Urinary Incontinence and Quality of Life: A Cross-Sectional Study

Abstract

Over half of women in the United States report urinary incontinence (UI). This condition can be treated conservatively, but many people do not seek treatment. The current correlational study assessed women’s knowledge of UI. Specifically, we investigated the relationships between knowledge level about UI and quality of life (QoL), and between severity level of UI and QoL. A convenience cross-sectional sample of 39 older women was obtained from two YMCA locations. Data were analyzed using the Spearman rank-order correlation coefficient. A significant relationship was found between severity of UI and QoL, r_s = −.73, p < .001; no relationship was found between knowledge level of UI and QoL, r_s = .24, p = .13. Results suggested women’s knowledge about the causes of UI and conservative therapy is limited. Occupational therapists need to address UI with their patients and educate them about treatment options and availability.

Plain Language Summary

This research article describes a study assessing the knowledge of women about urinary incontinence (UI), if they are experiencing UI, and their level of quality of life (QoL) as it pertains to UI. The authors explored the relationship between knowledge of UI and the QoL of the study participants and the relationship between their current symptom level of UI and their QoL. Results showed a significant relationship between increased severity of UI symptoms and decreased QoL. Although the results did not show a link between the level of knowledge about UI and QoL of the participants, the authors found that knowledge about the causes and possible treatments of UI by the study participants was limited. The study results indicate the need for community education on occupational therapy treatment options. Occupational therapy practitioners can expand their practice areas to address the needs of women experiencing a reduction in occupational engagement due to UI.

Keywords

occupational therapy health-related quality of life behavioral intervention

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References

Abdi

Spann

Borilovic

de Witte

Hawley

(2019). Understanding the care and support needs of older people: A scoping review and categorisation using the WHO International Classification of Functioning, Disability and Health framework (ICF). BMC Geriatrics, 19(1), 195. https://doi.org/10.1186/s12877-019-1189-9

Abufaraj

Cao

Siyam

Isleem

Massad

Soria

Shariat

S. F.

Sutcliffe

Yang

(2021). Prevalence and trends in urinary incontinence among women in the United States, 2005–2018. American Journal of Obstetrics and Gynecology, 225(2), 166.e1–166.e12. https://doi.org/10.1016/j.ajog.2021.03.016

American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process—Fourth edition. American Journal of Occupational Therapy, 74(Suppl. 2), 7412410010p1–7412410010p87. https://doi.org/10.5014/ajot.2020.74S2001

Aoki

Brown

H. W.

Brubaker

Cornu

J. N.

Daly

J. O.

Cartwright

(2017). Urinary incontinence in women. Nature Reviews Disease Primers, 3, 17097. https://doi.org/10.1038/nrdp.2017.97

Avery

Donovan

Peters

T. J.

Shaw

Gotoh

Abrams

(2004). ICIQ: A brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourology and Urodynamics, 23(4), 322–330. https://doi.org/10.1002/nau.20041

Aydin

Beji

N. K.

(2014). Management of incontinence in the female geriatric population: Behavioral therapy. Turkish Journal of Geriatrics, 17(3), 324–330. http://www.turkgeriatri.org

Baum

Christiansen

Bass

J. D.

(2015). Person-environment-occupational performance (PEOP) model. In Christiansen

Baum

Bass

J. D.

(Eds.), Occupational therapy: Performance, participation, well-being (4th ed.). (pp. 149–168). Slack.

Belarmino

J. A.

Jewell

(2019). Linking the international classification of functioning, disability and health (ICF) to OT older adult interventions. American Journal of Occupational Therapy, 72(4, suppl. 1), 7311505138p1. https://doi.org/10.5014/ajot.2019.73S1-RP202A

Branch

L. G.

Walker

L. A.

Wetle

T. T.

DuBeau

C. E.

Resnick

N. M.

(1994). Urinary incontinence knowledge among community-dwelling people 65 years of age and older. Journal of the American Geriatrics Society, 42(12), 1257–1262. https://doi.org/10.1111/j.1532-5415.1994.tb06507.x

10.

Carvalhais

Araújo

Ferreira

(2020). Incontinence Quiz: Translation, validation, and reproducibility in Portuguese women. Neurourology and Urodynamics, 39(8), 2490–2497. https://doi.org/10.1002/nau.24521

11.

Chen

C. C. G.

Cox

J. T.

Yuan

Thomaier

Dutta

(2019). Knowledge of pelvic floor disorders in women seeking primary care: A cross-sectional study. BMC Family Practice, 20(1), 70. https://doi.org/10.1186/s12875-019-0958-z

12.

Cygańska

A. K.

Sobieska

Truszczyńska-Baszak

Tomaszewski

Krzysztoszek

(2018). Women’s awareness of physiotherapeutic methods in the treatment of urinary incontinence. Advances in Rehabilitation, 32(4), 21–27. https://doi.org/10.5114/areh.2018.83391

13.

Dahl

T. H.

(2002). International classification of functioning, disability and health: An introduction and discussion of its potential impact on rehabilitation services and research. Journal of Rehabilitation Medicine, 34(5), 201–204. https://doi.org/10.1080/165019702760279170

14.

Damián

Pastor-Barriuso

García López

F. J.

de Pedro-Cuesta

(2017). Urinary incontinence and mortality among older adults residing in care homes. Journal of Advanced Nursing, 73(3), 688–699. https://doi.org/10.1111/jan.13170

15.

Dugger

B. R.

(2010). Concept analysis of health-related quality of life in nursing home residents with urinary incontinence. Urologic Nursing, 30(2), 112–118. https://doi.org//10.7257/1053-816x.2010.30.2.112

16.

Fernández-Cuadros

M. E.

Nieto-Blasco

Geanini-Yagüez

Ciprián-Nieto

Padilla-Fernández

Lorenzo-Gómez

M. F.

(2016). Male urinary incontinence: Associated risk factors and electromyography biofeedback results in quality of life. American Journal of Men’s Health, 10(6), N127–NP135. https://doi.org/10.1177/1557988315590653

17.

Fricke

Lark

S. D.

Fink

P. W.

Mundel

Shultz

S. P.

(2021). Exercise interventions to improve pelvic floor muscle functioning in older women with urinary incontinence: A systematic review. Journal of Women’s Health Physical Therapy, 45(3), 115–125. https://doi.org/10.1097/JWH.0000000000000202

18.

Giuliano

Milligan

L. M.

Ivy

C. C.

(2023). Pelvic floor dysfunction. In Manard

Muir

Day

Smith

Dahl-Popolizio

(Eds.), Primary care occupational therapy: A quick reference guide (1st ed.). Springer.

19.

Gorina

Schappert

Bercovitz

Elgaddal

Kramarow

(2014). Prevalence of incontinence among older Americans. Vital & Health Statistics, 3(36), 1–33. https://www.cdc.gov/nchs/data/series/sr_03/sr03_036.pdf

20.

Karakaya

İ. Ç.

Yenişehir

Karakaya

M. G

. (2019). Nursing home residents’ level of knowledge about urinary incontinence. Annals of Geriatric Medicine and Research, 23(1), 20–26. https://doi.org/10.4235/agmr.19.0003

21.

Maeda

Urabe

Suzuki

Hirado

Morikawa

Komiya

Mizuta

Naito

Shirakawa

(2021). Cross-sectional study of the prevalence and symptoms of urinary incontinence among Japanese older adults: Associations with physical activity, health-related quality of life, and well-being. International Journal of Environmental Research and Public Health, 18(2), 360. https://doi.org/10.3390/ijerph18020360

22.

Pahwa

A. K.

Andy

U. U.

Newman

D. K.

Stambakio

Schmitz

K. H.

Arya

L. A.

(2016). Nocturnal enuresis as a risk factor for falls in older community dwelling women with urinary incontinence. Journal of Urology, 195(5), 1512–1516. https://doi.org/10.1016/j.juro.2015.11.046

23.

Patrick

D. L.

Khalaf

K. M.

Dmochowski

Kowalski

J. W.

Globe

D. R.

(2013). Psychometric performance of the incontinence quality-of-life questionnaire among patients with overactive bladder and urinary incontinence. Clinical Therapeutics, 35(6), 836–845. https://doi.org/10.1016/j.clinthera.2013.04.013

24.

Seshan

Muliira

J. K.

(2014). Dimensions of the impact of urinary incontinence on quality of life of affected women: A review of the English literature. International Journal of Urological Nursing, 8(2), 62–70. https://doi.org/10.1111/ijun.12034

25.

Shaw

Wagg

(2021). Urinary and faecal incontinence in older adults. Medicine, 49(1), 44–50. https://doi.org/10.1016/j.mpmed.2020.10.012

26.

Smith

A. P.

(2016). Female urinary incontinence and wellbeing: Results from a multi-national survey. BMC Urology, 16, 22. https://doi.org/10.1186/s12894-016-0140-z

27.

Stamm

T. A.

Cieza

Machold

Smolen

J. S.

Stucki

(2006). Exploration of the link between conceptual occupational therapy models and the International Classification of Functioning, Disability and Health. Australian Occupational Therapy Journal, 53(1), 9–17. https://doi.org/10.1111/j.1440-1630.2005.00513.x

28.

Tremback-Ball

A. J.

Levine

A. M.

Dawson

Perlis

S. M.

(2008). Urinary incontinence knowledge among women 18-30 years of age. Journal of Women’s Health Physical Therapy, 32(2), 17–22. https://doi.org/10.1097/01274882-200832020-00004

29.

Vestal

L. (Host)

. (2023, May 31). If the pelvic floor is not healthy, there is no occupation we can perform’ with Alyson Stover, AOTA President (No. 52) [Audio podcast episode]. In Ot’s in Pelvic Health. Buzzsprout. https://www.buzzsprout.com/1971868/12940315

30.

Wagner

T. H.

Patrick

D. L.

Bavendam

T. G.

Martin

M. L.

Buesching

D. P.

(1996). Quality of life of persons with urinary incontinence: Development of a new measure. Urology, 47(1), 67–71. https://doi.org/10.1016/S0090-4295(99)80384-7

31.

Wong

S. R.

Fisher

(2015). Comparing and using occupation-focused models. Occupational Therapy in Health Care, 29(3), 297–315. https://doi.org/10.3109/07380577.2015.1010130

32.

World Health Organization. (2002). International classification of functioning, disability and health (ICF). https://www.who.int/standards/classifications/international-classification-of-functioning-disability-and-health

33.

J. M.

Matthews

C. A.

Conover

M. M.

Pate

Jonsson Funk

(2014). Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. Obstetrics & Gynecology, 123(6), 1201–1206. https://doi.org/10.1097/AOG.0000000000000286

34.

Zhang

(2018). An evolutionary concept analysis of urinary incontinence. Urologic Nursing, 38(6), 289–306. https://doi.org/10.7257/1053-816X.2018.38.6.289