Grealish M, O'Dowd T C
North Western Health Board, Sligo General Hospital, Ireland.
Br J Gen Pract. 1998 Feb;48(427):975-7.
Urinary incontinence is a common problem for adult women. It results in a large financial and psychosocial cost. Much urinary incontinence goes unreported. Women with urinary incontinence can be successfully assessed and treated in general practice but studies have shown that many GPs manage the condition inadequately.
This study aims to examine GPs' awareness of urinary incontinence in women and their management of, and attitudes to, female urinary incontinence.
A qualitative study was conducted with 21 GPs responding to semi-structured interviews. Thematic analysis was carried out on these interviews, with recurrent views and experiences being identified and grouped.
The interviews of 11 male and nine female GPs were suitable for analysis. GPs were aware of the prevalence and under-reporting of urinary incontinence in women. Many were unhappy with their own management of the condition and with the management options available to them. Male GPs in particular were reluctant to carry out gynaecological examinations, and few GPs expressed enthusiasm for teaching pelvic floor exercises or bladder drills. Medications were frequently used but generally considered ineffective or intolerable. The services of both public health nurses and practice nurses were under-used, largely because of lack of training in this area. Although incontinence nurses were employed in the area, many GPs did not know of their availability and, of those who did, few referred to them more than infrequently.
This study demonstrates that many GPs avoid dealing with the problem of urinary incontinence in women and that they find it to be a difficult, chronic problem to treat. Specialist options seem not to be useful in general practice. The findings need to be explored in other GP settings.
尿失禁是成年女性的常见问题。它会导致巨大的经济和心理社会成本。许多尿失禁情况未被报告。尿失禁女性患者可在全科医疗中得到成功评估和治疗，但研究表明，许多全科医生对该病症的处理并不充分。
本研究旨在调查全科医生对女性尿失禁的认知、对女性尿失禁的处理方式及态度。
对21名全科医生进行半结构化访谈，开展定性研究。对这些访谈进行主题分析，识别并归纳反复出现的观点和经历。
11名男性和9名女性全科医生的访谈适合进行分析。全科医生了解女性尿失禁的患病率及未报告情况。许多人对自己对该病症的处理方式以及现有的处理选项不满意。尤其是男性全科医生不愿进行妇科检查，很少有全科医生对教授盆底肌锻炼或膀胱训练表现出热情。药物使用频繁，但普遍认为效果不佳或难以耐受。公共卫生护士和执业护士的服务未得到充分利用，主要原因是该领域缺乏培训。尽管该地区聘用了尿失禁护理人员，但许多全科医生不知道有这些人员，而知道的人当中，很少有人会经常转诊患者。
本研究表明，许多全科医生回避处理女性尿失禁问题，且认为这是一个难以治疗的慢性问题。专科治疗选项在全科医疗中似乎并无用处。这些研究结果需要在其他全科医疗环境中进一步探讨。
