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

Department of Urology, Section of Female Urology and Neurourology
BMC Women's Health (Impact Factor: 1.5). 01/2010; 10(1):3. DOI: 10.1186/1472-6874-10-3
Source: PubMed


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.

Download full-text


Available from: Omar M Shaaban
  • Source
    • "It appears that a combination of embarrassment and the belief that UI is a natural consequence of ageing and childbirth discourages women from seeking appropriate treatments. [11] Urine leakage occurs when the pressure in the bladder is greater than the pressure within the urethra, i.e. the expulsive force overcomes the closure force. At this point involuntary loss of urine occurs. "

    Preview · Article · Feb 2015
  • Source
    • "Women’s medical help-seeking behavior is influenced by several factors, including the general understanding and interpretation of the disease itself, type and severity of the medical condition, available information regarding treatment opportunities, economic reasons, and the type of health care financing system that operates in such health care settings.5–8 Furthermore, the prevailing sociocultural views of a particular medical condition could either be enabling or inhibiting to seeking help by the sufferer.7,9 Previous studies have also revealed that associated or causal factors of health-seeking behaviors of women and men are largely dependent on their specific cultural and national differences, irrespective of other competing factors.10,11 "
    [Show abstract] [Hide abstract]
    ABSTRACT: We examined help-seeking behaviors and factors influencing their choice of hospital care in women currently leaking urine. This study was part of a multistage community survey conducted among 5001 women in Nigeria who participated in the Ibadan Urinary Incontinence Household Survey. Help-seeking behavior was analyzed among 139 respondents currently leaking urine within the population surveyed. The mean age of those currently leaking urine was 35.7 years (standard deviation = 15.8). Only 18 (12.9%) had ever sought help, of which 15 had received hospital care. Logistic regression analysis showed that the odds of seeking hospital care was higher among less educated women (odds ratio [OR] = 4.05, 95% confidence interval [CI]: 1.17-13.89) and among those with severe incontinence (OR = 4.20, 95% CI: 1.24-14.29). Reasons mentioned for not seeking hospital care include a belief that the condition is not life-threatening (51.2%), do not believe there is treatment (18.2%), lack of funds (1.7%), too shy to disclose (2.5%), afraid of complications (1.7%), other (2.5%), and no reason (22.3%). This study shows that very few women, currently experiencing urinary incontinence have sought medical care (approximately 1 in 10); and that the barriers identified are similar to those identified in previous studies, except that these women lack the necessary funds to seek care.
    Full-text · Article · Nov 2012 · Patient Preference and Adherence
  • [Show abstract] [Hide abstract]
    ABSTRACT: To describe the perceived causes of urinary incontinence (UI) and factors associated with awareness of causes of UI among women in the community. Secondary analysis of data extracted from the Ibadan Urinary Incontinence Household Survey (IUIHS), a multi-stage community survey conducted among 5001 women in Nigeria. The mean age was 34.8 years (SD=14.2). The majority had at least secondary education and were currently married. Within this population, 13% had ever leaked urine. On their perception of possible aetiological factors of UI, 20.5% mentioned pelvic floor or bladder-related causes such as stress incontinence triggers and bladder problems; 14.6% mentioned uncontrollable factors such as medical comorbidity, age and prior surgery; 8.8% attributed the cause to being female; and 6.8% mentioned sex-related factors. Multiple logistic regression analysis revealed significantly lower odds of awareness of the aetiology of urinary incontinence among women aged less than 30 years, those with lower level of education, rural women, those with five or more children and women without history of urine leakage. The study shows a low level of awareness of possible cause of UI amongst women surveyed. We recommend health education and mobilization of women on the right aetiological factors of UI.
    No preview · Article · Feb 2012 · European journal of obstetrics, gynecology, and reproductive biology
Show more