Khanijow Kavita D, Pahwa Avita K, Newman Diane K, Arya Lily A, Andy Uduak U
Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA.
Division of Urology, Department of Surgery, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA.
Female Pelvic Med Reconstr Surg. 2018 Jul/Aug;24(4):301-306. doi: 10.1097/SPV.0000000000000460.
The aim of this study was to describe important barriers to exercise in older women with urgency urinary incontinence (UUI) from the patient and provider perspectives.
Six focus groups (2 in active women, 2 in sedentary women, and 2 in providers) were conducted with 36 women with UUI and 18 providers. Focus group discussions were transcribed verbatim. All transcripts were coded and analyzed by 2 independent reviewers. Investigators identified emergent themes and concepts using a modified biopsychosocial conceptual model.
A wide range of physical, psychological, social, and environmental factors were perceived to influence exercise. Although women with UUI identified pain as a strong barrier to exercise, providers did not. Both women with UUI and providers identified shame associated with incontinence as a significant barrier, and, conversely, satisfaction with UUI treatment was noted as an enabler for exercising. Women and providers had incongruent views on the need for supervision during exercise; women viewed supervision as a barrier to exercise, whereas providers viewed lack of supervision as a barrier to exercise. Opportunity for socialization was noted as a major enabler of exercise by all groups and suggests that exercise programs that promote interactions with peers may increase exercise participation. The importance of financial incentive and reimbursement was congruent between women and their providers.
Women with UUI have unique perspectives on barriers to exercise. Understanding women's perspective can aid clinicians and researchers in improving exercise counseling and in creating exercise programs for women with UUI.
本研究旨在从患者和医疗服务提供者的角度，描述老年急迫性尿失禁（UUI）女性在运动方面的重要障碍。
对36名患有UUI的女性和18名医疗服务提供者进行了6个焦点小组访谈（活跃女性组2个，久坐女性组2个，医疗服务提供者组2个）。焦点小组讨论内容逐字记录。所有记录由2名独立审阅者进行编码和分析。研究人员使用改良的生物心理社会概念模型确定新出现的主题和概念。
人们认为多种身体、心理、社会和环境因素会影响运动。尽管患有UUI的女性将疼痛视为运动的强大障碍，但医疗服务提供者却不这么认为。患有UUI的女性和医疗服务提供者都认为与尿失禁相关的羞耻感是一个重大障碍，相反，对UUI治疗的满意度被认为是运动的一个促进因素。女性和医疗服务提供者在运动期间对监督需求的看法不一致；女性将监督视为运动的障碍，而医疗服务提供者则将缺乏监督视为运动的障碍。社交机会被所有小组视为运动的主要促进因素，这表明促进与同龄人互动的运动项目可能会增加运动参与度。女性及其医疗服务提供者对经济激励和报销的重要性看法一致。
患有UUI的女性对运动障碍有独特的看法。了解女性的观点有助于临床医生和研究人员改善运动咨询，并为患有UUI的女性制定运动计划。
