Seeking consultation for urinary incontinence: Behaviours and barriers among Jordanian women.

ABSTRACT

INTRODUCTION: The rates of seeking consultation for urinary incontinence (UI) and the barriers against consultations vary among countries and study populations and are influenced by various factors such as embarrassment, perception of illness, resources and culture. OBJECTIVES: To study healthcare-seeking behaviours and barriers among Jordanian women. METHODS: Between 1 March 2020 and 15 April 2020, we conducted a cross-sectional online survey among women 18 years of age or more who have UI and have access to the internet. We collected women's characteristics, UI types, severity, bother, seeking consultation behaviours and barriers. Logistic regression analyses were used to study the variables associated with seeking consultation. RESULTS: The data of 1454 women with a mean age (SD) of 41.5 (11.5) years were analysed. Mixed UI was the most common type (56.3%), while 43.8% of the participants sought consultation, and 33.8% waited 1 year before seeking consultation. The most common barriers were embarrassment (52.2%), considering UI as a normal occurrence with ageing (41.5%), and limited expectations of improvement from treatment (42.0%). The most common barriers vary according to UI type. Embarrassment was the most commonly reported barrier by women with mixed UI (29.4%), UI as normal with ageing was mostly considered by women with stress UI (11.5%) and treatment for UI is going to be expensive was expressed by women with mixed UI (19.4%). Seeking consultation decreased among women with more educational achievement (adjusted odds ratio [aOR] 0.62; 95% confidence interval [CI] 0.44-0.87) with university graduates doing so less than women with high school or less educational achievement. Additionally, seeking consultation was more among women who were aware of a family member with UI (aOR 1.44; 95% CI 1.03-2.01) compared to women who were not. Also, multiparous women (aOR 1.8; 95% CI 1.19-2.77) sought consultation more than nulliparous women. Seeking a consultation was more among women who were bothered by the impact of UI on various daily activities, namely, household activities (aOR 1.42; 95% CI 0.85-2.37), prayers (aOR 1.7; 95% CI 1.07-2.71) and sex life (aOR 2.48; 95% CI 1.45-4.21) compared to women who were not bothered. Seeking a consultation was less among women who reported embarrassment as a barrier (aOR 0.534; 95% CI 0.34-0.84) compared to women who were not embarrassed. CONCLUSION: Four in 10 women with UI sought care, but with a considerable delay between the onset of symptoms and actual care seeking. These outcomes could be explained by the impact of various barriers. Additionally, barriers might vary in different cultures and countries, so culture-sensitive questionnaires should be considered when healthcare-seeking consultations and barriers are studied.