Measuring the barriers against seeking consultation for urinary incontinence among Middle Eastern women.

Department of Urology, Section of Female Urology and Neurourology; Assiut University Hospital, Assiut University, Assiut, Egypt.
BMC Women s Health (Impact Factor: 1.51). 01/2010; 10:3. DOI: 10.1186/1472-6874-10-3
Source: PubMed

ABSTRACT Existing questionnaires to assess barriers against consultation for urinary incontinence (UI) are not appropriate for use in the Middle East culture. The aim of this study was to explore barriers against seeking help for UI and introducing a questionnaire that assess these barriers among those women. This is important before proceeding to any educational programs or having interval clinical audits to help incontinent women.
1- Screening for UI. Women - aged 20 years and older, attending the outpatient Urology and Gynaecology clinics were invited to participate and interviewed by a research nurse. The UDI-6 was administered to assess the presence and type of UI. Women with UI as their chief complaint were excluded. 2- Interviewing study subjects for possible barriers. Subjects who had UI - as determined by the UDI-6-were first asked an open question "what prevented you from seeking medical consultation for urine leakage?"." They were then asked the proposed questions to assess possible barriers. We developed a preliminary questionnaire based on a review of reasons for not seeking incontinence care from the literature and the response of UI sufferers to the open question in this study. The questionnaire was modified many times to reach this final form. 3- Pilot Study to assess characteristics of the questionnaire. Validity and reliability of the final version of the questionnaire were assessed in a small pilot study including 36 women who completed questionnaire at initial visit and again after 2 weeks.
Of the 1231 subjects who agreed to participate in the study, 348 reported having UI. About 80% of incontinent women have never sought medical advice. Factors significantly associated with seeking help were husband encouragement, prayer affection and having severe UI. Common barriers were embarrassment and assuming UI as a normal part of aging. A pilot study included 36 women to assess the psychometric properties of the questionnaire after modifying it. The number of missing or not interpretable responses per item ranged from 2.2% to 8.7%. Internal consistency of the items was good. The test-retest reliability of individual items of the questionnaire was variable, with weighted kappa statistics ranging from 0.32 to 0.94 (median, 0.76, p 0.000).
Preliminary data on our proposed questionnaire show that it is an easy to administer, stable and suits the Middle Eastern culture.

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    ABSTRACT: BACKGROUND: Barriers to seeking care for urinary incontinence are specific, objective, external conditions that prevent incontinence sufferers from seeking treatment. The aim of this study was to compare barriers, gender, and health care disparities in incontinence sufferers. METHODS: Incontinent patients were recruited into a questionnaire-based cross-sectional study. The 14-item Barriers to Incontinence Care Seeking Questionnaire (BICS-Q) and the three-item International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) were used to evaluate barriers to seeking health care for urinary incontinence. RESULTS: The representative sample (n = 1014) finally included 567 adults eligible to participate in this study (response rate 55.9%). Of the 147 incontinent males, 93 (63.3%) did not seek care, and of the 420 incontinent females, 282 (67.1%) did not seek care. Untreated males had significantly higher BICS-Q scores than other patients. Risk factors for barriers were obesity (odds ratio 2.13 for females versus 0.83 for males), stress urinary incontinence (1.57 versus 9.38, respectively), and urgency urinary incontinence (2.40 versus 1.75). CONCLUSION: The barriers to seeking care for urinary incontinence seem to be gender-specific. Obese females with urgency urinary incontinence and males with stress urinary incontinence were least likely to seek treatment.
    Patient Preference and Adherence 01/2012; 6:773-779. · 1.33 Impact Factor
  • International Journal of Clinical Practice 12/2012; 66(12):1132-8. · 2.43 Impact Factor
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    ABSTRACT: Objectives Urinary incontinence (UI) threatens women's physical, and mental health, but few women seek healthcare for their incontinence., Evidence is substantial that stigma may be associated with health service, utilization for such diseases as mental illness, but sparse for UI. We, examine the relationship between disease stigma and intentions to seek, care for UI., Design and setting A cross-sectional community-based study was used. A, purposive sample of 305 women aged 40 - 65 years in a Chinese city who, had stress urinary incontinence (SUI) was enrolled from May to October in, 2011., Measurements Data were collected on socio-demographic characteristics, UI, symptoms, disease stigma and intentions to seek care. Results Social rejection was positively linearly related to intentions to, seek care for UI (β = 0.207; 95% CI = 0.152, 0.784), indicating that more, social rejection predicted stronger intentions to seek care. Significant, curvilinear association between internalized shame and intentions to seek, care (β = -0.169; 95% CI = -0.433, -0.047) was observed. Compared to, women with the low and high levels of internalized shame, those with the, moderate level of internalized shame reported stronger intentions to seek, care. Conclusion The impact of stigma on intentions to seek care varies by, aspects and levels of stigma. Social rejection enhances intentions to, seek care while internalized shame influences intentions to seek care in, a quadratic way. The crucial step of targeted interventions will be to, disentangle subgroups of SUI women with different aspects and levels of, stigma.
    Maturitas 01/2014; · 2.84 Impact Factor

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