Determinants in the process of seeking help for urinary incontinence in the Chilean health system

Abstract

Objective To analyze via the Andersen model what leads women with urinary incontinence (UI) to seek help and remain in the healthcare system. Methods An interpretative phenomenologic study enrolling women aged 18 years or older who were diagnosed with UI at a tertiary care hospital in Chile between January and March 2016. Data were collected by semi‐structured interview. The categories explored experience with UI and reasons for seeking health care, and included the dimensions of the Andersen model. Results Ten women were enrolled. Characteristics that eased or hindered healthcare seeking were identified to come from the women (frequency and quantity of symptoms, coping strategies, and beliefs about its causes) and from their environment (reaction of partner, family, or coworkers to her condition). Some were associated with primary care (human and/or technical resources) and some with secondary care (pelvic floor units). Conclusion The results reflect the complexities of asking for health care for women with UI, especially in a country such as Chile with different healthcare levels. Raising awareness of this complexity and developing an approach that includes all stakeholders (institution, community, and family) is crucial for professionals who want to offer both medical therapy and wellness‐focused healthcare.

Application of Andersen’s behavioural model of health services use: a scoping review with a focus on qualitative health services research

“…Other studies fundamentally changed the original structure of the BMHSU, both in terms of the factors 24 38 74 and the feedback loops provided, 39 52 62 ultimately impacting the influence between each of the factors in the model. Some studies emphasised the distinction between the three core factors as predisposing and inhibiting factors, and as enabling and impeding factors, 24 26 62 while others combined the model with another model. 61 …”

Health-related quality of life in women aged 20-64 years with urinary incontinence

“…In the mobility dimension of EQ-5D, and counterintuitively, women with moderate/severe SPAUL were significantly 30% less likely to present moderate/severe mobility problems, compared to women with little/nothing SPAUL. A possible explanation can be found in the study of Bascur (2020), in which women acquire the need to hide the symptoms and use comfort elements as the symptomatology progresses, especially so as not to be ridiculed by those around them, especially those who live in a restrictive cultural environment [ 11 ].…”

“…It is possible that women, especially those under 50, hide UI for fear of social rejection, the culture in which they are inserted, the relationship it has with aging, shame, anxiety, its impact on daily activities or that they simply learn to live with UI despite limitations [ 10 ]. On the other hand, since it is not incorporated among the usual preventive health care, there is a care gap in the Chilean health system in terms of the number of professionals trained in pelvic floor dysfunctions and access to UI consultations [ 11 ].…”

Urinary Incontinence in Women Living in Rural Areas and Reflections on Quality of Life

“…Other patients with incontinence either do not mention these complaints to the doctor because they are embarrassed, or they consider it is normal at that age. In a study that focuses on how women feel in reality with the focus group study, it was observed that women developed strategies to cope on their own with reactions from their spouses and the environment (18). Shyness and cultural retreat play an important role in this and also with the belief that UI is a normal situation caused by increasing age.…”