Getting on with life: Daily-living management of urinary incontinence for community-dwelling people

Abstract

Title: Getting on with life: Daily-living management of urinary incontinence for community-dwelling people

Objectives: Urinary incontinence is a chronic condition commonly experienced by community-dwelling women and men of all ages. Approximately 3.84 million Australians (3.1 million/38.1% women; 780,000/10.2% men) suffer from this condition(1). People with urinary incontinence use adaptive daily-living strategies to help normalise incontinence in their daily lives. This multi-method project explored strategies for daily-living self-management of persistent urinary incontinence used by community-dwelling, working-age women, retired-aged women and men. The aims of this project were to: 1. Identify which symptoms and situations are the most bothersome; and 2. Identify daily-living self management strategies for managing urinary incontinence.

Methods: To explore the perspectives of people who live with incontinence, 310 community-dwelling women and men and were surveyed and 29 participated in in-depth interviews. The questionnaire included items related to: demographic information, activity level, severity and duration of urinary incontinence, impact on daily life, daily-living strategies, and management difficulties experienced. Interviews explored clients' perspectives on how and why they developed strategies for managing urinary incontinence. A survey of 84 continence nurse specialists was conducted to explore current best practice for client advice on daily-living self management of urinary incontinence.

Results: The most difficult incontinence symptoms to manage were those that: occur frequently, publicly, have social stigma, or over which there is limited control. To prevent, reduce or manage urinary incontinence episodes, participants used modifying, concealing, containing and restricting strategies applied to everyday functions including: planning, routines, toileting, using pads and aids, adjusting diet and fluids, body care and hygiene, physical activity and exercise, modifying the environment, and managing social situations. Participants distinguished between treatment and managing socially, and strategies used at home and when out. Health professional advice could be ignored, if short-term social continence could be maintained.

Conclusions: Understanding the strategies that women and men use to manage incontinence in their daily lives will enable community nurses to assist people with urinary incontinence to develop effective daily-living continence management strategies and provide differentiated advice, based on clients' settings and activities. This study provided the evidence for development of evidence-based materials for clients and advice guidelines for generalist health professionals.

1. Australian Institute of Health and Welfare (AIHW). (2006). Australian incontinence data analysis and development. AIHW cat. no. DIS44. Canberra: AIHW. Confirm

Acknowledgement: Project Funded by a National Continence Management Strategy Innovative Grant.

Project study resulted in materials published by the Australian Government Department of Health and Ageing. St John, W., Wallis, M., McKenzie, S., & Griffiths, S. (2007). … what now?: Helping clients live positively with urinary incontinence. Canberra: Australian Federal Government, Department of Health and Ageing. Available: http://www.bladderbowel.gov.au/doc/HelpingClients.pdf St John, W., Wallis, M., McKenzie, S., & Griffiths, S. (2007). Live better with urinary incontinence. Canberra: Australian Federal Government, Department of Health and Ageing. Available: http://www.bladderbowel.gov.au/doc/LiveBetter.pdf