Understanding help-seeking in older people with urinary incontinence: an interview study

Vethanayagam, Natalie; Orrell, Alison; Dahlberg, Lena; McKee, Kevin; Orme, Susie; Parker, Stuart G.; Gilhooly, Mary

doi:10.1111/hsc.12406

Cited by 37 publications

(40 citation statements)

References 35 publications

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“…It may be that continuing to search for studies beyond the point of theoretical saturation is not time well spent. The two studies identified when we re ran our search did not highlight any additional concepts, suggesting saturation of conceptual categories [168,169]. Our findings resonate with those in two descriptive QES of UI [25,26].…”

Section: /41supporting

confidence: 79%

“…Table 2 shows the overlaps and additional studies found in all 3 QES. Our updated search (February 2019 identified two additional studies [168,169]. Table 3 shows the country, condition and age of participants, number or participants (number of men), aim of the study and the data collection and methodology of included studies.…”

Section: Resultsmentioning

confidence: 99%

“…GRADE-CERQUal was not designed to assess confidence in conceptual models. Two studies identified when we re ran our search did not highlight any additional concepts, suggesting saturation of conceptual categories [168,169]. We also compared our finding to those in two descriptive QES of UI [25,26] (Table 5) and found resonance in concepts across studies.…”

Section: Confidence In Findingsmentioning

confidence: 89%

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A meta-ethnography to understand the experience of living with urinary incontinence: ‘is it just part and parcel of life?’

Toye

Barker

2020

BMC Urol

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Background: Urinary incontinence (UI) is highly prevalent and affects the lives of many men and women. We aimed to conduct a qualitative evidence synthesis (QES) to explore the experience of living with UI and to develop a conceptual model that can help us to understand this experience, and the potential barriers to appropriate healthcare. Methods: We used the methods of meta-ethnography developed by Noblit and Hare and recently refined for larger studies. Meta-ethnography involves identifying concepts from the studies and abstracting these concepts into a line of argument. We searched for studies that explored the experience of adults with UI. We used the GRADE-CERQual framework to assess confidence in review findings.Results: We screened 2307 titles, 429 abstracts, 107 full texts and included 41 studies (36 unique samples) in the synthesis. We organised the concepts into 26 conceptual categories, which we further abstracted into 6 themes: (1) Am I ill or is this normal? (2) It effects who I am and how I feel; (3) I feel stigmatised, ashamed and guilty; (4) talking can be difficult but it can help; (5) keeping incontinence under control; (6) have I got to the point that I need help? Our model conceptualises living with UI as navigating antagonists: Is UI normal or am I ill? Do I need help or am I managing? Do I keep UI to myself (and manage alone) or do I tell other people (and get the support that I need)? Do I use control strategies that focus on concealing (avoid risky situations, wear pads) versus, I use strategies that focus on improving the bodily function to improve continence. Our model highlights the experience of stigma, shame and guilt which exert a pull towards concealment. Conclusions:The culture of secrecy and profound sense of shame is barrier to seeking help. An environment which reduces the shame and stigma of UI may help people to switch the focus to strategies that will improve continence, rather than conceal incontinence.

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Section: /41supporting

confidence: 79%

Section: Resultsmentioning

confidence: 99%

Section: Confidence In Findingsmentioning

confidence: 89%

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A meta-ethnography to understand the experience of living with urinary incontinence: ‘is it just part and parcel of life?’

Toye

Barker

2020

BMC Urol

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“…There are conflicting data about effect of age on consultation rate. Some studies suggested no effect (12,13), on the contrary a few indicated that older people are frequently not assessed and treated partly due to lack of awareness among both patients and professionals (14,15) and majority of studies similarly showed an increase in consultation rate (16,17). Increasing rate with increasing age was supposed to be a cumulative effect.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Help Seeking Behavior of Turkish Women with Urinary Incontinence; A Single Center Cross-Sectional Study

Sönmez

Eraydın

Arıcan

et al. 2017

Gynecol Obstet Reprod Med

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Objectives: The aim of this study was to determine the patient and urinary incontinence-related factors affecting help seeking behavior of Turkish women with undiagnosed urinary incontinence STUDY DESIGN: This cross-sectional study was conducted on 490 female patients aged >18 years old and were seen in general gynecology outpatients' clinic of Denizli State Hospital. According to referral complaint and results of UDI-6 questionnaire, the participants were classified into 3 groups: Group A: Help seeker patient, Group B: Non help seeker patient and Group C: Continent patient. RESULTS:Overall urinary incontinence prevalence was 24%. Nearly two thirds (67%) of the urinary incontinence patients do not complain about their urinary incontinence symptoms unless they were asked specifically about urinary incontinence. Consultation rate increased with age, duration of incontinence, menopause and the severity of urinary incontinence. After logistic regression analyses, only increasing age, UDI-6 score and severity (SSI) were found to be associated independently with help seeking behavior. CONCLUSIONS:This study showed that, older, more bothered and severe urinary incontinence patients visit physician and seek medical help. Still nearly half of women who are suffering from clinically significant urinary incontinence remain undiagnosed and untreated. Regardless the visiting reason if its asked specifically for urinary incontinence symptoms by using simple questionnaires, we can reveal and diagnose this patients' group who is suffering from urinary incontinence but yet keeps it disguise.

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“…Despite its association with negative outcomes, incontinence is under-recognized by both older adult patients and their health care providers who may falsely believe it is a normal, untreatable part of aging [6]. As a result, only about half of older adults with incontinence seek help from a general practitioner [7].…”

Section: Introductionmentioning

confidence: 99%

Continence Promotion and Successful Aging: The Role of the Multidisciplinary Continence Clinic

Yoo

Spencer

2018

Geriatrics

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Incontinence is a common yet under-recognized issue that impacts quality of life, especially for older adults in whom there is often a multifactorial etiology. A retrospective chart review was performed on a representative sample of patients seen at our multidisciplinary continence clinic in Vancouver, Canada from January to December 2017 inclusive. Initial assessment was performed by the nurse continence advisor (NCA) or geriatrician depending on the source of referral. The pelvic floor physiotherapist (PFP) could then be consulted based on perceived need. The average age at assessment was 76 years old (range 29–102), with 82% of patients ≥65 years and 27% ≥85 years old. The majority of patients were referred for bladder incontinence (72%), with the remaining patients referred for bowel incontinence (28%) or pessary care (7%). Referrals came from a variety of sources including physicians (62%), nurses (22%), allied health care providers (12%) and self-referral (5%). Multimorbidity was common, with 40% of patients having a Charlson Comorbidity Index ≥6. The same proportion of patients (40%) were on ≥5 prescription medications. Many patients were functionally dependent for either instrumental activities of daily living (52%) or activities of daily living (25%). Non-pharmacologic treatments were commonly recommended, with the majority of patients counselled on lifestyle changes (88%) and taught Kegel exercises (70%). For patients seen by the geriatrician, modifications were made to non-continence medications in 50% of cases and medical comorbidities were optimized in 39% of cases. In terms of pharmacologic therapy, over-the-counter (OTC) medications were initiated in 45% of patients whereas continence-specific prescription medications were started in 17% of patients. A multidisciplinary continence clinic can play an important role in promoting successful aging by assessing and treating medical causes of incontinence in medically complex older adults.

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Understanding help-seeking in older people with urinary incontinence: an interview study

Cited by 37 publications

References 35 publications

A meta-ethnography to understand the experience of living with urinary incontinence: ‘is it just part and parcel of life?’

A meta-ethnography to understand the experience of living with urinary incontinence: ‘is it just part and parcel of life?’

Factors Associated with Help Seeking Behavior of Turkish Women with Urinary Incontinence; A Single Center Cross-Sectional Study

Continence Promotion and Successful Aging: The Role of the Multidisciplinary Continence Clinic

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