Why Older Community‐Dwelling Adults Do Not Discuss Urinary Incontinence with Their Primary Care Physicians

Dugan, Elizabeth; Roberts, Callie; Cohen, Stuart J.; Preisser, John S.; Davis, Cralen; Bland, Deirdre R.; Albertson, Elizabeth

doi:10.1046/j.1532-5415.2001.49094.x

Cited by 149 publications

(105 citation statements)

References 15 publications

(46 reference statements)

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“…The increasing prevalence rate in this study is primarily driven by an increase in big UI problems. A prior study consistently showed that patients tended to report UI‐related problems when symptoms became more severe 8. The prevalence estimate in this study is similar to that reported by Gnanadesigan et al.…”

Section: Discussionsupporting

confidence: 89%

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Prevalence, management and outcomes of medically complex vulnerable elderly patients with urinary incontinence in the United States

et al. 2015

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SummaryObjectivesTo assess the prevalence, patient–physician communication, treatment and health outcomes associated with urinary incontinence (UI) among the medically complex vulnerable elderly (MCVE) in the United States (US).MethodsData from the 2006 to 2012 Medicare Health Outcomes Survey (HOS) were used. MCVE patients were aged 65+ years with a HOS VE score ≥ 3. UI was reported as a small, big or no problem. Descriptive statistics were used to assess patient–physician communication and treatment. Multivariable regression analyses were performed to assess the association of small or big UI problems with various outcomes.ResultsThe annual UI prevalence increased among MCVE [from 35.8% (2006) to 38.6% (2012)]. MCVE with big UI problems communicated with their physicians more often than those with small UI problems (77.9% and 49.6%, respectively); however, treatment of UI remained low (48.5% and 29.1%, respectively). Physical component summary (PCS) and mental component summary (MCS) scores were lower among MCVE with small or big UI problems compared with those with no UI problems, respectively. The decrements in PCS and MCS scores associated with big UI problems were greater than the decrements associated with any of the other assessed conditions. MCVE with small or big UI problems, respectively, were more likely to report past falls, depression and activity daily living limitations vs. those without UI. The odds of having experienced these outcomes were greater for those with big UI vs. small UI problems.ConclusionsUrinary incontinence prevalence in the USA increased among MCVE from 2006 to 2012, although treatment of UI remained low. UI problems, particularly big UI problems, adversely impact health outcomes. Efforts to better identify and manage UI among the MCVE are needed.

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Section: Discussionsupporting

confidence: 89%

“…Even though UI can be managed by a number of treatment options 16, previous literature has demonstrated that older adults with UI considered it not as a medical condition but as a normal part of ageing 17. Because of this perception, they did not raise this health subject with their physicians and believed they could cope with UI 8.…”

Section: Discussionmentioning

confidence: 99%

Prevalence, management and outcomes of medically complex vulnerable elderly patients with urinary incontinence in the United States

et al. 2015

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“…UI is commonly concealed to preserve a women's sense of identity, and accepted as a normal part of ageing and being a woman (Bradway et al, 2010;Bush et al, 2001;Stewart, 2010). Frequently, elderly women lack knowledge of treatments that are available and are not often presented with opportunities to discuss or explain their UI with healthcare providers (Mardon et al, 2006;Zeznock et al, 2009;Dugan et al, 2001). Dugan et al (2001) reported that almost 70% of older adults experiencing UI were not asked by their healthcare provider about their UI.…”

Section: Empowering Women Experiencing Ui In Ltcmentioning

confidence: 99%

Elderly Women and Urinary Incontinence in Long-Term Care

Macdonald¹

2012

Urinary Incontinence

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“…5,9,10 Studies on why women do not seek treatment for UI have identified potential reasons, such as embarrassment, viewing it as a normal part of aging, feeling that they can cope on their own, and having low expectations of benefit from treatment. 4,6,11,12 Very few studies, however, have addressed what women perceive as the cause of their leakage, 11,13 and none of these studies was conducted in the United States. This gap in incontinence research is crucial, as comprehending perceived causes is necessary to understanding care-seeking behavior and compliance with treatment recommendations.…”

mentioning

confidence: 99%

Women's Perceptions about the Etiology of Urinary Incontinence

Melville

Wagner

Fan

et al. 2008

Journal of Women's Health

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Objective: Incontinent women have low rates of care seeking and treatment, some of which may be explained by their beliefs about the causes of their own urine loss. As little is known about these beliefs, our aim was to qualitatively assess what women perceive as the etiology of their urinary incontinence (UI). Methods: In a written survey on urinary symptoms administered to female HMO enrollees aged 30-90 years, incontinent women were asked the open-ended question: "Why do you think you lose urine?" Qualitative analyses of the responses identified themes, which were quantified and organized into major categories. Subjects were assigned multiple themes/categories as indicated. Relationships between major categories and subject/incontinence characteristics were explored. Results: Of the 1458 women with incontinence who completed the survey, 1192 (82%) responded to the openended question. Qualitative analyses identified 23 themes, with 5 themes cited by Ն10% of subjects: pelvic floor/bladder muscles (31%), pregnancy/childbirth (18%), age (14%), exertional triggers (12%), and waiting too long to void (10%). The 23 themes were organized into 5 major categories: pelvic floor/bladder related (53%), uncontrollable factors (23%), part of being female (21%), personal/lifestyle attributes (21%), and don't know (12%). Subjects expressed a range of 1-4 themes/categories. Major categories differed by age, and significant associations were seen between major categories and incontinence severity. Conclusions: Women attribute their UI to a number of causes, which can be condensed into workable themes and categories. By understanding women's beliefs about the etiology of incontinence, clinicians may improve their ability to educate, counsel, and treat women with incontinence.

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Why Older Community‐Dwelling Adults Do Not Discuss Urinary Incontinence with Their Primary Care Physicians

Abstract: Embarrassment or lack of awareness of treatment options were not significant barriers to discussing UI. Adults with a fairly high frequency of UI (average of 1.7 episodes per day) did not view UI as abnormal or a serious medical condition.

Cited by 149 publications

References 15 publications

Prevalence, management and outcomes of medically complex vulnerable elderly patients with urinary incontinence in the United States

Prevalence, management and outcomes of medically complex vulnerable elderly patients with urinary incontinence in the United States

Elderly Women and Urinary Incontinence in Long-Term Care

Women's Perceptions about the Etiology of Urinary Incontinence

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