One hundred and fifty men with urinary incontinence. II. Help seeking and self care.

150 Norwegian men with urinary incontinence living in the community were interviewed about their self care and help seeking behaviour. They were recruited to the study after responding to a marketing campaign for incontinence aids. A wide variety of control measures was used, the most popular being absorbent products. 25 men had not used any control measure. 104 men had mentioned their problem to a doctor. The consultation rate increased with the severity of urinary incontinence but was not correlated to its type or duration, nor to the patient's age or marital status. A multiple regression analysis showed that none of the recorded variables explained more than 10% of the total variation in consultation rate, and that no combination of variables explained more than 12%. Subtle personal and idiosyncratic mechanisms are probably more important, thus presenting a challenge for the case-finding strategy in general practice for urinary incontinence in men.     

Levels of comfort and ease among patients suffering from urinary incontinence

Urinary incontinence is a common phenomenon among women, which harms social ties and is perceived as embarrassing and incurable. Despite its prevalence, there are few studies that have examined how those affected by this syndrome feel. The goal of this study was to examine the personal characteristics and levels of comfort among women suffering from urinary incontinence. The study included 50 women who had been diagnosed as suffering from urinary incontinence. The participants answered the Urinary Incontinence and Frequency Comfort Questionnaire, which examines levels of physical, mental, social and environmental comfort. α reliability has been found to be high in previous studies (α= 0·82). Our findings indicated that urinary incontinence occurred among the patients from several times a day to several times a week caused by sneezing, coughing and laughing. Most participants delayed treatment for up to 3 years. The general level of comfort was identified as medium low (SD = 0·04, M= 2·95) from a possible range of 1–6. Particularly low levels of comfort were recorded on items such as ‘I feel clean and fresh,’‘finding a toilet in close proximity is a worrisome issue when I exit the house’ and ‘I fear having sex due to the urinary incontinence problem’. Identifying patients’ needs and understanding their emotions are a useful basis for nursing intervention in promoting quality of life.     

Personal and social determinants of health services utilization by Mexican older people

de córdova m.i.p ., mier n., curi e.j.m. , gómez t.g., quirarte n.h.g. & barrios f.f. (2009) Personal and social determinants of health services utilization by Mexican older people. International Journal of Older People Nursing 5 , 193–201
doi: 10.1111/j.1748-3743.2009.00193.x Background. Increased healthcare needs among older individuals around the world demands a better understanding of factors influencing healthcare service utilization patterns. Objective. To examine personal and social correlates to health services utilization among Mexican older persons. Design and methods. This was a cross-sectional study conducted between 2004 and 2006 with 2030 Mexican adults 60 years and older and based on a health services utilization framework. A two-stage cluster sampling with probability proportionate to size was used. Participants were randomly selected and recruited in four metropolitan areas in Northeastern Mexico. Chi-square and Pearson’s chi-squared tests and logistic regression were used for data analyses. Results. Significantly more women than men had lost a spouse and were illiterate. Also, females reported significantly poorer health, higher nutritional risk and lower ability to perform activities of daily and instrumental living than males. Predictors of healthcare utilization were: Having a caregiver during an illness; perceiving to have a health problem; being able to afford food, and having children. Conclusions. Predisposing, enabling and need factors are strong predictors of health services utilization among Mexican older persons. In addition, gender differences exist among this population in relation to health status, but not to health services demands.     

Perinatal urinary and fecal incontinence: suffering in silence

This article focuses on the prevention, identification, and management of urinary and fecal incontinence in the perinatal period. Both urinary and fecal incontinence are common concerns affecting women throughout pregnancy, intrapartum, and postpartum. These are the problems that are not approached by healthcare providers during the initial antepartal assessment, nor are they fully investigated after delivery. Many women hesitate to disclose this information. Women tend to consider this to be a minor discomfort of pregnancy and a consequence resulting from childbirth in the postpartum period. Intervention strategies and nursing care components in the perinatal period will be presented.     

健康教育对社区老年人尿失禁知识和态度的影响

[目的]探讨健康教育对社区老年人尿失禁知识和态度的影响.[方法]对97名社区老年人进行尿失禁相关知识的健康教育,并于健康教育前后采用自行设计的问卷进行测评.[结果]对社区老年人进行健康教育后有关尿失禁危险因素、症状因素、影响因素、预防因素方面知识答对率显著高于健康教育前(P＜0.01),而有关尿失禁治疗因素、管理因素方面知识答对率尽管高于健康教育前,但差异无统计学意义(P＞0.05);社区老年人健康教育后的尿失禁态度得分明显高于健康教育前(P＜0.05).[结论]健康教育能提高社区老年人尿失禁知识水平,间接地增强社区老年人对待尿失禁的积极态度.     

Help seeking by health professionals for addiction: A mixed studies review

BackgroundWhen health professionals practice with active and untreated addiction, it is a complex occupational and professional issue impacting numerous stakeholders. Health professionals are responsive to evidence-based addiction interventions and their return-to-work has been demonstrated to be achievable, sustainable and safe. Facilitating help seeking in health professionals with addiction is a priority for reducing associated risks to their health and to patient safety.AimThe purpose of this study was to identify the process by which health professionals seek help for addiction, and factors that facilitate and deter help seeking, through a review of the qualitative and quantitative literature.MethodsBoth phases of this sequential mixed studies review followed the standard systematic review steps of: (1) identifying the review question, (2) defining eligibility criteria, (3) applying an extensive search strategy, (4) independent screening of titles and abstracts, (5) selecting relevant studies based on reviewing the full text, (6) appraising the quality of included studies, and (7) synthesizing the study findings. Our two searches of five databases from 1995 to 2015 resulted in the inclusion of eight qualitative and twenty-three quantitative studies. We first conducted a meta-synthesis of the qualitative literature to garner an understanding of the help seeking process for health professionals for addiction. We then conducted a narrative synthesis of the quantitative studies to generalize these findings through examining the data for convergent, complementary or divergent results.ResultsSynthesis of the included qualitative studies revealed that the professional and experiential context of healthcare compromised the health professional's readiness to seek help for addiction. Typically, a pivotal event initiated the help seeking process. The studies in the quantitative review identified that help seeking most often resulted from reports of adverse events to formal organizations such as their employer and regulatory bodies. This process does not adequately address the scope of health professionals requiring help for addiction. Informal sources such as colleagues and family, often aware of the addiction earlier, preferred referral to voluntary, confidential treatment programs.ConclusionsFacilitating the help seeking process for health professionals with addiction in as effective strategy to reduce the associated risks to the health professional, their families and colleagues, their employers and regulatory bodies, and to the general public. Our findings suggest that intervention is possible at multiple points in the help seeking process for health professionals with addiction. Confidential, compassionate and supportive alternatives offer potential for closing this gap.     

Poverty reduction by improving health and social services in Vietnam

This article describes the development and implementation of a five-year plan for the reduction of poverty and the enhancement of human development through improving public health and social services in rural Vietnam. This plan was achieved by training the trainers and building capacity for the social workers. The project was a collaborative effort between the Schools of Nursing and Social Work at Memorial University, Newfoundland and Labrador, Canada and the University of Labor and Social Affairs, Hanoi, Vietnam. The collaboration was also committed to improving the quality of social work education and training in Vietnam. All the project's objectives were achieved beyond original expectations. The actual outcomes are sustainable and in addition gender equality has been a cross-cutting theme.     

尿失禁病人的家庭护理和健康指导

尿失禁是指客观存在的非自主的尿液漏出，是泌尿系统常见症状。引起尿失禁的原因有疾病、精神、心理等因索且较复杂。老年人患有尿失禁者高达55％，因各种原因而不能在医院里接受治疗和护理的占70％以上，很多病人因怕被人嘲笑或丧失尊严，不敢多饮水，甚至拒绝外出，使其生活质量受到严重影响。因此，尿失禁已经成为一个令人关注的社会问题。自1998年我院社区服务中心开设以来，为328例尿失禁病人提供了家庭护理和健康指导，使病人尿失禁状况得到极大改善，生活质量提高。现报道如下。     

尿失禁病人的家庭护理和健康指导

尿失禁是指客观存在的非自主的尿液漏出,是泌尿系统常见症状。引起尿失禁的原因有疾病、精神、心理等因素且较复杂[1]。老年人患有尿失禁者高达55%[2],因各种原因而不能在医院里接受治疗和护理的占70%以上,很多病人因怕被人嘲笑或丧失尊严,不敢多饮水,甚至拒绝外出,使其生活质量受到严重影响。因此,尿失禁已经成为一个令人关注的社会问题。自1998年我院社区服务中心开设以来,为328例尿失禁病人提供了家庭护理和健康指导,使病人尿失禁状况得到极大改善,生活质量提高。现报道如下。1临床资料本组328例,其中女203例,男125例,年龄最大91岁,最小5…     

Information needs and information seeking behaviour in primary health care

A questionnaire survey of 186 general practitioners in Sweden showed that 67% saw the overall supply of medical information as less satisfactory or unsatisfactory, and that 80% experienced major hindrances in seeking relevant information. The most frequent need for information concerned general medicine, with respect to both diagnosis and choice of therapy. Of situations which required additional information, only every second was completely resolved. These results imply a need for a reorganization of the supply of information to general practitioners. As they cannot depend on conventional medical libraries for day-to-day information, personal libraries should be improved and updated regularly, and be readily to hand. Computer technology should be considered for communication between health care providers, and as support for differential diagnosis in general medicine.     

Providing seamless community health and social services

This article reviews a variety of Government community health policies and initiatives, from the NHS and Community Care Act 1990 to the emergence of primary care groups (PGCs). The Labour administration abolished GP fundholding and has placed considerable emphasis on its commitment to partnership with the care professions. The Government is also expecting a commitment to partnership between the community care professions in order to reflect the entwined social and health-care needs of the individual requiring care in the community. The role of the district nursing service has been brought into focus with the opportunity of representation at PCG board level. Evaluating how a district nursing service may integrate with social services is therefore, and appropriate strategy for assessing whether recent policy initiatives go far enough at grass roots level in facilitating collaboration and quality community care.     

A review of the psychosocial predictors of help-seeking behaviour and impact on quality of life in people with urinary incontinence

Although urinary incontinence is common and can have a substantial impact on an individual's quality of life, few people seek help for this symptom. This paper examines a theoretical framework proposed by Shaw (1999) as a possible explanatory model for help-seeking and the impact of incontinence on a person's quality of life. Although aetiology and symptom severity are important predictors of behaviour and impact of symptoms, they did not explain all the variation and so other predictors proposed by the model were explored. Appraisals of illness and coping resources were found to be important moderating factors between the experience of symptoms and subsequent behaviour and outcome in urinary incontinence. In the appraisal of symptoms, lack of knowledge of the causes and treatments of urinary incontinence can be a barrier to help-seeking and successful outcome. Other factors such as personality, group differences, and social support can contribute to the appraisal process. Areas for future research and implications for clinical practice are discussed.     

Public awareness and health education: findings from an evaluation of health services for incontinence in England

Improving the health and well being of local populations is a feature of international and national health policy and initiatives. Promotion of health has been attempted traditionally via health education and public awareness campaigns. More recently, attention has been drawn to inter-agency collaboration and alliances in formalised health improvement programmes. This study has evaluated health services for incontinence in two health authorities in England in relation to health education and public awareness. One health authority had an established continence service and the other did not. A convenience sample of self selecting respondents from an earlier postal survey were interviewed via the telephone (n=376). Significantly, more people in the health authority with a continence service than the one without received information on incontinence from within formal health services (p<0.001) and read about services in health centres and clinics (p<0.001), whereas people in the health authority without a continence service were more likely to obtain information on incontinence from local newspapers (p<0.01) and local chemist shops (p<0.01). People in the health authority without a continence service were significantly more likely to feel that services could be improved than those where there was a service (p<0.0001). Only a minority of people with incontinence had received information about their condition or related health care and services. The availability of a continence service significantly influenced the information received. More information on incontinence had been obtained from informal sources than formal health sources. Local initiatives on the availability of services and how to access them, as well as health education information on incontinence may be more effective in raising public awareness and should supplement national campaigns.     

Prevalence of urinary incontinence and its relationship with health status

A postal survey of two random samples of adult populations within two health authorities in the UK was undertaken during 1994. One health authority had an established continence advisory service (HA1) and the other one did not have a continence advisory service (HA2). A total of 12,529 patients (HA1, 6319; HA2, 6210) were mailed a structured questionnaire and 53% (n = 6139) returned completed questionnaires. A point prevalence of current urinary incontinence of 9% (n = 519, 95% CI, or confidence interval, from 7.9% to 9.3%) was found. A large number of people within the populations had experienced urinary incontinence at some time during their adult years (23%, n = 1427, 95% CI from 22.2% to 24.3%). People who were incontinent had a significantly lower health status than people who were continent (mean scores across all eight domains of the Short Form 36, SF36, P < 0.0001), indicative of greater health and social care needs. The prevalence of urinary incontinence in the adult populations of two communities indicates that it is a sizeable public health and primary healthcare issue.