Strategies and decision-making in self-care for urinary incontinence

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Urinary incontinence (UI) is a prevalent condition with a wide range of psychosocial impact. Behavioral therapies such as pelvic floor muscle exercises, bladder training, and dietary modification are generally considered to be the first line of treatment because of their non-invasive nature, yet little is known about the ability/motivation of individuals to maintain them and current evidence suggests performance may be sporadic at best. The purpose of this qualitative descriptive study was to enhance understanding about the strategies people with UI perform at home, factors that influence their self-care choices, and factors that facilitate or impede on-going performance of behavioural therapies. Three major themes emerged from qualitative content analysis of individual (n=25) and focus group (n=3) interviews. First, participants' self-care efforts were motivated by the desire for a normal lifestyle. Strategies perceived to be personally disruptive (for example bladder training) were either not initiated or not maintained. Second, seeing enhanced believing. Participants were motivated by first or second-hand experience of UI, by experiencing the positive or negative consequences of their self-care behavior, and by heightened awareness of progress through biofeedback and follow-up. Finally, barriers to UI care persist at personal and societal levels. Social stigmatization, self-blame, financial cost, and unclear care pathways had negatively impacted participants' help-seeking behaviour and care. Findings suggest the need to focus on individual as well as social realities of UI and UI care and develop therapeutic interventions that enable sufficient choice and flexibility to promote quality of life.
Bibliography: p. 141-157
Milne, J. L. (2003). Strategies and decision-making in self-care for urinary incontinence (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from doi:10.11575/PRISM/24515