MacKay K, Hemmett L
Barnet, Enfield and Haringey Health Authority, Holbrook House, The Hyde, Cockfosters Road, London NW9 6QQ.
Br J Gen Pract. 2001 Oct;51(471):801-4.
The prevalence of urinary incontinence in women is difficult to estimate because definitions vary between researchers and among women, for whom thresholds of complaint differ. However, studies have also shown that only about a quarter of women affected by urinary incontinence consult a doctor for their symptoms, despite evidence of effective treatments and better management of the condition in primary care.
To assess the perceived needs of women with urinary incontinence living at home.
Cross-sectional community survey.
A 1% stratified random sample of women living at home, registered with a local GP, and aged 45 years and over (n = 720) in a north London district health authority with a total population of 308,000.
Out of 720 questionnaires, 489 were returned completed (68%). A total of 227 (46%) women had symptoms of significant urinary incontinence. Seventy-eight (16%) had significant symptoms which they said were not a problem, and 149 (30%) of the total number of responders acknowledged that they had significant symptoms and that these symptoms were a problem for them; of these, 48 (32%) sought help from their GP; 16 out of the 48 consulting their GP were happy with the treatment given, and the remaining 101 women who considered their incontinence to be a problem had not consulted their GP and 76 of those had also not told anyone else that they had a problem. The commonest reasons given by the 101 women who admitted having a problem and who had not consulted their GPs were that they thought that they should cope on their own (43 [42.6%]), that incontinence was inevitable with age (26 [25.7%]) or that it was embarrassing to talk about the problem to their GP (14 [13.8%]).
Despite the existence of effective interventions for urinary incontinence, many women who are incontinent do not seek help even when they perceive their incontinence to be a problem. Half of the women who did consult their GP did not find the treatment offered helpful. Achieving health gain for women with urinary incontinence will require a more active approach than currently exists to inform people that better care is available, to help counteract the stigma attached to the problem, and to ensure that primary care professionals are able to provide effective services.
女性尿失禁的患病率难以估计，因为不同研究者之间以及女性自身对于尿失禁的定义存在差异，她们对症状的阈值也不尽相同。然而，研究还表明，尽管有证据表明在初级保健中尿失禁有有效的治疗方法和更好的管理措施，但只有约四分之一受尿失禁影响的女性会因症状就医。
评估居家生活的尿失禁女性的感知需求。
横断面社区调查。
在伦敦北部一个拥有30.8万总人口的地区卫生管理局中，从当地全科医生处登记在册、年龄在45岁及以上且居家生活的女性中抽取1%的分层随机样本（n = 720）。
720份问卷中，489份被完整返还（68%）。共有227名（46%）女性有明显的尿失禁症状。78名（16%）女性有明显症状，但她们表示这不是问题；在所有回复者中，149名（30%）承认自己有明显症状，且这些症状对她们来说是个问题；其中，48名（32%）向全科医生寻求了帮助；在这48名咨询全科医生的女性中，16名对所接受的治疗感到满意，其余101名认为自己的尿失禁是个问题的女性没有咨询全科医生，其中76名也没有告诉其他人她们有这个问题。在这101名承认有问题但未咨询全科医生的女性中，最常见的原因是她们认为自己应该独自应对（43名[42.6%]）、尿失禁是年龄增长不可避免的（26名[25.7%]）或向全科医生谈论这个问题很尴尬（14名[13.8%]）。
尽管存在针对尿失禁的有效干预措施，但许多尿失禁女性即使认为自己的尿失禁是个问题也不寻求帮助。在咨询全科医生的女性中，有一半认为所提供的治疗没有帮助。要让尿失禁女性获得健康改善，需要采取比目前更积极的方法，告知人们有更好的护理可供选择，帮助消除与该问题相关的耻辱感，并确保初级保健专业人员能够提供有效的服务。
