Factors associated with variations in older people's use of community-based continence services

Abstract

Many people who have urinary incontinence and who may benefit from healthcare and professional advice do not currently access UK National Health Service services, even though effective treatments are available in the community. Older people have an increased prevalence of incontinence and a correspondingly increased need for continence services. Therefore, increasing older people's access to continence services has the potential to reduce inequalities and improve quality of life. The present study aimed to identify older people with urinary incontinence living in the community, to describe and compare the characteristics of users and non-users of continence services, and to identify factors which prevent older people seeking help. A cross-sectional postal survey of patients aged over 65 years registered with four general practices in an urban area found an overall prevalence of 39% of older people with urinary incontinence, only 15% of whom had accessed services. Two-thirds of respondents who reported that they experienced urinary leakage several times per week to all the time, and up to two-thirds of those reporting leakage of moderate or large volumes of leakage had not accessed services. The majority of older people are in regular contact with health professionals, and the greatest single influence on use of services was that of being asked whether there were continence problems by a health professional. Being married or having a partner, experiencing less pain generally, and suffering relatively high frequency and volumes of urinary leakage also appeared to be associated independently with continence service use. In conclusion, there appears to be considerable unmet need for continence services. Health professionals should be aware that incontinence is an important health problem for older people, and by asking older people specifically about urinary leakage, they could reduce inequalities in use of services.

Urinary incontinence in community dwelling elderly: are there sex differences in help-seeking behaviour?

“…4 Chi-squared test for categorical variables and t-test for continuous variable to analyse sex differences in patients who sought help and in patients who did not seek help. 5 Á/not significant; *p B/0.05. [ ] the odds ratio is the difference between the group in brackets and the others.…”

ICIQ: A brief and robust measure for evaluating the symptoms and impact of urinary incontinence

“…Data from Japan have con¢rmed that the psychometric properties of the questionnaire have been retained throughout this process [Subcommittee of Symptom and Quality of Life Assessment, 2001]. The ICIQ is being increasingly used and further evaluated in both clinical practice and research in the UK and internationally [Subcommittee of Symptom and Quality of Life Assessment, 2001; Karantanis et al, 2002;Peters et al, 2004]. Further research is required, however, to investigate its usefulness in routine clinical practice, for speci¢c groups, such as the frail elderly, and in the developing world.…”

Occupational stress in palliative medicine, medical oncology and clinical oncology specialist registrars

“…Parametric and nonparametric analysis was conducted as appropriate. Binary logistic regression was used to assess the association between potential predictor variables and GHQ-12 and SCL-D caseness following methods recommended by Peduzzi et al 25 and Peters et al 26 Data reported are based on numbers of valid responses to items for each group or subgroup. Thus numerators and denominators may not always total to full sample size.…”