Reasons why women with long-term urinary incontinence do not seek professional help: a cross-sectional population-based cohort study

Hägglund, Doris; Walker-Engström, Marie-Louise; Larsson, Gregor; Leppert, Jerzy

doi:10.1007/s00192-003-1077-9

Cited by 92 publications

(90 citation statements)

References 12 publications

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“…3,4 The presence of UI should therefore influence our exercise prescription for women with osteoporosis-yet it is not routine for physicians 5 or other health care professionals to ask about incontinence, 6 and it is typically only after symptoms have been present for 6 to 10 years that women mention UI to a health care professional. 7 So when we don't ask, they don't tell, and we prescribe and hope for compliance.…”

Section: Meena M Sranmentioning

confidence: 99%

Filling in the Gaps Before Clients Fall Through the Cracks: Physiotherapists Have the Skills to Help Clients Preserve Bone and Prevent Falls

Sran

2011

Physiotherapy Canada

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Osteoporosis imposes an enormous personal and societal burden. In clinical practice, most clients with low bone density or osteoporosis are mid-life adults or seniors, and therefore they typically present with other comorbidities or chronic conditions that may influence their bone health and their risk of falls and fractures.Consider the 55-year-old postmenopausal woman who presents to the physiotherapist for recommendations on exercise for bone health. The physiotherapist recognizes that this woman needs exercise aimed at bone preservation, and gives her options including a jumping routine, a walk-jog programme, and recommendations on appropriate fitness classes. But what the physiotherapist does not know is that this woman also has frequent stress urinary incontinence; the client did not mention it, and the physiotherapist did not ask. The client leaves knowing that she won't be able to comply with the exercise prescription without the undesirable consequence of leaking urine. Incontinence is a deterrent to this woman's being physically active.She is not alone. A recent study conducted in the Osteoporosis Clinic at the BC Women's Health Centre found that almost 40% of all new female patients seen in 1 year (163/412) reported leakage one time per week or more, and 10% reported urgency without any leakage. 1 These data suggest that the prevalence of at least weekly urinary incontinence (UI) in this population is much higher than that reported in studies of other older adult female populations. We know that physical activity is an important part of osteoporosis treatment aimed at preserving bone mass and preventing falls, and we aim to prescribe appropriate exercise for all individuals presenting with osteoporosis or low bone density. But UI can significantly limit a woman's ability to be physically active 2 and is an independent risk factor for falls and low-trauma fractures in older women. 3,4 The presence of UI should therefore influence our exercise prescription for women with osteoporosis-yet it is not routine for physicians 5 or other health care professionals to ask about incontinence, 6 and it is typically only after symptoms have been present for 6 to 10 years that women mention UI to a health care professional. 7 So when we don't ask, they don't tell, and we prescribe and hope for compliance.In this case, hope is not enough. We can do better. Knowing that UI is prevalent in our osteoporosis clinic population should lead to changes in our clinical practice. By routinely asking if UI is present, then following up with more detailed questions as necessary, the physiotherapist can provide more useful exercise prescription for bone health while at the same time helping to guide the client toward conservative treatment options for UI that have been shown to be effective. [8][9][10][11] While the majority of Canadian physiotherapists do not have the full arsenal of skills to comprehensively assess and treat incontinence and pelvic-floor disorders, we do have physiotherapy colleagues with just that specific ski...

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Section: Meena M Sranmentioning

confidence: 99%

Filling in the Gaps Before Clients Fall Through the Cracks: Physiotherapists Have the Skills to Help Clients Preserve Bone and Prevent Falls

Sran

2011

Physiotherapy Canada

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“…The rationale for the creation of this instrument centred on improving communication and patient assessment; particularly, as many of the symptoms associated with pelvic disorders are of a personal and sensitive nature [3]. A major advantage of electronic systems relate to the practicalities of data capture.…”

Section: Introductionmentioning

confidence: 99%

Electronic pelvic floor symptoms assessment: tests of data quality of ePAQ-PF

2008

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The objective of the study was to test the data quality, scaling assumptions and scoring algorithms underlying the electronic personal assessment questionnaire-pelvic floor (ePAQ-PF). A cross-sectional survey of 599 women with pelvic floor disorders was carried out. Tests of data quality included secondary factor analysis, internal reliability, descriptive statistics, levels of missing data, floor and ceiling effects, item-to-total correlation scores, item discriminant and convergent validity. Secondary factor analysis verified the domain structure of ePAQ-PF. All 19 domains were internally reliable with Cronbach's alpha scores ranging from 0.71 to 0.93. Missing response rates ranged from 0.2% to 1.3%, and all items were found to be most highly correlated with their own corrected scale. Results confirmed the factor structure, data quality and scoring and scaling assumptions of ePAQ-PF, thereby verifying its suitability for measuring symptoms, bother and quality of life in women with pelvic floor disorders.

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“…7 This was similar in Sweden where three out four incontinent women had never sought help as they felt that their incontinence was not a serious disease that needed professional care. 13 This study aims to investigate the prevalence of UI, the health seeking behaviour and knowledge of pelvic floor exercises of women in a health district in KwaZulu-Natal.…”

Section: Introductionmentioning

confidence: 99%

High prevalence of urinary incontinence and poor knowledge of pelvic floor exercises among women in a health district in Kwazulu-Natal, South Africa

Madombwe

Knight

2008

South African Journal of Physiotherapy

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Reasons why women with long-term urinary incontinence do not seek professional help: a cross-sectional population-based cohort study

Cited by 92 publications

References 12 publications

Filling in the Gaps Before Clients Fall Through the Cracks: Physiotherapists Have the Skills to Help Clients Preserve Bone and Prevent Falls

Filling in the Gaps Before Clients Fall Through the Cracks: Physiotherapists Have the Skills to Help Clients Preserve Bone and Prevent Falls

Electronic pelvic floor symptoms assessment: tests of data quality of ePAQ-PF

High prevalence of urinary incontinence and poor knowledge of pelvic floor exercises among women in a health district in Kwazulu-Natal, South Africa

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