Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9A, 2. Sal, 5000, Odense C, Denmark.
BMC Urol. 2021 Jul 12;21(1):99. doi: 10.1186/s12894-021-00864-x.
Urinary incontinence (UI) is a frequently occurring condition among women and increases with age. Effective treatments exist but many women hesitate to contact their general practitioner (GP) regarding UI. Therefore, it is important to generate knowledge regarding barriers for healthcare-seeking. Several factors such as age, duration and number of symptoms are associated with healthcare-seeking. How socioeconomic status (SES) is associated with experiencing barriers for healthcare-seeking for UI has not been explored. The objectives of this study were to: (1) analyze frequencies of barriers for healthcare-seeking, and (2) investigate associations between SES and barriers for contacting the GP, among women reporting bothersome UI.
A cross-sectional web-based questionnaire study of symptoms occurrence among 51,090 randomly selected women. This study investigates reported symptoms of three types of UI (stress UI, urge UI and UI without stress or urge) and reported barriers for GP contact combined with register data on SES.
A total of 4,051 (16.4%) women reported to be bothered by either stress UI (9.1%), urge UI (4.0%) or incontinence without stress or urge (2.4%) and 76.3%, 70%, and 64% respectively, had not contacted their GP regarding the symptom(s). The most frequently reported barriers were 'being too embarrassed' (19.3%) and 'being too busy' (18.4%) for stress incontinence, and 'being too embarrassed (19.0%) or 'worried about wasting the doctor's time' (16.9%) for women with bothersome urge UI or UI without stress or urge. Younger women had higher odds of reporting barriers and the barriers embarrassment and being worried about what the doctor might find were significantly associated with lower educational level.
Women with lower educational level have an increased risk of not seeking healthcare for UI symptoms. The GP should be aware of identifying women bothered by UI for whom effective treatment options to alleviate the symptoms are available.
尿失禁(UI)是女性中常见的病症,并随着年龄的增长而增加。虽然有有效的治疗方法,但许多女性在涉及尿失禁问题时,会犹豫是否要联系她们的全科医生(GP)。因此,了解寻求医疗保健的障碍因素非常重要。许多因素,如年龄、症状持续时间和数量,与寻求医疗保健有关。社会经济地位(SES)与寻求尿失禁医疗保健的障碍之间的关系尚未得到探索。本研究的目的是:(1)分析寻求医疗保健的障碍的频率,(2)调查报告有麻烦的尿失禁的女性中,SES 与联系 GP 的障碍之间的关系。
这是一项基于网络的横断面调查,随机抽取了 51090 名女性,调查她们的症状发生情况。本研究调查了三种类型的尿失禁(压力性尿失禁、急迫性尿失禁和无压力或急迫性尿失禁)的报告症状,以及报告的与联系 GP 相关的障碍,并结合 SES 的登记数据。
共有 4051 名(16.4%)女性报告称,她们受到压力性尿失禁(9.1%)、急迫性尿失禁(4.0%)或无压力或急迫性尿失禁(2.4%)的困扰,分别有 76.3%、70%和 64%的女性没有就这些症状联系她们的 GP。最常报告的障碍是压力性尿失禁的“尴尬”(19.3%)和“忙碌”(18.4%),急迫性尿失禁或无压力或急迫性尿失禁的“尴尬”(19.0%)或“担心浪费医生的时间”(16.9%)。年轻女性报告障碍的可能性更高,尴尬和担心医生可能发现的问题这两个障碍与较低的教育水平显著相关。
教育程度较低的女性更有可能不寻求治疗尿失禁症状的医疗保健。GP 应该意识到,对于那些有麻烦的尿失禁患者,有有效的治疗方法可以缓解她们的症状。