Quality Of Life,disease Recognition And Care-Seeking Intention In Women With Urinary Incontinence:An Observational Study In China

UI is the complaint of any involuntary leakage of urine and is also a worldwide public-health problem.Studies indicate an estimated 8.2% of the 2008 worldwide population was affected by UI.By 2018,21.6% of the individuals will be affected by UI.The age standardized prevalence of urinary incontinence in women in the combined surveys was significantly higher than that in men.Specifically,the prevalence of urinary incontinence peaks at age 50-54.The variation in prevalence rates might be related to differences in the studied populations,methods of data collection,and definitions of UI.Although urinary incontinence was not life-threatening,it affected a woman's ability to take part in a variety of recreational and social activities,and had negative psychological effects.In addition,urinary incontinence increased the economic burden of the patients as well as the society,especially in developing regions.Urinary incontinence was a frequent problem of women that affect negatively their quality of life,whose extent differed because of social and cultural factors.UI can affect the social,psychological,domestic,occupational,physical,and sexual aspects of patients' lives.In the study,Mixed UI was the one that had the greatest impact on their QOL,whereas the mixed and stress types had the greatest impact on their sexual function.Although QOL was impaired in women with UI,their care-seeking intention was low.It was revealed that improvement of quality of life,reduction of anxiety and depression in patients with stress urinary incontinence could be achieved by surgery.Although adequate treatment is available,intention of care-seeking is still low.The study of European and North American countries found the care-seeking rate of UI was 12%~53%,and the care-seeking rate of female is lower than that of male.Due to the social and cultural background,some patients of UI had different degree of shame and embarrassment,thus hindering their intention of care-seeking.Many women assumed UI as a symptom or condition that was a normal part of aging or that could be explained by parturition,thus did not need treatment by a medical provider.There was no study to evaluate the quality of life and status of care-seeking of women with UI in china.Moreover,Chinese women is influenced by traditional concepts and ethics,so some of them were conservative,less educated,and possessed limited medical knowledge.Therefore,in this study we investigated these issues in the Anhui province of China.Objective: The aim of this study was to evaluate the quality of life,awareness of UI,and influential factors of care-seeking intention of women with urinary incontinence in China.Methods: From April 2013 to November 2013,subjects were selected from four cities in Anhui province,China.They participated in this survey by completing a detailed verbal questionnaire regarding their demographic data,medical history,and the International Consultation on Incontinence Questionnaire for Urinary Incontinence-Short Form questionnaire(ICIQ-UI-SF)and incontinence quality of life(I-QOL)questionnaire.Results: 1,653 women were recruited in this study,and 60.48% of the women with UI did not seek medical advice,and the major reasons for women without care-seeking intention were assuming UI as a normal phenomenon(58.0%)and embarrassment(27.33%).Positive factors for promoting care-seeking among patients with UI included the in-depth disease recognition,urge UI(UUI),mixed UI(MUI),and higher educational level.Conclusions: QOL in women with SUI was better than those with UUI and MUI.Almost half of the patients had limited knowledge about UI.The influential factors regarding to care-seeking intention among patients with UI was associated with disease recognition,embarrassment,assuming UI as a normal phenomenon,the type of UI,and educational level.Objective: The aim of this study was to estimate the risk factors of women withstress urinary incontinence in Anhui province in China.Methods: This subject was selected from four cities in Anhui province,China from April2013 to November 2013.Volunteers who participated in this survey all completed a detailed verbal questionnaire regarding their demographic data,medical history,and the International Consultation on Incontinence Questionnaire for Urinary Incontinence-Short Form questionnaire(ICIQ-UI-SF).Result:The prevalence of SUI was significantly associated with age(X2=63.373,P<0.001),BMI(X2=4.741,P=0.029),parity(X2=7.889,P=0.005),perineum tear(X2=8.887,P=0.003),postpartum premature labor(X2=13.809,P<0.001)and constipation(X2=7.685,P=0.006).However,the following factors did not show significant difference: cesarean(X2=1.205,P=0.293),diabetes mellitus(X2=0.023,P=0.878)and smoking(X2=0.346,P=0.557).Multiariable Logistic regression analysis model,show that age,including 40 to 59 years old(OR 5.200,CI 3.347-8.080),more than 60 years old(OR 3.819,CI 2.277-6.406),body mass index(OR 1.413,CI1.018-1.967),the production is greater than 2(OR 1.641,CI 1.095-2.460),perineal laceration(OR 2.089,CI 1.275-3.422),postpartum premature labor(OR 1.912,CI 1.352-2.703),and constipation(OR 1.797,CI 1.181-2.732)as a precipitating factor for stress urinary incontinence.Conclusions: The prevalence of SUI is very high.It was significantly associated with age,BMI,parity,perineum tear,postpartum premature labor and constipation.Diabetes mellitus,smoking and cesarean didn't have direct relation with SUI in women.