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The Concerns of Community-Dwelling Older Women Living with Urinary Incontinence: Qualitative Research

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Abstract

Introduction and Hypothesis

The world including Iran is facing population aging. Urinary incontinence (UI) is one of the most common health concerns of older women that can be accompanied by an increased sense of loneliness, social restrictions, and disruption in activities of daily living in addition to the regular challenges of old age. This study was aimed at explaining the concerns of community-dwelling older women living with UI.

Methods

This study used the conventional, qualitative, content analysis approach with purposive sampling. Twenty interviews were conducted with 18 participants, including 15 community-dwelling older women with UI and three family members (a husband and two daughters), over the span of 14 months (from August 2021 to October 2022). The data were collected via semi-structured, face-to-face interviews until data saturation was achieved, and were analyzed using Graneheim and Lundman’s method.

Results

The findings revealed that the concerns of older women with UI include the impasse of UI, being powerless in life, distorted social identity, and marital frustration, which fell under the main theme of sense of inadequacy.

Conclusions

Recognizing the concerns of older women with UI can make health care teams more sensitive to the importance of resolving these concerns and can offer some insight into how best to provide targeted training, support, and counseling services at individual, family, and society levels, to eventually resolve the older adult’s sense of inadequacy.

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Data availability

The datasets generated and analyzed during the current study are not publicly available owing to an agreement with the participants on the confidentiality of the data, but are available from the corresponding author on reasonable request.

References

  1. Statistical Centre of Iran. Selected Findings of the 2016 National Population and Housing Census. Vice Presidency Plan and Budget Organization. 2019. Available online at: https://www.amar.org.ir/Portals/1/census/2016/Census_2016_Selected_Findings.pdf. Accessed 22 June 2021.

  2. Devi BN, Megala M, Saravanakumar P. Social and health concerns of elderly women in rural area in Tirupur District, Tamil Nadu. J Family Med Prim Care. 2022;11(8):4447. https://doi.org/10.4103/jfmpc.jfmpc_42_22.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Murukesu RR, Singh DK, Shahar S. Urinary incontinence among urban and rural community dwelling older women: prevalence, risk factors and quality of life. BMC Public Health. 2019;19(4):529. https://doi.org/10.1186/s12889-019-6870-6.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Tsuchiya Y, Shida N, Tsujiuchi T, Machida K. Healthy aging and concerns among elderly Japanese: a text analysis approach. Int Q Commun Health Educ. 2015;35(3):215–26. https://doi.org/10.1177/0272684x15576515.

    Article  Google Scholar 

  5. Kim O, Dan H. Experience of elderly Korean women with diabetes and multimorbidity in elderly couple households: a qualitative study. Healthcare. 2022;10(9):1675. https://doi.org/10.3390/healthcare10091675.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Dumoulin C, Morin M, Danieli C, et al. Group-based vs individual pelvic floor muscle training to treat urinary incontinence in older women: a randomized clinical trial. JAMA Intern Med. 2020;80(10):1284–93. https://doi.org/10.1001/jamainternmed.2020.2993.

    Article  Google Scholar 

  7. Abrams P, Cardozo L, Fall M, et al. The standardization of terminology of lower urinary tract function: report from the standardization sub-committee of International Continence Society. Textbook of female urology and urogynecology. Boca Raton: CRC Press; 2010.

    Google Scholar 

  8. Batmani S, Jalali R, Mohammadi M, Bokaee S. Prevalence and factors related to urinary incontinence in older adults women worldwide: a comprehensive systematic review and meta-analysis of observational studies. BMC Geriatr. 2021;21(1):1–17. https://doi.org/10.1186/s12877-021-02135-8.

    Article  Google Scholar 

  9. Morowatisharifabad MA, Rezaei PH, Mazyaki A, Bandak Z. Prevalence of urinary incontinence among elderly women in Yazd, Iran: a population-based study. Elder Health J. 2015;1(1):27–31.

    Google Scholar 

  10. Delarmelindo RCA, de Lima Parada CMG, Rodrigues RAP, Bocchi SCM. Estratégias de enfrentamento da incontinência urinária por mulheres. Rev Esc Enfer USP. 2013;47(2):296–303. https://doi.org/10.1590/S0080-62342013000200004.

    Article  Google Scholar 

  11. Halter JB. Hazzard’s geriatric medicine and gerontology. 6th ed. New York: McGraw-Hill; 2009.

    Google Scholar 

  12. Fouad R, Hafez S. Elderly urinary incontinence, self esteem and quality of life. Alex Sci Nurs J. 2017;19(1):91–108.

    Google Scholar 

  13. Pakgohar M, Hamid T-A, Ibrahim R, Vahid-Dastjerdi M. Portrait representation of postmenopausal women’s experiences of living with urinary incontinence. J Women Aging. 2015;27(1):81–95. https://doi.org/10.1080/08952841.2014.928145.

    Article  PubMed  Google Scholar 

  14. Lee HY, Rhee Y, Choi KS. Urinary incontinence and the association with depression, stress, and self-esteem in older Korean Women. Sci Rep. 2021;11(1):9054.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Rada MP, Jones S, Betschart C, et al. 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 Gynecol Obstet. 2022;158(1):3–12. https://doi.org/10.1002/ijgo.13934.

    Article  Google Scholar 

  16. Yang E, Lisha NE, Walter L, Obedin-Maliver J, Huang AJ. Urinary incontinence in a national cohort of older women: implications for caregiving and care dependence. J Womens Health (Larchmt). 2018;27(9):1097–103. https://doi.org/10.1089/jwh.2017.6891.

    Article  PubMed  Google Scholar 

  17. Hakimi S, Aminian E, Mohammadi M, Mohammad Alizadeh S, Bastani P, Houshmandi S. Prevalence and risk factors of urinary/anal incontinence and pelvic organ prolapse in healthy middle-aged Iranian women. J Menopausal Med. 2020;26(1):24–8. https://doi.org/10.6118/jmm.19201.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Mishra GD, Kumar D, Pathak GA, Vaishnav BS. Challenges encountered in community-based physiotherapy interventions for urinary incontinence among women in rural areas of Anand District of Gujarat, India. Indian J Public Health. 2020;64(1):17–21. https://doi.org/10.4103/ijph.ijph_436_18.

    Article  PubMed  Google Scholar 

  19. Mendes A, Hoga L, Gonçalves B, Silva P, Pereira P. Adult women’s experiences of urinary incontinence: a systematic review of qualitative evidence. JBI Database System Rev Implement Rep. 2017;15(5):1350–408. https://doi.org/10.11124/jbisrir-2017-003389.

    Article  PubMed  Google Scholar 

  20. 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. https://doi.org/10.3389/fpsyg.2022.785446.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Gjerde JL, Rortveit G, Muleta M, Blystad A. Silently waiting to heal: experiences among women living with urinary incontinence in northwest Ethiopia. Int Urogynecol J. 2013;24:953–8. https://doi.org/10.1007/s00192-012-1951-4.

    Article  PubMed  Google Scholar 

  22. Javanmardifard S, Gheibizadeh M, Shirazi F, Zarea K, Ghodsbin F. Experiences of urinary incontinence management in older women: a qualitative study. Front Public Health. 2022;9:738202. https://doi.org/10.3389/fpubh.2021.738202.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Mack N, Woodsong C, Macqueen KM, Guest G, Namey EE. Qualitative research methods. A data collector’s field guide. Durham, NC: Family Health International; 2005.

    Google Scholar 

  24. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105–12. https://doi.org/10.1016/j.nedt.2003.10.001.

    Article  CAS  PubMed  Google Scholar 

  25. Hajebrahimi S, Nourizadeh D, Hamedani R, Pezeshki MZ. Validity and reliability of the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form and its correlation with urodynamic findings. Urol J. 2012;9(4):685–90. https://doi.org/10.22037/uj.v9i4.1800.

    Article  PubMed  Google Scholar 

  26. Horrocks S, Somerset M, Stoddart H, Peters TJ. What prevents older people from seeking treatment for urinary incontinence? A qualitative exploration of barriers to the use of community continence services. Fam Pract. 2004;21(6):689–96. https://doi.org/10.1093/fampra/cmh622.

    Article  PubMed  Google Scholar 

  27. Wang C, Li J, Wan X, Wang X, Kane RL, Wang K. Effects of stigma on Chinese women’s attitudes towards seeking treatment for urinary incontinence. J Clin Nurs. 2015;24(7–8):1112–21. https://doi.org/10.1111/jocn.12729.

    Article  PubMed  Google Scholar 

  28. Park S, Yeoum S, Kim Y, Kwon HJ. Self-management experiences of older Korean women with urinary incontinence: a descriptive qualitative study using focus groups. J Wound Ostomy Continence Nurs. 2017;44(6):572–7.

    Article  PubMed  Google Scholar 

  29. Cheng S, Lin D, Hu T, et al. Association of urinary incontinence and depression or anxiety: a meta-analysis. J Int Med Res. 2020;48(6):0300060520931348. https://doi.org/10.1177/0300060520931348.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Al-Badr A, Brasha H, Al-Raddadi R, Noorwali F, Ross S. Prevalence of urinary incontinence among Saudi women. Int J Gynecol Obstet. 2012;117(2):160–3. https://doi.org/10.1016/j.ijgo.2011.12.014.

    Article  Google Scholar 

  31. Treister-Goltzman Y, Peleg R. Urinary incontinence among Muslim women in Israel: risk factors and help-seeking behavior. Int Urogynecol J. 2018;29:539–46. https://doi.org/10.1007/s00192-017-3438-9.

    Article  PubMed  Google Scholar 

  32. Lee JJ. The relationship between gender and the psychological impact of urinary incontinence on older people in Hong Kong: an exploratory analysis. Ageing Soc. 2004;24(4):553–66. https://doi.org/10.1017/S0144686X03001612.

    Article  Google Scholar 

  33. Stadnicka G, Łepecka-Klusek C, Pilewska-Kozak A, Jakiel G. Psychosocial problems of women with stress urinary incontinence. Ann Agric Environ Med. 2015;22(3):499–503. https://doi.org/10.5604/12321966.1167723.

    Article  PubMed  Google Scholar 

  34. Wang YH, Chen SH, Jou HJ, Tsao LI. Doing the best to control: the experiences of Taiwanese women with lower urinary tract symptoms. Nurs Res. 2011;60(1):66–72. https://doi.org/10.1097/nnr.0b013e3181ff72ec.

    Article  CAS  PubMed  Google Scholar 

  35. Hägglund D, Ahlström G. The meaning of women’s experience of living with long-term urinary incontinence is powerlessness. J Clin Nurs. 2007;16(10):1946–54. https://doi.org/10.1111/j.1365-2702.2007.01787.x.

    Article  PubMed  Google Scholar 

  36. Kohler M, Mayer H, Kesselring J, Saxer S. (Can) Not talk about it–urinary incontinence from the point of view of stroke survivors: a qualitative study. Scand J Caring Sci. 2018;32(1):371–9. https://doi.org/10.1111/scs.12471.

    Article  PubMed  Google Scholar 

  37. Chui RCF. The role of meaning in life for the quality of life of community-dwelling Chinese elders with low socioeconomic status. Gerontol Geriatr Med. 2018;4:2333721418774147. https://doi.org/10.1177/2333721418774147.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Toye F, Barker KL. A meta-ethnography to understand the experience of living with urinary incontinence: ‘is it just part and parcel of life?’ BMC Urol. 2020;20:1–25. https://doi.org/10.1186/s12894-019-0555-4.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Southall K, Tuazon JR, Djokhdem AH, van den Heuvel EA, Wittich W, Jutai JW. Assessing the stigma content of urinary incontinence intervention outcome measures. J Rehabil Assist Technol Eng. 2017;4:2055668317738943. https://doi.org/10.1177/2055668317738943.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Brittain KR, Shaw C. The social consequences of living with and dealing with incontinence—a carers perspective. Soc Sci Med. 2007;65(6):1274–83. https://doi.org/10.1016/j.socscimed.2007.04.002.

    Article  PubMed  Google Scholar 

  41. Lobchuk MM, Rosenberg F. A qualitative analysis of individual and family caregiver responses to the impact of urinary incontinence on quality of life. J Wound Ostomy Continence Nurs. 2014;41(6):589–96.

    Article  PubMed  Google Scholar 

  42. Dekker J, de Groot V. Psychological adjustment to chronic disease and rehabilitation–an exploration. Disabil Rehabil. 2018;40(1):116–20. https://doi.org/10.1080/09638288.2016.1247469.

    Article  PubMed  Google Scholar 

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Acknowledgements

This research is part of a doctoral dissertation. The authors wish to express their gratitude to the Deputy of Research of Semnan and Rofiedeh Rehabilitation Hospital for supporting this project.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

E.T.: conceptualization, methodology, investigation, data curation, writing the original draft, writing review and editing; M.N.: conceptualization, methodology, investigation, data curation, writing the original draft, writing review and editing, supervision, project administration; M.F.: conceptualization, data curation, writing the original draft, writing review and editing; M.R.A.: conceptualization, data curation, writing the original draft, writing review and editing.

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Correspondence to Monir Nobahar.

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Talebi, E., Nobahar, M., Foroughan, M. et al. The Concerns of Community-Dwelling Older Women Living with Urinary Incontinence: Qualitative Research. Int Urogynecol J (2024). https://doi.org/10.1007/s00192-024-05810-7

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