article  PubMed Central  PubMed  Google Scholar 

  30. Milsom I, Kaplan SA, Coyne KS, et al. Effect of bothersome overactive bladder symptoms on health-related quality of life, anxiety, depression, and treatment seeking in the United States: results from EpiLUTS. Urology. 2012;80:90–6. doi:10.1016/j.urology.2012.04.004.

    Article  PubMed  Google Scholar 

  31. Coyne KS, Sexton CC, Kopp Z, et al. Assessing patients’ descriptions of lower urinary tract symptoms (LUTS) and perspectives on treatment outcomes: results of qualitative research. Int J Clin Pract. 2010;64:1260–78. doi:10.1111/j.1742-1241.2010.02450.x.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We thank Susanne Elsner and Jessica Lueckert, Institute for Social Medicine and Epidemiology, University of Luebeck, for assistance during the conduct of the survey, Tobias Windfeldt Klausen, Department of Hematology, Herlev Gentofte University Hospital, for statistical advice, and Philip Greenwood for language advice.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Herlev Gentofte University Hospital, Herlev Ringvej 75, DK 2730, Herlev, Denmark

    Louise Schreiber Pedersen & Gunnar Lose

  2. Interdisciplinary Research Unit, Elective Surgery Center, Silkeborg Hospital, Silkeborg, Denmark

    Mette Terp Høybye

  3. Institute for the History of Medicine and Science Studies, University of Lübeck, Lübeck, Germany

    Martina Jürgensen

  4. Institute for Social Medicine and Epidemiology, Universitätsklinikums Schleswig-Holstein (UKSH), Lübeck, Germany

    Annika Waldmann

  5. Authority for Health and Consumer Protection, Hamburg Cancer Registry, Hamburg, Germany

    Annika Waldmann

  6. Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark

    Martin Rudnicki

Authors
  1. Louise Schreiber Pedersen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gunnar Lose
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mette Terp Høybye
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Martina Jürgensen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Annika Waldmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Martin Rudnicki
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Louise Schreiber Pedersen.

Ethics declarations

Funding

The study was funded by tthe European Commission’s INTERREG IVA program.

Conflicts of interest

Louise Schreiber Pedersen: none.

Gunnar Lose has accepted payment for research from Astellas and has been a consultant for Contura. Neither this funding source nor this relationship influenced the performance of this study.

Mette Terp Høybye: none.

Martina Jürgensen: none.

Annika Waldmann: none.

Martin Rudnicki: none.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Schreiber Pedersen, L., Lose, G., Høybye, M.T. et al. Predictors and reasons for help-seeking behavior among women with urinary incontinence. Int Urogynecol J 29, 521–530 (2018). https://doi.org/10.1007/s00192-017-3434-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-017-3434-0

Keywords

Search

Navigation