Urinary incontinence in community dwelling elderly: Are there sex differences in help-seeking behaviour?

Abstract

Objective - To assess sex differences in disorder- and patient-specific factors influencing help-seeking behaviour by independently living elderly people with urinary incontinence. Design - Qualitative and quantitative analyses of the collected data. Setting - Patients from nine family practices involved in the Nijmegen Monitoring Project. Subjects - Independently living elderly aged 60 or over. Main outcome measures - The study population consisted of participants in a study on the prevalence of incontinence among elderly people. Independently living elderly people aged 60 or over from nine family practices with uncomplicated urinary incontinence were interviewed at home using a disorder-specific questionnaire and open-ended questions. Results - In total, 56 men and 314 women were interviewed. Half of them had sought help from a general practitioner. Men sought help from their GP when they had less severe incontinence than women. Help-seeking behaviour in women was related to the duration of symptoms (odds ratio 3.66, 95% CI 1.44-9.39), the presence of incontinence-related symptoms such as constant feeling of vaginal pressure and pain in the lower abdomen (odds ratio 2.69, 95% CI 1.52-4.76) and the severity of incontinence (odds ratio 1.69, 95% CI 0.99-2.88). In men help-seeking was related to the distress experienced in daily life (odds ratio 7.10, 95% CI 1.15-43.91). Most men and women who did not seek help consider their incontinence as not being serious enough, or they had inappropriate beliefs such as that "incontinence is age-related" and "there is nothing that can be done about incontinence". Conclusion - Help-seeking in women is determined by the duration of the symptoms, the presence of concomitant complaints and the severity of incontinence. In men help-seeking behaviour is mostly related to the distress experienced in daily life. In men and women the most important reasons for not seeking help are that they consider the incontinence not serious enough and that they believe that there are no treatment options available.