“A secret club”: focus groups about women’s toileting behaviors

Abstract

Background Understanding reasons for and impact of women’s toileting behaviors on bladder health is important to prevent and manage urinary incontinence (UI) and overactive bladder (OAB). Methods Women, regardless of urinary incontinence (UI) and overactive bladder (OAB) status, were recruited in Pennsylvania and North Carolina. Focus groups were conducted by trained female moderators and sessions were audiotaped. Participants completed an anonymous questionnaire containing validated items to determine the presence of UI and OAB. Audiotapes were transcribed and content was analyzed by two investigators to identify themes. Results Twenty-four women participated (mean age 68 ± 13.4 years); most had UI (75%) or OAB (87.5%). Many women had difficulty in describing bladder health, and talked about bladder function, diseases or conditions, and control over the bladder. Four themes about toileting emerged: 1) cues/triggers/alerts women used to find and use toilets, 2) toilet cleanliness away from and at home, 3) toileting as a nuisance, and 4) situational awareness. Women described internal (e.g., sensation of heaviness) and external cues/triggers/alerts (e.g., walking by restrooms), and the trade-off between their concerns about public toilet cleanliness and the need to urinate. Some women expressed being irritated or annoyed about having to stop activities to urinate. Most women reported sitting on their home toilets, whereas, many hovered or stood over the toilet in public places. Conclusions The information gained from this study will facilitate the development of relevant public health messaging and interventions to raise public awareness about UI, OAB, and bladder health with the aim to encourage women to seek help when symptoms are present. Electronic supplementary material The online version of this article (10.1186/s12905-019-0740-3) contains supplementary material, which is available to authorized users.

I never knew anyone who peed on themselves on purpose: Exploring adolescent and adult women's lay language and discourse about bladder health and function

“…The same pattern was observed for nocturia and enuresis, with adolescents and adult women using less clinical terminology such as “night pees” and “pee dreams.” Similarly, episodic bladder issues were characterized on a spectrum ranging from minor nuisances to burdensome problems, rather than labeled as clinically defined problems. This viewpoint is consistent with recent qualitative research on the toileting behavior of adult women characterizing the need to void often as a nuisance …”

Prevalence and associated factors of urinary incontinence in women living in China: a literature review

“…Besides UI’s impact on women’s physical and mental health, UI affects women’s quality of life by limiting social activities [ 10 ] and interactions, interfering with the ability to work [ 11 ], and increasing the financial burden on women and society [ 12 – 14 ]. Therefore, UI should be viewed as both a women’s health issue and a public health issue [ 15 ].…”

Self‐reported toileting behaviors in employed women: Are they associated with lower urinary tract symptoms?

“…The second measure, International Consultation on Incontinence Questionnaire OAB (ICIQ‐OAB), consists of four items on frequency, nocturia, urgency, UUI, and symptom bother . The third measure, the Toileting Behaviors‐WEB (TB‐WEB) scale revised version of the original 18‐item 5‐point Likert scale, was used. This measure consists of five subscales: place preference for voiding, premature voiding, delayed voiding, strained voiding, and voiding position preference, and it elicits information about the behaviors women use in public and private environments to empty their bladders.…”