Predictive and barrier factors to treatment-seeking behavior among women with urinary incontinence

Abstract

Urinary incontinence (UI), the complaint of involuntary loss of urine, is a common condition among women in various population ages, which has significant impact on quality of life (QoL). Estimates of the prevalence of UI vary greatly with reports ranging from approximately 2.7% to 84.12% of all women in population ages. UI affects the QoL of women in four domains including physical activity, travel, social relationships and emotional health. Several incontinent women have responded that UI restricts lifestyles, inhibits daily activities, interferes with social activities and sexual function, and results in a loss of self-confidence. Specifically, several women who had UI symptoms have reported that UI decreases overall QoL with feelings of embarrassment, depression, anxiety, difficulty and discomfort. More than half (60%) of the women reported that they suffered moderate to extreme discomfort or difficulty caused by their UI symptoms. The predicting factors of treatment-seeking behavior among incontinent women are associated with various factors such as older age, long duration and greater severity of UI symptoms with higher emotional and physical impact on QoL, more discomfort and perceived UI suffering. Women suffering from severe UI are significantly more likely to have sought treatment than those with mild to moderate UI. Therefore, the major reasons for treatment-seeking are perceived increase in severity or distress and the need for incontinence materials. In many countries, women with UI who have treatment-seeking behavior can directly visit general practitioners (GP), specialists, gynecologists or urologists to consult about their UI symptoms. However, the rate of treatment-seeking for UI is significantly lower when compared to UI prevalence. The rate of treatment-seeking behavior among incontinent women is reported at approximately 15% to 45%. The barrier factors of treatment-seeking behavior among UI women are also associated with various factors including older age, different racial and ethnic groups, social stigmas, embarrassment about visiting healthcare providers, consideration of UI as a normal consequence of pregnancy, childbirth or aging, characteristics and types of UI, perception that UI severity is not a serious or life-threatening problem, insufficient knowledge about urinary incontinence and treatment, healthcare professionals or healthcare providers, and other factors such as perceived self-efficacy and counseling about UI symptoms from healthcare providers. Therefore, several women tend to consider UI as a common problem in women that is inevitable with age, especially in older age. Most women who do not seek treatment do not do so because they consider their incontinence as not a very serious problem, have deficient knowledge about UI etiology and available treatments. The majority of women are not provided with information on UI by health professionals. Moreover, incontinent women who have mild symptoms of UI or do not experience daily leakage and those who do not perceive leakage as a serious troublesome with impact on their daily lives do not want treatment-seeking. The rate of non-treatment-seeking behavior among incontinent women is reported at approximately 50% to 80%. Although these women are often inconvenienced and troubled by UI symptoms, they are reluctant to seek help from health professionals. Moreover, approximately two-thirds of suffering women who do not seek help are too embarrassed to do so. The purpose of this chapter is to review and discuss the predictive and barrier factors associated with treatment-seeking behavior among women with UI. This information can be useful for healthcare professionals when informing and counseling women who have UI to promote women's knowledge about seeking treatment for urine leakage. © 2016 Nova Science Publishers, Inc.