Psychosocial Impact of Urinary Incontinence in the Community‐Dwelling Population

PhD, RN Jean F. Wyman; Harkins, Stephen W.; Fantl, J. Andrew

doi:10.1111/j.1532-5415.1990.tb03505.x

Cited by 295 publications

(256 citation statements)

References 18 publications

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“…The tolerance of UI varies significantly from individual to individual, and the impact of UI on everyday life is not directly related to any objectively measured degree of UI. 22 A woman's personal assessment of the severity of UI is modified by several factors, including age, symptom severity, type of UI, and mental state. 23 It is probable that patients with cervical carcinoma who have undergone chemotherapy and radical surgery have a diminished reaction to the severity of urinary symptoms; thus, the introduction of a specific and validated quality-of-life questionnaire regarding UI may improve the detection of urinary symptoms.…”

Section: Discussionmentioning

confidence: 99%

Long‐term bladder function in patients with locally advanced cervical carcinoma treated with neoadjuvant chemotherapy and type 3–4 radical hysterectomy

Benedetti‐Panici

Zullo

Plotti

et al. 2004

Cancer

109

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BACKGROUNDThe objective of the current study was to evaluate the incidence of long‐term bladder dysfunction after type 3–4 radical hysterectomy in patients with locally advanced cervical carcinoma treated with neoadjuvant chemotherapy (NACT).METHODSA case–control study was conducted to evaluate the occurrence of long‐term bladder dysfunction in 76 patients with International Federation of Gynecology and Obstetrics Stage IB–IIA (> 4 cm), Stage IIB, and Stage III cervical carcinoma who underwent type 3–4 radical hysterectomy after NACT. Preoperative assessment included acquisition of a standardized urogynecologic history, evaluation of severity of urinary incontinence symptoms, maintenance of a 3‐day voiding diary, pelvic examination, urogynecologic physical examination, urodynamic assessment, and estimation of hydronephrosis. Follow‐up was carried out at least 12 months after surgery.RESULTSUrinary symptoms (sensory loss, difficult micturition, severe urinary incontinence) were reported by 20 patients (26%). Eighteen patients (24%) had a normal urodynamic profile, 16 patients (21%) had detrusor overactivity, 22 patients (29%) had urodynamic stress incontinence, 2 patients (2%) had aconctractile detrusor, and 18 patients (24%) had mixed urinary incontinence. The length of vagina removed was significantly greater among patients who had detrusor overactivity and mixed urinary incontinence compared with patients who had a normal diagnosis.CONCLUSIONSThe observed rate of bladder dysfunction was higher than the corresponding rate reported in the literature (76%). Three main disturbances were found: detrusor overactivity (21%), mixed urinary incontinence (24%), and de novo stress incontinence (21%). Detrusor overactivity was related to a prevalence of hypertonic bladder. Among patients who underwent type 4 radical hysterectomy, the extent of caudal resection of rectovaginal ligaments and vaginal tissue was found to be more strongly associated with bladder dysfunction than was the extent of lateral parametrial resection. Despite the fact that 76% of patients had abnormal urodynamic parameters, most patients were satisfied with their voiding condition. Cancer 2004. © 2004 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Long‐term bladder function in patients with locally advanced cervical carcinoma treated with neoadjuvant chemotherapy and type 3–4 radical hysterectomy

Benedetti‐Panici

Zullo

Plotti

et al. 2004

Cancer

109

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“…For example, one study found that patients with detrusor instability and sensory urgency were more anxious than patients with other types of incontinence. 34 However, we suspect that considering all types of UI together makes it more difficult to find any association with distress and may have biased our results toward the null. Fourth, there is the potential for all the sources of error associated with retrospective interview data including imperfect recall and response bias (e.g., socially desirable responding).…”

mentioning

confidence: 88%

Urinary Incontinence and Psychological Distress in Community‐Dwelling Older Adults

Bogner¹,

Gallo²,

Sammel

et al. 2002

J American Geriatrics Society

101

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OBJECTIVES-To examine the relationship between urinary incontinence (UI) and psychological distress in older adults. We hypothesized that persons with UI associated with condition-specific functional loss would be most likely to report psychological distress. DESIGN-A population-based longitudinal survey. SETTING-Continuing participants in a study of community-dwelling adults who were initially living in East Baltimore in 1981.PARTICIPANTS-Persons aged 50 and older (n = 781) at follow-up interviews conducted between 1993 and 1996 for whom complete data were available.MEASUREMENTS-Participants were classified as incontinent if they reported any uncontrolled urine loss within the 12 months preceding the 13-year follow-up interview. Condition-specific functional loss secondary to UI was further assessed based on a series of questions relating directly to participants' inability to engage in certain activities due to their UI. Psychological distress was assessed using the General Health Questionnaire (GHQ) at interviews in 1981 and at the 13-year follow-up.RESULTS-Persons with UI were more likely to experience psychological distress as measured by the GHQ than were persons without UI (unadjusted odds ratio (OR) = 1.74, 95% confidence interval (CI) = 1.13-2.68). Persons with condition-specific functional loss secondary to UI were substantially more likely to have psychological distress as measured by the GHQ than were persons without UI (unadjusted OR = 4.02, 95% CI = 1. 86-8.70). In multivariate models that controlled for potentially influential characteristics such as age, gender, ethnicity, and chronic medical conditions the association between condition-specific functional loss secondary to UI and psychological distress remained statistically significant. Among people with UI, persons with persistently elevated GHQ scores were much more likely to report condition-specific functional impairment from UI (adjusted OR = 6.55, 95% CI = 1.94-22.12).CONCLUSION-Individuals with UI, especially when incontinence was associated with conditionspecific functional loss, were more likely to have psychological distress than were other older adults. © 2002 by the American Geriatrics SocietyAddress correspondence to Hillary R. Bogner, MD, MSCE, Department of Family Practice and Community Medicine, University of Pennsylvania, 3400 Spruce Street, 2 Gates Building, Philadelphia, PA 19104. bogner@mail.med.upenn.edu Our findings support a general conceptual model that condition-specific functional impairment mediates the relationship between a chronic medical condition and psychological distress.Keywords urinary incontinence; older adults; psychological distress; depression; functional status Urinary incontinence (UI) is a commonly encountered problem, especially in older adults. Although sampling and methodological differences account for variability in estimates from surveys, 1 the prevalence of UI in community-dwelling older adults has been reported as at least 10% for men and 20% for women. 2 , 3 As many as half of nursing ...

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“…Symptoms of urinary frequency, urgency and urge incontinence are embarrassing for those affected and thus women with such symptoms are often reluctant to seek advice and treatment [6,7]. This is illustrated by the results of the present study, which showed low levels of baseline knowledge of urinary symptoms.…”

Section: Discussionmentioning

confidence: 58%

A randomized trial comparing the effectiveness and preference of a touch‐screen computer system with a leaflet for providing women with information on urinary symptoms suggestive of detrusor instability

et al. 2001

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Objectives To evaluate how well women learned and retained information given to them by either a leaflet or a computer-generated information system, and which system they preferred to use for obtaining information about urinary symptoms. Subjects and methods Forty women answered 11 questions on the aetiology, investigation and treatment of lower urinary tract symptoms. They were then randomized to use one of the information systems for 20 min, after which they answered the same urological questions. The women then crossed over to use the other information system for 20 min and afterwards completed a preference questionnaire. Results The mean baseline scores from a possible total of 11 were 3.9 and 4.3 for the computer and lea¯et groups, respectively. The mean improvements in scores were 3.6 (P<0.001) and 2.8 (P<0.001) for the computer and lea¯et groups, respectively. Both information systems were well liked by all of the women and 26 (65%) said they would prefer to use a computer-generated system in the future if given a choice. Conclusions Women signi®cantly increased their knowledge of urinary problems after using a computergenerated information system or a lea¯et. Although there were few subjects, there appeared to be a trend for the computer system to be both better liked and slightly more effective. Keywords patient information, detrusor instability, touch screen, lea¯ets, randomized trial IntroductionClinicians are encouraged to provide patients with extensive knowledge of their condition, to allow joint decision-making and informed consent on their future treatment [1]. Such information is given in several different ways. Apart from direct consultation, the most common methods are lea¯ets, posters, audiotapes and videotapes. More recently, the use of computers with touch screens was described [2,3]. We have developed such a system to provide information about the causes, investigation and treatment of urinary frequency, urgency or urge incontinence in women. Herein we report the results of a pilot study comparing this computer system with our existing lea¯et method. The aim was to evaluate from which system women best learned and retained information, and which system they preferred to use. Subjects and methodsThe setting was an associated teaching hospital of the University of Bristol. The urodynamic unit receives new and tertiary referrals from GPs, gynaecologists and urologists. Between August 1999 and February 2000, women referred to the unit were invited to participate in this study comparing a computer-generated information system with a lea¯et. Women were eligible if they were referred by their GPs before further hospital consultation, investigation or treatment. Women with visual or mental handicap were excluded. The study was approved by the local research ethics committee. Eligible women were sent information describing the study, along with their clinic appointment letter. Those interested in participating were asked to attend the department 1 h before their appointment. On arrival a written co...

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Psychosocial Impact of Urinary Incontinence in the Community‐Dwelling Population

Cited by 295 publications

References 18 publications

Long‐term bladder function in patients with locally advanced cervical carcinoma treated with neoadjuvant chemotherapy and type 3–4 radical hysterectomy

Long‐term bladder function in patients with locally advanced cervical carcinoma treated with neoadjuvant chemotherapy and type 3–4 radical hysterectomy

Urinary Incontinence and Psychological Distress in Community‐Dwelling Older Adults

A randomized trial comparing the effectiveness and preference of a touch‐screen computer system with a leaflet for providing women with information on urinary symptoms suggestive of detrusor instability

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