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2.
Rev. enferm. UERJ ; 28: e51896, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1146280

RESUMO

Objetivo: verificar o impacto da incontinência urinária na qualidade de vida das mulheres. Método: revisão integrativa realizada em fontes eletrônicas da CAPES, LILACS e PubMed. Utilizou-se como critério de inclusão, os artigos disponíveis eletronicamente na íntegra e que dissertaram sobre a temática, e de exclusão os que apresentaram duplicidade na busca. Foram selecionados doze artigos. Resultados: os estudos analisados foram publicados no período de 2015 a 2019, sendo nove estudos do tipo transversal. Identificaram-se quatro categorias temáticas: percepção das mulheres sobre a IU; impacto da IU na QV de mulheres; tipo de IU de maior influência sobre a QV; e importância da avaliação da QV de mulheres incontinentes. Conclusão: evidenciouse o impacto negativo da IU na QV de mulheres, devido a limitações físicas, sexuais, ocupacionais e sociais, e sentimentos como vergonha, falta de controle, mal-estar, insegurança, sofrimento e culpa.


Objective: to verify the impact of urinary incontinence on women's quality of life. Method: integrative review conducted in CAPES, LILACS and PubMed electronic sources. For inclusion, articles had to be available in full electronically and address the subject; search duplicates were excluded. Twelve articles were selected. Results: these studies, nine cross-sectional, were published from 2015 to 2019. Four thematic categories were identified: women's perception of UI; impact of UI on women's QOL; UI type with greatest impact on QOL; and importance of assessing incontinent women's QOL. Conclusion: UI had adverse impact on QOL of women, because of physical, sexual, occupational, and social limitations, as well as feelings of shame, lack of control, discomfort, insecurity, suffering and guilt.


Objetivo: verificar el impacto de la incontinencia urinaria en la calidad de vida de las mujeres. Método: revisión integradora realizada en fuentes electrónicas CAPES, LILACS y PubMed. Para su inclusión, los artículos debían estar disponibles en su totalidad en formato electrónico y abordar el tema; Se excluyeron los duplicados de búsqueda. Se seleccionaron doce artículos. Resultados: estos estudios, nueve transversales, se publicaron entre 2015 y 2019. Se identificaron cuatro categorías temáticas: percepción de las mujeres sobre la IU; impacto de la IU en la calidad de vida de las mujeres; Tipo de IU con mayor impacto en la calidad de vida; e importancia de evaluar la calidad de vida de las mujeres con incontinencia. Conclusión: la IU tuvo un impacto adverso en la calidad de vida de las mujeres, debido a limitaciones físicas, sexuales, ocupacionales y sociales, así como sentimientos de vergüenza, descontrol, malestar, inseguridad, sufrimiento y culpa.


Assuntos
Humanos , Feminino , Qualidade de Vida , Incontinência Urinária , Saúde da Mulher , Percepção , Vergonha , Incontinência Urinária/psicologia
3.
Enferm. clín. (Ed. impr.) ; 30(5): 349-353, sept.-oct. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-196778

RESUMO

La Incontinencia Urinaria es un problema de salud relevante con una prevalencia elevada en ancianos hospitalizados. El aumento de población anciana en la sociedad española justifica la actualización de cuidados y técnicas aplicables a pacientes geriátricos, dependientes y crónicos. Los procedimientos de cuidados de salud basados en la evidencia ayudan a los profesionales en la toma de decisiones y disminuyen la variabilidad en la práctica clínica. En este artículo se describe el procedimiento de cuidados al paciente con incontinencia urinaria del Hospital Guadarrama basado en el uso de terapias conductuales


Urinary Incontinence is a highly prevalent and important health problem in hospitalized elderly people. The increase in the elderly population in Spain requires the care and techniques that apply to geriatric, dependent and chronic patients to be updated. Evidence-based health care procedures assist professionals in decision-making and reduce variability in clinical practice. This article describes the care procedure for patients with urinary incontinence in the Guadarrama Hospital based on the use of behavioural therapies


Assuntos
Humanos , Masculino , Feminino , Idoso , Enfermagem Primária/métodos , Terapia Comportamental/métodos , Incontinência Urinária/enfermagem , Qualidade de Vida/psicologia , Incontinência Urinária/psicologia , Hospitalização , Avaliação em Enfermagem
4.
Int J Rehabil Res ; 43(3): 261-265, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32769584

RESUMO

Urinary incontinence is a clinical condition that can negatively affect activities, psychosocial well-being, and health-related quality of life. The Incontinence Impact Questionnaire short version (IIQ-7) is useful to quantify quickly the urinary incontinence-related life-impact. Previous psychometric studies on the IIQ-7, using classical test theory methods, demonstrated good internal consistency, test-retest reliability, and a substantial unidimensionality of the tool. This latter property is a prerequisite for performing advanced modern psychometric analyses such as Rasch analysis. In this study, we aimed to examine in depth - through Rasch analysis - some key metric properties of the IIQ-7. We analyzed data from 100 women with urinary incontinence. Results confirmed the correct functioning of the four response categories of the questionnaire and indicated an adequate level of internal structural validity. Given the good fit of the items to the Rasch model, it was possible to obtain a nomogram to transform the total raw scores of the IIQ-7 into linear measure estimates. Our findings obtained through Rasch analysis confirm the substantial unidimensionality and good psychometric properties of the IIQ-7 found in previous studies. They enhance the confidence in the use of this short tool - for group-level decisions - to assess the life-impact related to stress, urge or mixed urinary incontinence among women.


Assuntos
Incontinência Urinária , Feminino , Humanos , Psicometria , Qualidade de Vida , Reprodutibilidade dos Testes , Inquéritos e Questionários , Incontinência Urinária/psicologia
5.
Ceska Gynekol ; 85(2): 94-102, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32527102

RESUMO

BACKGROUND: Examination of pelvic floor muscle function is very important before starting exercises in patients with urine leakage and other pelvic floor dysfunctions. Perineometer and palpation examination is currently being used. A new trend in physiotherapy is the ultrasound examination of pelvic floor muscles. The examination can be performed by abdominal approach or perineal approach. We evaluate 2D and 3/4D images of pelvic floor muscles. METHODS: The International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF). OAB-q - overactive bladder questionnaire - short form. The Urinary Incontinence Quality of Life scale (I-QoL) - self-assessment scale for assessing the quality of life of patients with urinary incontinence. Adjusted Oxford scale to assess pelvic floor muscle strength. PERFECT scheme by Laycock and Jerwood. Pelvic floor examination by perineometer (Peritron-Ontario, L4V, Canada). Pelvic floor examination by 2D and 3/4D ultrasound examination (Volunson-i BT 11 Console, VCI volume contrast imaging software, (GE Healthcare Austria GmbH & Co OG, Zipf, Austria, RAB4-8-RS 3D/4D 4-8 MHz probe). High intensity exercise of pelvic floor muscles with stabilization elements. CONCLUSION: The effect of pelvic floor muscle training was objectively proved by the above mentioned objectivization methods with subjective improvement of quality of life. There was also a significant effect of education in USG exercise.


Assuntos
Terapia por Exercício/métodos , Diafragma da Pelve/fisiologia , Incontinência Urinária por Estresse/reabilitação , Incontinência Urinária/reabilitação , Feminino , Humanos , Diafragma da Pelve/diagnóstico por imagem , Qualidade de Vida , Ultrassonografia , Incontinência Urinária/diagnóstico , Incontinência Urinária/psicologia , Incontinência Urinária por Estresse/diagnóstico , Incontinência Urinária por Estresse/psicologia
6.
J Urol ; 204(5): 1003-1011, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32469267

RESUMO

PURPOSE: We established severity banding ranges, bother assessment and key item content in principal patient reported outcomes measures in men seeking therapy for lower urinary tract symptoms. MATERIALS AND METHODS: Data for International Prostate Symptom Score (I-PSS) and International Consultation on Incontinence Questionnaire Male Lower Urinary Tract Symptoms (ICIQ-MLUTS) were derived from a study evaluating 820 men at 26 United Kingdom hospitals. ROC curves were used to establish severity bandings. RESULTS: Classification tree showed that thresholds between mild-moderate and moderate-severe severity bands were 15 and 27 for I-PSS, 16 and 26 for ICIQ-MLUTS/severity, and 22 and 81 for ICIQ-MLUTS/bother, respectively. Highest area under the ROC curve and lowest Akaike's information criteria of univariate logistic regression indicated that ICIQ-MLUTS/bother was more related to global quality of life than were I-PSS and ICIQ-MLUTS/severity. The symptoms affecting I-PSS-quality of life (QoL) were only fully identified by ICIQ-MLUTS, because 2 key symptoms (urinary incontinence and post-micturition dribble) are not measured by I-PSS. ICIQ-MLUTS demonstrated that bother of some lower urinary tract symptoms is disproportionate to severity, and that persisting high bother levels following surgery are more likely due to storage (18% to 25%) and post-voiding (18% to 28%) lower urinary tract symptoms than voiding lower urinary tract symptoms (5% to 13%). Symptom improvement after surgery was uncertain if baseline I-PSS-QoL score was less than 3. CONCLUSIONS: The severity threshold scores were measured for the 2 key lower urinary tract symptoms patient reported outcomes measures, and the results indicate suitable categories of symptom severity for use in men referred for urological care. The ICIQ-MLUTS measures all the lower urinary tract symptoms affecting quality of life and includes individual symptom bother scores.


Assuntos
Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida , Índice de Gravidade de Doença , Incontinência Urinária/diagnóstico , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Planejamento de Assistência ao Paciente , Reino Unido , Incontinência Urinária/complicações , Incontinência Urinária/psicologia , Incontinência Urinária/terapia
7.
Rev. chil. obstet. ginecol. (En línea) ; 85(2): 123-131, abr. 2020. tab
Artigo em Espanhol | LILACS | ID: biblio-1115507

RESUMO

INTRODUCCIÓN Y OBJETIVO: La incontinencia urinaria (IU) es una patología qué por sus características epidemiológicas y fisiopatológicas, afecta en gran medida a los adultos mayores (AM); en particular en Chile, se han reportado prevalencias que van desde el 12,2 al 30% para este grupo. El objetivo de esta investigación fue evaluar la prevalencia de la IU a nivel nacional en personas mayores que viven en comunidad; analizar y describir si aquellos que presentan IU perciben una disminución en su calidad de vida evaluado a través del cuestionario SF-36, en los aspectos físicos y mentales. MÉTODOS: Estudio transversal, analítico, realizado en una muestra de personas chilenas de 60 años y más, residentes en la comunidad; con representatividad nacional, regional y urbano-rural. El análisis se realizó con el software STATA 15.0 RESULTADOS: Este estudio fue realizado en 4186 adultos mayores chilenos, se encontró una prevalencia de IU de un 12,1% siendo más frecuente en mujeres que en hombres (15,2% v/s 7,1 % respectivamente, p<0,0001). Los análisis de asociación mostraron que la IU afecta de manera negativa la autopercepcion de calidad de vida tanto en el aspecto físico como mental. La Calidad de vida, medida por SF-36 reportó una disminución en sus puntajes en personas incontinentes y de los AM que refieren una calidad de vida regular, mala o muy mala, el 50% de ellos presenta IU. CONCLUSIÓN: La IU se asocia a una percepción de disminución en la calidad de vida en las personas mayores chilenas residentes en la comunidad.


INTRODUCTION AND OBJECTIVES: Due to its epidemiological and pathophysiological characteristics, urinary incontinence (UI) is a pathology which greatly affects older adults. The reported prevalence for this group in Chile, specifically, ranges from 12.2 to 30%. The objective of this study was to evaluate, at the national level, the prevalence of UI in older people living in the community; analyze and describe whether those who experience UI perceive diminished quality of life, using the physical and mental subscales of the SF-36 questionnaire to evaluate. METHODS: Cross-sectional, analytical study conducted on a nationally, regionally and urban-rural representative sample of Chilean people aged 60 and over, who residents of the community. The analysis was performed using STATA 15.0 software. RESULTS: This study of 4,186 older Chilean adults found the prevalence of UI to be 12.1%, with higher frequency in women than in men (15.2% v / s 7.1%, respectively, p <0, 0001). Association analysis showed that UI negatively affects perceptions of the subject's own physical and mental quality of life. Quality of life, measured using SF-36, showed lower scores for incontinent people and, of the older adults who report normal, bad or very bad quality of life, 50% present UI. CONCLUSION: UI is associated with a perception of diminished in the quality of life in older Chilean people living in the community.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Incontinência Urinária/psicologia , Incontinência Urinária/epidemiologia , Qualidade de Vida , Autoimagem , Chile/epidemiologia , Prevalência , Estudos Transversais , Inquéritos e Questionários , Instituição de Longa Permanência para Idosos
8.
Urologe A ; 59(4): 408-415, 2020 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-32125449

RESUMO

The combination of a severe urethral sphincter defect with simultaneous development of recurrent bladder outlet obstruction characterizes a "devastated bladder outlet", which often is not surgically reconstructable. Clinically, quality of life is considerably compromised in affected patients with a wide variance of symptoms, mostly complete incontinence, but also urinary retention. This condition is usually preceded by multiple endoscopic interventions or even open surgical procedures, occasionally also in combination with radiotherapy of the pelvic region as part of multimodal oncological therapy. Treatment of these cases is complex and limited to few promising procedures. A potential therapy should primarily include the decision about the possibility of preserving the urinary bladder. In individual cases, this can result in simple therapy options while at the same time maintaining an acceptable quality of life for those affected. If there is no possibility of a refunctionalization of the original bladder, supravesical urinary diversion is indicated as a last-resort therapy. This paper provides a review as well as the limits and possibilities of conservative and surgical treatment options for a devastated bladder outlet.


Assuntos
Cistostomia/métodos , Obstrução do Colo da Bexiga Urinária/cirurgia , Incontinência Urinária/complicações , Retenção Urinária/complicações , Constrição Patológica , Humanos , Masculino , Qualidade de Vida , Uretra , Estreitamento Uretral , Obstrução do Colo da Bexiga Urinária/psicologia , Incontinência Urinária/psicologia , Retenção Urinária/psicologia
9.
BJOG ; 127(8): 1002-1013, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32141709

RESUMO

OBJECTIVE: To compare standard (native tissue) repair with synthetic mesh inlays or mesh kits. DESIGN: Randomised controlled trial. SETTING: Thirty-three UK hospitals. POPULATION: Women having surgery for recurrent prolapse. METHODS: Women recruited using remote randomisation. MAIN OUTCOME MEASURES: Prolapse symptoms, condition-specific quality-of-life and serious adverse effects. RESULTS: A Mean Pelvic Organ Prolapse Symptom Score at 1 year was similar for each comparison (standard 6.6 versus mesh inlay 6.1, mean difference [MD] -0.41, 95% CI -2.92 to 2.11: standard 6.6 versus mesh kit 5.9, MD -1.21 , 95% CI -4.13 to 1.72) but the confidence intervals did not exclude a minimally important clinical difference. There was no evidence of difference in any other outcome measure at 1 or 2 years. Serious adverse events, excluding mesh exposure, were similar at 1 year (standard 7/55 [13%] versus mesh inlay 5/52 [10%], risk ratio [RR] 1.05 [0.66-1.68]: standard 3/25 [12%] versus mesh kit 3/46 [7%], RR 0.49 [0.11-2.16]). Cumulative mesh exposure rates over 2 years were 7/52 (13%) in the mesh inlay arm, of whom four women required surgical revision; and 4/46 in the mesh kit arm (9%), of whom two required surgical revision. CONCLUSIONS: We did not find evidence of a difference in terms of prolapse symptoms from the use of mesh inlays or mesh kits in women undergoing repeat prolapse surgery. Although the sample size was too small to be conclusive, the results provide a substantive contribution to future meta-analysis. TWEETABLE ABSTRACT: There is not enough evidence to support use of synthetic mesh inlay or mesh kits for repeat prolapse surgery.


Assuntos
Procedimentos Cirúrgicos em Ginecologia/métodos , Satisfação do Paciente/estatística & dados numéricos , Prolapso de Órgão Pélvico/cirurgia , Telas Cirúrgicas , Incontinência Urinária/cirurgia , Prolapso Uterino/cirurgia , Adulto , Coito , Feminino , Seguimentos , Procedimentos Cirúrgicos em Ginecologia/instrumentação , Humanos , Pessoa de Meia-Idade , Prolapso de Órgão Pélvico/fisiopatologia , Prolapso de Órgão Pélvico/psicologia , Qualidade de Vida , Reoperação/estatística & dados numéricos , Resultado do Tratamento , Incontinência Urinária/fisiopatologia , Incontinência Urinária/psicologia , Prolapso Uterino/fisiopatologia , Prolapso Uterino/psicologia
10.
Ginekol Pol ; 91(1): 13-16, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32039462

RESUMO

OBJECTIVES: Urinary incontinence (UI) can affect up to 50% of the population of women over the age of 50. In order to objectively assess discomfort in women with UI prior to initiating treatment and monitoring the outcomes of the treatment, validated questionnaires need to be used to examine the impact of UI on health-related quality of life (HR-QoL). The Urogenital Distress Inventory - Short Form (UDI-6) and the Medical Epidemiologic and Social Aspects of Ageing (MESA) questionnaires are used typically. Assessment of the Polish translation of the MESA and UDI-6 questionnaires. MATERIAL AND METHODS: 155 patients with symptoms of UI were enrolled. Each of the patients completed the MESA and UDI questionnaires prior to being examined. The final diagnosis was made after diagnostic tests were carried out in the patients. RESULTS: Principle component analysis showed division of the Polish versions of the questionnaires into domains identical to the original version. Analyses of internal consistency reliability revealed high internal consistency for the MESA questionnaire (0.90) and a low reliability of the UDI-6 questionnaire (0.44). CONCLUSIONS: The Polish version of the MESA questionnaire was demonstrated to be a clinically useful diagnostic tool in the studied population, UDI-6 did not reached a sufficiently high reliability in the study group to be recommended as a diagnostic tool.


Assuntos
Ageismo/psicologia , Ageismo/estatística & dados numéricos , Qualidade de Vida/psicologia , Inquéritos e Questionários/normas , Traduções , Incontinência Urinária/epidemiologia , Incontinência Urinária/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Polônia/epidemiologia , Análise de Componente Principal , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Adulto Jovem
11.
Neurourol Urodyn ; 39(3): 962-968, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32032453

RESUMO

AIMS: To enable the use of ICIQ-FLUTS, ICIQ-FLUTS-long-form (ICIQ-FLUTS-LF), ICIQ-LUTS-quality-of-life (ICIQ-LUTSqol), and ICIQ-FLUTS sexual functions (ICIQ-FLUTSsex) in Turkish speaking women, questionnaires were translated into Turkish and validity, reliability, and sensitivity to change were evaluated in women suffering from urinary incontinence (UI). MATERIALS AND METHODS: Permissions were obtained from ICIQ Advisory Board, English versions of the questionnaires were initially translated into Turkish, then back-translated into English and translations were modified according to recommendations of ICIQ Advisory Board. Pilot testing was performed in 10 women. Validity (content/face validity and discriminant validity), reliability (test-retest reliability and internal consistency), and sensitivity to change were evaluated. RESULTS: A total of 58 women with UI completed ICIQ-FLUTS, ICIQ-LUTSqol, and the ICIQ-FLUTS-LF, and 37 who were sexually active completed ICIQ-FLUTSsex. All women completed same questionnaires 15 days later. More than 90% of women thought that the questions were clear, unequivocal, and comprehensive. Missing data were less than 1% indicating adequate content/face validity. Cronbach's α coefficients were .933 (ICIQ-FLUTS), .979 (ICIQ-LUTSqol), .865 (ICIQ-FLUTS-LF), and .863 (ICIQ-FLUTSsex), representing adequate internal consistency. Kappa values and intraclass correlation coefficient for individual items were over 0.70, indicating adequate test-retest reliability. A total of 52 healthy volunteers completed ICIQ-FLUTS and ICIQ-FLUTS-LF, 30 completed ICIQ-LUTSqol, and 30 sexually active healthy volunteers completed ICIQ-FLUTSsex. All four questionnaires had good discriminant validity. Twenty-eight women with UI were analyzed 3 months after treatment. There was significant improvement in four questionnaires in correlation with pre- and posttreatment bladder diary results showing good sensitivity to change. CONCLUSION: Turkish versions of four ICIQ modules were shown valid and reliable and can be used in Turkish speaking women in the evaluation of UI.


Assuntos
Sintomas do Trato Urinário Inferior/fisiopatologia , Qualidade de Vida , Disfunções Sexuais Fisiológicas/fisiopatologia , Incontinência Urinária/fisiopatologia , Adulto , Idoso , Estudos de Casos e Controles , Dispareunia/fisiopatologia , Feminino , Voluntários Saudáveis , Humanos , Sintomas do Trato Urinário Inferior/psicologia , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Inquéritos e Questionários , Traduções , Turquia , Incontinência Urinária/psicologia , Adulto Jovem
12.
Midwifery ; 83: 102647, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32014618

RESUMO

OBJECTIVE: Many women experience urinary incontinence (UI) during and after pregnancy. Pelvic floor muscle exercises (PFME) can prevent and reduce the symptoms of UI. The objective of the study was to explore challenges, opportunities and concerns for women and health care professionals (HCPs), related to the implementation of PFME training for women in current antenatal care. DESIGN: An ethnographic study design was used. Researchers also formed and collaborated with a public advisory group, consisting of seven women with recent experiences of pregnancy, throughout the study. PARTICIPANTS: Seventeen midwife-woman interactions were observed in antenatal clinics. In addition, 23 midwives and 15 pregnant women were interviewed. Repeat interviews were carried out with 12 of the women postnatally. Interviews were also carried out with other HCPs; four physiotherapists, a linkworker/translator and two consultant obstetricians. Additional data sources included field notes, photographs, leaflets, policy and other relevant documents. SETTING: Data were collected in three geographical areas of the UK spanning rural, urban and suburban areas. Data collection took place in antenatal clinics, in primary and secondary care settings, and the majority of women were interviewed in their homes. FINDINGS: Three broad and inter-related themes of "ideological commitment", "confidence" and "assumptions, stigma and normalisation" were identified. The challenges, opportunities and concerns regarding PFME implementation were explored within these themes. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Although HCPs and some women knew that PFME were important, they were not prioritised and the significant benefits of doing PFME may not have been communicated by midwives or recognised by women. There was a lack of confidence amongst midwives to teach PFME and manage UI within the antenatal care pathway and amongst women to ask about PFME or UI. A perceived lack of consistent guidelines and policy at local and national levels may have impeded clear communication and prioritisation of PFME. Furthermore, assumptions made by both women and midwives, for example, women regarding UI as a normal outcome of pregnancy, or midwives' perception that certain women were more likely to do PFME, may have exacerbated this situation. Training for midwives to help women in the antenatal period to engage in PFME could address challenges and concerns and to help prevent opportunities for women to learn about PFME from being missed.


Assuntos
Exercício Físico/psicologia , Relações Enfermeiro-Paciente , Diafragma da Pelve/fisiologia , Adulto , Antropologia Cultural/métodos , Feminino , Humanos , Gravidez , Complicações na Gravidez/prevenção & controle , Complicações na Gravidez/psicologia , Resultado do Tratamento , Reino Unido , Incontinência Urinária/etiologia , Incontinência Urinária/prevenção & controle , Incontinência Urinária/psicologia
13.
J Wound Ostomy Continence Nurs ; 47(2): 166-171, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31913876

RESUMO

PURPOSE: The aim of this study was to evaluate sleep quality and quality of life in older women with urinary incontinence. DESIGN: Cross-sectional. SUBJECTS/SETTING: Women ages 65 to 84 years with reported urinary incontinence and were receiving care in the Gynecology and Obstetrics Polyclinic in Gynecology and Obstetrics Polyclinic, Medical Practice and Research Center, Ondokuz Mayis University, Samsun, Turkey. METHODS: Data were collected over a 3-month period during one-on-one interviews using the investigator-developed Personal Information Form to capture demographic data, and with questionnaires including the Incontinence-Quality of Life Instrument (I-QOL), and Pittsburgh Sleep Quality Index (PSQI). Data were analyzed using nonparametric tests, Mann-Whitney U tests, and Kruskal-Wallis variance analysis. Written informed consent was obtained from all participants. RESULTS: We approached 210 individuals, of which 140 were consented, enrolled, and completed the study. The mean age of participants was 70.3 ± 4.1 years. The mean sleep quality score measured with the PSQI was 9.6 ± 6.0, suggesting poor sleep quality, which affected 89.3% of the sample. The quality-of-life mean total score measured with the I-QOL was 67.8 ± 14.9, reflecting normal quality of life specific to urinary incontinence. However, quality of life was lower in the older age group, 75 to 84 years, who also reported at least one chronic condition, had not received treatment for urinary incontinence, and had irregular sleep patterns. CONCLUSIONS: We found a strong correlation between sleep quality and quality of life in older females with urinary incontinence, raising awareness of the need for health care providers to inquire about sleep and quality of life and provide treatment options to ameliorate these negative health outcomes.


Assuntos
Qualidade de Vida/psicologia , Sono/fisiologia , Incontinência Urinária/complicações , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Estatísticas não Paramétricas , Inquéritos e Questionários , Turquia , Incontinência Urinária/psicologia
14.
Am J Nurs ; 120(2): 55-60, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31977423

RESUMO

This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home.The articles in this new installment of the series provide simple and useful instructions that nurses should reinforce with family caregivers. This article is the second of two that provide an update on urinary incontinence and its management in older adults. It includes an informational tear sheet-Information for Family Caregivers-that contains links to the instructional videos. To use this series, nurses should read the articles first, so they understand how best to help family caregivers, and then encourage caregivers to watch the videos and ask questions. For additional information, see Resources for Nurses.


Assuntos
Cuidadores/educação , Tampões Absorventes para a Incontinência Urinária , Incontinência Urinária/enfermagem , Idoso , Cuidadores/psicologia , Humanos , Tampões Absorventes para a Incontinência Urinária/economia , Relações Enfermeiro-Paciente , Incontinência Urinária/psicologia
15.
JAMA Intern Med ; 180(3): 411-419, 2020 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-31930360

RESUMO

Importance: First-line behavioral and drug therapies for overactive bladder (OAB) symptoms in men are effective but not usually curative. Objective: To determine whether combining behavioral and drug therapies improves outcomes compared with each therapy alone for OAB in men and to compare 3 sequences for implementing combined therapy. Design, Setting, and Participants: In this 3-site, 2-stage, 3-arm randomized clinical trial, participants were randomized to 6 weeks of behavioral therapy alone, drug therapy alone, or combined therapy followed by step-up to 6 weeks of combined therapy for all groups. Participants were recruited from 3 outpatient clinics and included community-dwelling men 40 years or older with urinary urgency and 9 or more voids per 24 hours. Data were collected from July 2010 to July 2015 and analyzed from April 2016 to September 2019. Interventions: Behavioral therapy consisted of pelvic floor muscle training with urge suppression strategies and delayed voiding. Drug therapy included an antimuscarinic (sustained-release tolterodine, 4 mg) plus an α-blocker (tamsulosin, 0.4 mg). Main Outcomes and Measures: Seven-day bladder diaries completed before and after each 6-week treatment stage were used to calculate reduction in frequency of urination (primary outcome) and other symptoms (ie, urgency, urgency incontinence, and nocturia). Other secondary outcomes included validated patient global ratings of improvement and satisfaction, Overactive Bladder Questionnaire score, and International Prostate Symptom Score. Results: Of the 204 included men, 133 (65.2%) were white, and the mean (SD) age was 64.1 (11.1) years. A total of 21 men discontinued treatment and 183 completed treatment. Mean (SD) voids per 24 hours decreased significantly in all 3 groups from baseline to 6-week follow-up (behavioral therapy: 11.7 [2.4] vs 8.8 [2.1]; change, 2.9 [2.4]; percentage change, 24.7%; P < .001; drug therapy: 11.8 [2.5] vs 10.3 [2.7]; change, 1.5 [2.3]; percentage change, 12.7%; P < .001; combined therapy: 11.8 [2.4] vs 8.2 [2.3]; change, 3.6 [2.1]; percentage change, 30.5%; P < .001). Intention-to-treat analyses indicated that posttreatment mean (SD) voiding frequencies were significantly lower in those receiving combined therapy compared with drug therapy alone (8.2 [2.3] vs 10.3 [2.7]; P < .001) but not significantly lower compared with those receiving behavioral therapy alone (8.2 [2.3] vs 8.8 [2.1]; P = .19) and were lower for behavioral therapy alone compared with drug therapy alone (8.8 [2.1] vs 10.3 [2.7]; P < .001). At 12-week follow-up, after all groups had received combined therapy, improvements in mean (SD) voids per 24 hours were also greatest for those receiving initial combined therapy compared with baseline (behavioral therapy: 11.7 [2.4] vs 8.0 [2.2]; change, 3.7 [2.3]; percentage change, 31.6%; P < .001; drug therapy: 11.8 [2.5] vs 8.6 [2.3]; change, 3.2 [2.5]; percentage change, 27.1%; P < .001; combined therapy: 11.8 [2.4] vs 8.0 [2.2]; change, 3.8 [2.1]; percentage change, 32.2%; P < .001), but there were no statistically significant group differences on primary or secondary measures. Conclusions and Relevance: Combining behavioral and drug therapy yields greater improvements in OAB symptoms than drug therapy alone but not behavioral therapy alone. When using a stepped approach, it is reasonable to begin with behavioral therapy alone. Trial Registration: ClinicalTrials.gov identifier: NCT01175382.


Assuntos
Terapia Comportamental , Terapia por Exercício , Tartarato de Tolterodina/uso terapêutico , Bexiga Urinária Hiperativa/terapia , Incontinência Urinária/terapia , Agentes Urológicos/uso terapêutico , Idoso , Terapia Combinada , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Bexiga Urinária Hiperativa/tratamento farmacológico , Bexiga Urinária Hiperativa/psicologia , Incontinência Urinária/tratamento farmacológico , Incontinência Urinária/psicologia
16.
Health Qual Life Outcomes ; 18(1): 16, 2020 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-31992311

RESUMO

BACKGROUND: There is a large body of evidence showing that incontinence is associated with decreased health-related quality of life (HRQoL). Moreover, while a few cross-sectional studies have shown that incontinence is associated with decreased life satisfaction, there is a lack of studies regarding whether the onset of incontinence influences life satisfaction of affected individuals longitudinally. Thus, the objective of this study is: (i) to investigate the impact of incontinence on life satisfaction and (ii) whether this effect differed between women and men using a large population-based sample longitudinally. METHODS: Longitudinal data from 2008 to 2014 were retrieved from a nationally representative sample (9869 observations in regression analysis) of community-dwelling individuals aged 40 years and over (German Ageing Survey, DEAS). Physician-diagnosed incontinence was reported by respondents. Life satisfaction was quantified using the well-established Satisfaction with Life Scale. Linear fixed-effects regressions were used. RESULTS: After adjusting for potential confounders (e.g., self-rated health or depression), regressions revealed that the onset of incontinence was associated with a decline in life satisfaction in men (ß = -.25, p < .01), but not in the total sample and in women. These differences were significant (p < .05). In a further sensitivity analysis, individuals with cancer were excluded. However, in terms of significance and effect size, the impact of incontinence on life satisfaction in men remained almost the same in both models. CONCLUSIONS: The onset of incontinence markedly reduces life satisfaction among men aged 40 and over. Interventional strategies to postpone incontinence may assist in maintaining life satisfaction in men.


Assuntos
Incontinência Fecal/psicologia , Satisfação Pessoal , Qualidade de Vida/psicologia , Incontinência Urinária/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Alemanha , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Distribuição por Sexo , Inquéritos e Questionários
17.
Qual Life Res ; 29(5): 1311-1321, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31900760

RESUMO

PURPOSE: To estimate the prevalence of lower urinary tract symptoms (LUTS) in primary care using the International Continence Society symptom definition; to evaluate the association between LUTS and health-related quality of life (HRQOL); and to evaluate the treatment gaps. METHODS: Patients aged 40 and above were randomly recruited in a Hong Kong public primary care. Patients were asked (i) how often they experienced 18 individual LUTS during the past 4 weeks and (ii) whether they had sought treatments for their LUTS. The 12-Item Short Form Health Survey version 2 (SF-12 v2) and the modified Incontinence Impact Questionnaire-Short Form (IIQ-7) were used to measure HRQOL. RESULTS: 500 patients completed the survey. 75.8% of the patients had at least one LUTS "at least sometimes", with patients with a combination of storage, voiding, and post-micturition symptoms being the most prevalent (22.2%), followed by a combination of voiding and storage symptoms (14%). Only 14% of LUTS patients had sought treatments for their LUTS. LUTS was associated with a negative effect in all domains of the SF-12 v2 and IIQ-7 and patients with a combination of storage, voiding, and post-micturition symptoms had the worst HRQOL. Finally, having a combination of storage, voiding, and post-micturition symptoms and poorer HRQOL were factors associated with having sought treatments for LUTS. CONCLUSION: A high prevalence of LUTS but low treatment-seeking rates implied possible unmet needs of LUTS patients in primary care, suggesting the potential for more active interventions to alleviate the negative impact of LUTS on patients' HRQOL.


Assuntos
Sintomas do Trato Urinário Inferior/epidemiologia , Sintomas do Trato Urinário Inferior/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Qualidade de Vida/psicologia , Incontinência Urinária/psicologia , Estudos Transversais , Feminino , Comportamentos Relacionados com a Saúde , Inquéritos Epidemiológicos , Hong Kong/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Atenção Primária à Saúde , Inquéritos e Questionários , Micção/fisiologia
18.
Enferm. glob ; 19(57): 390-401, ene. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-193656

RESUMO

INTRODUCCIÓN: La incontinencia urinaria (IU) es la pérdida involuntaria de orina que constituye un problema social o higiénico importante y es demostrable de forma objetiva. Es un síntoma común que aparece en muchas enfermedades, afectando a todos los grupos de edad y a ambos sexos. En España se estima una prevalencia global de 24% en la mujer y 7% en el hombre, aumentando con la edad hasta el 50% y 29% respectivamente. A pesar de su repercusión en la calidad de vida se encuentra infradiagnosticada por diversos motivos. OBJETIVO: Determinar la prevalencia de la IU y sus factores asociados. MATERIAL Y MÉTODO: En este estudio epidemiológico observacional retrospectivo se recogieron datos de las historias clínicas de pacientes con IU de la Unidad de Suelo Pélvico del Área de Salud Este de Valladolid. RESULTADOS: Los tipos de incontinencia más frecuentes fueron: de esfuerzo (43,13%) y mixta (39,21%). Los factores de riesgo y patología asociada más importantes fueron episiotomía (57,1%) y cistocele (32,6%) en las mujeres y adenocarcinoma de próstata (60%) en los hombres. Tras tratamiento rehabilitador en un intervalo de 2 a 3 meses mejoraron las respuestas en los cuestionarios de incontinencia urinaria (ICIQ-SF). CONCLUSIONES: Los datos recopilados están en consonancia con estudios revisados, y viendo los avances en prevención y tratamiento de IU resulta coherente su abordaje multidisciplinar


INTRODUCTION: Urinary incontinence (UI) is the involuntary loss of urine that is a major social or hygienic problem and is objectively provable. It is a common symptom that appears in many diseases, affecting all age groups and both sexes. In Spain it is estimated a prevalence of 24% in women and 7% in men, increasing with age up to 50% and 29% respectively. Despite its impact on quality of life, it is under-diagnosed for various reasons. OBJECTIVE: To determine the prevalence of UI and its associated factors. MATERIAL AND METHOD: In this retrospective longitudinal epidemiological study data were collected from the medical histories of patients with UI belonging to the Pelvic Floor Unit of the East Health Area in Valladolid. RESULTS: The most frequent types of incontinence were: effort (43,13%) and mixed (39,21%). The most important risk factors and associated diseases were episiotomy (57.1%) and cystocele (32.6%) in women and adenocarcinoma of prostate (60%) in men. Responses in the questionnaires of urinary incontinence (ICIQ-SF) improved after 2-3 months of rehabilitation treatment. CONCLUSIONS: The collected data are consistent with studies reviewed, and seeing the progress in prevention and treatment of UI, multidisciplinary approach is coherent


Assuntos
Humanos , Masculino , Feminino , Incontinência Urinária/epidemiologia , Cuidados de Enfermagem/métodos , Programas de Rastreamento/tendências , Distúrbios do Assoalho Pélvico/epidemiologia , Prevalência , Espanha/epidemiologia , Estudos Retrospectivos , Incontinência Urinária/psicologia , Fatores de Risco , Qualidade de Vida/psicologia , Perfil de Impacto da Doença
19.
Neurourol Urodyn ; 39(1): 25-34, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31692067

RESUMO

AIMS: To analyze the psychometric properties of instruments measure knowledge and/or attitude and/or practice related to urinary incontinence (UI). METHODS: This review was conducted in September 2018 without restrictions regarding language and year of publication. DATA SOURCES: MEDLINE/PubMed, CINAHL, SCOPUS, PsycINFO, Web of Science, Cochrane, LILACS, and Google. The psychometric properties were evaluated using the COnsensus-based Standards for the selection of health status Measurement INstruments and the Quality Criteria for Measurement Properties. RESULTS: A total of seven articles published between 1999 and 2018 were included. The evaluation of the psychometric properties showed that the majority of the instruments presented "excellent" or "good" methodological quality; however, the description of aspects related to the validation stages was inadequate in some studies, causing the quality of the results to be evaluated as "indeterminate" in some properties. This review cannot recommend any questionnaire without reservations; however, the Urinary Incontinence Scales and the Barriers Incontinence Care Seeking Questionnaire presented better evaluations, regarding both methodological quality and the quality of the results. CONCLUSION: This review provides a strategy to select the most suitable instrument to assess knowledge, attitude, and practice regarding UI, according to the psychometric properties, guiding their use by researchers in clinical practice.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Psicometria , Incontinência Urinária/diagnóstico , Incontinência Urinária/psicologia , Humanos , Sintomas do Trato Urinário Inferior/diagnóstico , Sintomas do Trato Urinário Inferior/psicologia , Aceitação pelo Paciente de Cuidados de Saúde
20.
Am J Nurs ; 120(1): 57-62, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31880731

RESUMO

This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aim to help nurses provide caregivers with the tools they need to manage their family member's health care at home.The articles in this new installment of the series provide simple and useful instructions that nurses should reinforce with family caregivers. This article is the first of two that provide an update on urinary incontinence and its management in older adults. The second article will contain an informational tear sheet-Information for Family Caregivers-that contains links to the instructional videos. To use this series, nurses should read the articles first, so they understand how best to help family caregivers, and then encourage caregivers to watch the videos and ask questions. In this article, the videos can be found in Resources for Nurses.


Assuntos
Cuidadores/educação , Cuidadores/psicologia , Família/psicologia , Cuidados de Enfermagem/normas , Guias de Prática Clínica como Assunto , Incontinência Urinária/enfermagem , Incontinência Urinária/psicologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade
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