A quasi-experimental study on a community-based stroke prevention programme for clients with minor stroke

Aim. The aim of this study was to determine the effectiveness of a community‐based stroke prevention programme in (1) improving knowledge about stroke; (2) improving self‐health‐monitoring practice; (3) maintaining behavioural changes when adopting a healthy lifestyle for stroke prevention. Background. People with minor stroke (or transient ischaemic attack) tend to under‐estimate the long‐term impact of this on their health. The challenge for nurses is to prevent subsequent strokes by finding ways to promote and sustain appropriate behaviours. Educational intervention is of paramount importance in equipping those at risk with relevant knowledge and self‐care strategies for secondary stroke prevention. Design. This study adopted a quasi‐experimental design. Method. One hundred and ninety subjects were recruited, of whom 147 (77 in the intervention group and 70 in the control group) completed the study. Data were obtained at three time points: baseline (T₀); one week after (T₁) and three months after (T₂) the intervention. The intervention programme consisted of eight weekly two‐hour sessions, with the aims of improving the participants’ awareness of their own health signals and of actively involving them in self‐care management of their own health for secondary stroke prevention. Results. Significant positive changes were found among participants of the intervention group in the knowledge on stroke warning signs (P < 0·001); treatment seeking response in case of a stroke (P < 0·001); medication compliance (P < 0·001); self blood pressure monitoring (P < 0·001) as well as lifestyle modification of dietary habits (reduction in salted food intake, P = 0·004). No significant improvement was found in walking exercise participation in the intervention group, yet a significant decrease was detected among the control group. Conclusion. This study found a three‐month‐sustained effect of positive changes in knowledge and skill from participants who undertook a nurse‐led community‐based stroke prevention programme. Relevance to clinical practice: Effective educational intervention by professional nurses helped clients integrate their learned knowledge into their real‐life practice. This empowering, that is, the taking of responsibility by clients for their own self‐care management on a daily basis, affirms that patient education has moved beyond teaching people facts.     

Beliefs about appropriate pain behaviour: gender differences between health care professionals and non-health care professionals in Hong Kong

Aims. The purpose of this study was to examine the effects of participants’ gender on their beliefs regarding gender‐appropriate pain behaviour among health care professionals and non‐health care professionals. Background. Gender may influence beliefs about appropriate pain behaviour among health care professionals and non‐health care professionals. Methods. The study consisted of a survey of 152 participants, 38 male and 38 female health care professionals and 38 male and 38 female non‐health care professionals. Each participant completed both questionnaires, the Appropriate Pain Behaviour Questionnaire‐Female (APBQ‐F) and Appropriate Pain Behaviour Questionnaire‐Male (APBQ‐M). Results. Occupation had a significant effect: the health care professionals rated pain behaviours as more acceptable in both genders than the non‐health care professionals, F(1, 148) = 13·636, p < 0·01. Gender also had a significant effect: female participants considered pain behaviours more acceptable than male participants, F(1, 148) = 5·056, p < 0·026. There was a significant effect between APBQ‐M and APBQ‐F: for both genders in both occupations, pain behaviours in women were rated as more acceptable than in men, F(1, 148) = 105·469, p < 0·005. Conclusions. Health care professionals would consider overt pain‐related behaviours by both men and women to be more acceptable than non‐health care professionals. Both genders and both occupations would consider overt pain‐related behaviours to be more acceptable in women than in men. Relevance to clinical practice. Health care professionals need to be aware that their attitude to pain behaviours may influence their management of patients and that different genders experience pain differently. This has clear implications in terms of clinical treatment and diagnosis.     

Individualized programme to promote self-care among older adults with asthma: randomized controlled trial

Title. Individualized programme to promote self‐care among older adults with asthma: randomized controlled trial. Aim. This paper is a report of a trial to examine the effectiveness of individualized self‐care education programmes in older adults with moderate‐to‐severe asthma. Background. Asthma is a common chronic disease in adults and a major cause of frequent work absences, emergency room visits, and hospitalization. The results of studies of self‐care education programmes have been largely supportive and suggest that they have positive outcomes for people with asthma. However, for older people with asthma, the effectiveness of computer‐aided, self‐learning video programmes has been controversial. Methods. Older adult patients with asthma (N = 148) were randomly assigned to one of three groups: usual care, individualized education, or individualized education with peak flow monitoring, and followed for 6 months. Data were collected from January to December 2006. The variables studied included demographic data, asthma self‐care competence, asthma self‐efficacy, and asthma self‐care behaviour. Findings. Patients in both individualized education groups reported higher asthma self‐care competence scores (F = 334·06 and 481·37, P < 0·001) and asthma self‐care and self‐efficacy scores (F = 104·08 and 68·42, P < 0·001) than patients in the usual care group. In addition, patients who received individualized education with peak flow monitoring had statistically significantly higher asthma self‐care behaviour and self‐efficacy scores (P < 0·001) and asthma control indicators (P = 0·025) than the education alone group. No differences were found among the three groups in unscheduled health service usage. Conclusion. Our results suggest that individualized education helps older people with asthma to enhance their self‐care behaviours, manage their disease, and increase their quality of life.     

Contraceptive self‐efficacy and contraceptive knowledge of Hong Kong Chinese women with unplanned pregnancy

Aim and objectives. The purpose of this study was to explore contraceptive practice, the level of knowledge and self‐efficacy of contraception among Chinese women with unplanned pregnancy and to determine the relationships between these variables. Background. The construct of self‐efficacy can be employed as a theory to design a nursing intervention to prevent sexually active women from unplanned pregnancy. Only a few western studies have investigated the relationships between self‐efficacy and contraception behaviour yet none targeted at the Chinese population. Design. Cross‐sectional survey. Methods. This study employed a cross‐sectional survey design. A convenience sample of 117 eligible Chinese females completed all the questionnaires, which included the Chinese version of the Contraceptive Self‐efficacy Scale and Contraceptive Knowledge Scale. Results. The findings in this study suggested that younger, unmarried women at the lower income group, who adopted male condoms are at risk for unplanned pregnancy. The sample demonstrated an above medium level of knowledge and self‐efficacy in contraception. However, no significant relationship was found between contraceptive self‐efficacy and knowledge (p>0·05). Conclusions. Contraceptive obstacles were revealed by participants’ moderate level of contraceptive self‐efficacy and contraceptive knowledge. The relationship between contraceptive knowledge of specific methods and contraceptive self‐efficacy need further exploration in future studies. Relevance to clinical practice. The dominant use of male condoms by the sample of this study sheds light on future direction in the development of educational programmes and contraceptive promotion strategies appropriate for women with unplanned pregnancy.     

Sexual self-concept as influencing intended sexual health behaviour of young adolescent Taiwanese girls

Aims and objectives. The purpose of this study was to test a process model that assesses the relationship of sexual health knowledge and normative beliefs to sexual health behavioural intention, with sexual self‐concept as a mediating variable. The model is intended to assist in the prediction of which adolescents would exhibit a lower intention to engage in protective sexual health behaviour. Background. Previous research has shown that sexual‐related behaviours are associated with sexual self‐concept, sexual health knowledge and perceived parental/peer approval of sexual behaviour. Design. This study is a cross‐sectional research. Methods. This study was conducted with 545 adolescent girls, aged 12–15 years, from eight junior high schools in Taiwan. Participants were assessed using the Sexual Self‐Concept Inventory, the Sexual Health Behavior Intention Scale, the Parental Approval of Sexual Behavior Scale (PASB), the Friends’ Approval of Sexual Behavior Scale and the Sexual Health Knowledge Scale. Data were analysed using structural equation modelling, with the maximum likelihood estimate determined by the LISREL 8.52 program. Results. The model exhibited adequate fit (goodness‐of‐fit index = 0·96, adjusted goodness‐of‐fit index = 0·94, normed fit index = 0·96, comparative fit index = 0·98, standardised root mean square residual = 0·049 and root mean square error of approximation = 0·048) and the findings indicate that sexual self‐concept was a significant influence on the relationship of sexual health knowledge and normative beliefs to sexual health behavioural intention. Conclusions. The results of this study revealed the importance of sexual self‐concept for adolescent girls’ sexual health behaviour. Relevance to clinical practice. Evidence‐based strategies that reinforce and clarify sexual self‐concept as a mediating factor may aid in adolescent females’ intention to engage in protective sexual health behaviour.     

Breast cancer awareness and practice of breast self examination among primary health care nurses: influencing factors and effects of an in-service education

Aim. The purposes of this study were to identify the level of breast cancer and breast self examination practice knowledge of primary health nurses and the factors influencing breast cancer and breast self examination knowledge as well as to investigate the frequency of breast self examination practice of primary health nurses and influencing factors and to evaluate the effects of an in‐service training program about breast cancer and breast self examination practice for primary health nurses. Background. An increased awareness among nurses about breast cancer prevention would most likely result in a higher number of better educated women about breast cancer and also motivate adherence to screening recommendations. Design and methods. A pre‐test and post‐test design was implemented to evaluate the effectiveness of a Breast Cancer and Breast Self Examination Education Program for primary health nurses. The program was instructed to 192 of the 215 primary health nurses by two nurse trainers. Pre‐ and post‐tests made available a quantitative evaluation of the level of improvement in breast cancer and breast self‐examination knowledge. Results. Mean of total breast cancer knowledge score of primary health nurses prior to the program was 58·51 SD 15·63 whereas, it increased to 75·96 SD 9·53, revealing a statistically significant escalation (p < 0·0001). A significant increase was detected in the number of primary health nurses practising breast self examination as a result of the significant improvement in the mean of self breast self examination practice knowledge score which rose evidently from 71·09 SD 19·31 to 85·02 SD 12·92 (p < 0·0001). Conclusion. The in‐service education program improved the knowledge about breast cancer and practice of breast self examination in trained primary health nurses. The program model, which involved trained primary health nurse also represented an efficient use of the resources. Relevance to clinical practice. It is important that primary health nurses have adequate breast cancer knowledge and practice of breast self examination to contribute effectively to primary health care. Findings of this study can be used to guide the planning efforts on continuous education of primary health nurses about breast cancer and breast self examination issues.     

Evaluating the effects of an Internet education programme on newborn care in Taiwan

Aim. The objectives of this study were to evaluate an Internet education programme provided to primigravida in the third trimester of pregnancy with the aim of enhancing mothers’ knowledge about newborn care and increasing their maternal confidence. Background. Shorter hospital stays have had an impact on the traditional role of mother–baby nurses in providing education about parenting to their parturient women. Internet education is an efficient way to provide nursing instruction. Design. A randomised controlled trial was used. A total of 118 women receiving prenatal care in a hospital clinic who met study criteria and who consented were assigned randomly to intervention and control groups. The study was conducted at a hospital in Taiwan. Methods. The target population was women at 32–34 weeks gestation, using the Internet on a regular basis. The primigravida were randomly assigned to either the control group (n = 57) or the experimental group (n = 61). Two primary outcome measures were newborn‐care knowledge and maternal confidence. Results. The changes in newborn‐care knowledge were 7·21 for the experimental group, compared with 1·95 for the control group; the difference between the least‐squares means computed by ancova was 5·73 and statistically significant (p < 0·001). The changes in maternal confidence were 8·46 for the experimental group and 3·05 for the control group; the difference between the least‐squares means computed by ancova was 5·94 and statistically significant (p < 0·001). Conclusion. Results suggest that Internet education about newborn care may contribute to greater care knowledge and maternal confidence. Relevance to clinical practice. Internet newborn‐care education programmes can achieve success in promoting newborn care and provide health professionals with evidence‐based intervention.     

Development and psychometric testing of the Cancer Knowledge Scale for Elders

Aim. To develop the Cancer Knowledge Scale for Elders and test its validity and reliability. Background. The number of elders suffering from cancer is increasing. To facilitate cancer prevention behaviours among elders, they shall be educated about cancer‐related knowledge. Prior to designing a programme that would respond to the special needs of elders, understanding the cancer‐related knowledge within this population was necessary. However, extensive review of the literature revealed a lack of appropriate instruments for measuring cancer‐related knowledge. A valid and reliable cancer knowledge scale for elders is necessary. Design. A non‐experimental methodological design was used to test the psychometric properties of the Cancer Knowledge Scale for Elders. Methods. Item analysis was first performed to screen out items that had low corrected item‐total correlation coefficients. Construct validity was examined with a principle component method of exploratory factor analysis. Cancer‐related health behaviour was used as the criterion variable to evaluate criterion‐related validity. Internal consistency reliability was assessed by the KR‐20. Stability was determined by two‐week test–retest reliability. Results. The factor analysis yielded a four‐factor solution accounting for 49·5% of the variance. For criterion‐related validity, cancer knowledge was positively correlated with cancer‐related health behaviour (r = 0·78, p < 0·001). The KR‐20 coefficients of each factor were 0·85, 0·76, 0·79 and 0·67 and 0·87 for the total scale. Test–retest reliability over a two‐week period was 0·83 (p < 0·001). Conclusion. This study provides evidence for content validity, construct validity, criterion‐related validity, internal consistency and stability of the Cancer Knowledge Scale for Elders. The results show that this scale is an easy‐to‐use instrument for elders and has adequate validity and reliability. Relevance to clinical practice. The scale can be used as an assessment instrument when implementing cancer education programmes for elders. It can also be used to evaluate the effects of education programmes.     

Effects of an empowerment-based education program for public health nurses in Taiwan

Aim and objectives. The aim of this study was to examine the effects of an empowerment‐based education program (EBEP) on employee empowerment, job satisfaction, job productivity and innovative behaviours for public health nurses (PHN) in Taiwan. Background. Empowerment is an important consideration among nurses trying to function in ever‐changing health care and education settings. Several studies focused on the trend of public health nursing revealed that PHN have experienced a severe feeling of powerlessness. Developing empowerment strategies through organisations may be a means of helping employees recognise powerlessness in difficult situations and take appropriate action. Design. Quasi‐experimental design. Methods. PHN in two health bureaus in Taiwan were assigned into an empowerment group (n = 29) and a control group (n = 32). Twenty‐four hours of the EBEP lasted four weeks included four empowerment classes and four group workshops following each curriculum for PHN to apply principles of empowerment in their work environment. Data were collected at baseline and four weeks after the intervention. Analysis of covariance (ancova ) was used to examine the intervention effect. Results. The experimental group reported significantly higher psychological empowerment [F (1,47) = 5·09, MSE = 3·25, p = 0·001, η² = 0·18] and competence [F (1,47) = 3·96, MSE = 28·78, p = 0·05, η² = 0·22] and impact [F (1,47) = 4·98, MSE = 44·79, p = 0·002, η² = 0·20] subscales, job productivity [F (1,47) = 4·88, MSE = 5·18, p = 0·002, η² = 0·19] and innovative behaviours [F (1,47) = 5·09, MSE = 3·25, p = 0·001, η² = 0·24] than the control group after the EBEP. Conclusion. The EBEP had significant effect on psychological empowerment and subscales of competence and impact, innovative behaviour and job productivity but no effect on organisational empowerment and job satisfaction for PHN. Relevance to clinical practice. Our findings suggest public health administration could design empowerment‐based education to improve employee empowerment and job productivity for PHN. Furthermore, using multiple components to design empowerment education should be considered in further studies.     

Effects of a feeding skills training programme on nursing assistants and dementia patients

Aims and objectives. The purposes of this study were to develop a comprehensive feeding skills training programme for nursing assistants and to test the effects of this training programme on their knowledge, attitude and behaviour and the outcome of dementia patients including total eating time, food intake and feeding difficulty. Background. Dementia patients have a high probability of feeding problems that result in a substantial risk of malnutrition. Assisting residents with eating is a major task for nursing assistants and they require better training to provide adequate quality of nutritional care. Design methods. A quasi‐experimental study was conducted. Two convenience‐chosen dementia‐specialized long‐term care facilities in North Taiwan were randomly assigned into either a control or a treatment group. Sixty‐seven nursing assistants were enrolled (treatment: 31; control: 36). Twenty nursing assistants and the same number of dementia patients were observed during mealtime. The treatment group participated in a feeding skills training programme including three hours of in‐service classes and one hour of hands‐on training, whereas the control group did not receive any training. Results. The treatment group had significantly more knowledge (F = 47·7, P < 0·001), more positive attitude (F = 15·75, P = 0·001) and better behaviours (t = 6·0, P < 0·001) than the control group after the intervention. Dementia patients in the treatment group had significantly longer total eating time (t = 2·7, P < 0·05) and higher Edinburgh Feeding Evaluation in Dementia scores (more feeding difficulty) (t = 2·1, P < 0·05) than the control group. There was no significant difference on food intake between the two groups (t = 0·8, P = 0·49). Conclusion. This feeding skills training programme has been found to change nursing assistants’ knowledge, attitude, and behaviour as well as increasing the eating time for the dementia patients. Relevance to clinical practice. This study raises attention regarding on‐the‐job training for nursing assistants. Furthermore, the feeding problems among dementia patients should be further explored as well as the nutritional care.     

To evaluate the effectiveness of a discharge‐planning programme for hip fracture patients

Aims and objectives. This study aimed to evaluate the effectiveness of a comprehensive discharge‐planning service for hip fracture patients, including length of stay, functional status, self‐care knowledge and quality of life (QOL). Background. Hip fractures are the most devastating result of osteoporosis. Care of these patients from the moment they enter the hospital until discharge and postdischarge is a challenging task, requiring a coordinated approach by an interdisciplinary team. Design. An experimental design was used. Methods. Fifty hip fracture patients were recruited from a medical centre in Taipei, Taiwan and randomly divided into two groups. The control group received routine discharge nursing care and the experimental group received comprehensive discharge planning. After patient admission, researchers assessed discharge‐planning needs, provided discharge nursing instruction, coordinated services and determined discharge placement based on assessment results. Results. (i) Mean age of 50 hip fracture patients was 78·75 (SD 6·99) years. Mean length of stay was 6·04 (SD 2·41) days for the experimental group and 6·29 (SD 2·17) for the control group. Difference between groups was not significant (t = ?0·394, p = 0·696). (ii) The self‐care knowledge of the experimental group was higher than that of the control group (F = 11·569, p = 0·001). (iii) Significant improvements were observed in functional status of both groups at three months postdischarge, with no significant differences observed between groups. However, the functional status of experimental group patients showed a slightly better trend than that of the control group. (iv) At three months postdischarge, QOL of experimental group patients was better than control group patients. Conclusions. A comprehensive discharge‐planning service can improve hip fracture patients’ self‐care knowledge and QOL. Relevance to clinical practice. Results of this study can be used clinically as a basis for practical implementation of discharge‐planning services in fracture patients.     

Assessment of a training programme for the prevention of ventilator‐associated pneumonia

Background: Ventilator‐associated pneumonia (VAP) is the most frequent nosocomial infection in intensive care units (ICUs). Most published studies have analysed nurses' theoretical knowledge about a specific procedure; however, the transfer of this knowledge to the practice has received little attention. Aim: To assess the impact of training session on nurses' knowledge regarding VAP, compliance with VAP preventive measures, VAP incidence and determining whether nursing workload affects compliance. Method: A prospective, quasiexperimental, pre‐ and post‐study of the nursing team in a 16‐bed medical/surgical ICU. Pre‐intervention phase: a questionnaire to assess nurses' knowledge of VAP prevention measures, direct observation and review of clinical records to assess compliance. Intervention phase: eight training sessions for nurses. The post‐intervention phase mirrored the pre‐intervention phase. Findings: Nurses answered more questions correctly on the post‐intervention questionnaire than on the pre‐intervention (17·87 ± 2·69 versus 15·91 ± 2·68, p = 0·002). Compliance with the following measures was better during the post‐intervention period (p = 0·001): use of the smallest possible nasogastric tube, controlled aspiration of subglottic secretions and endotracheal tube cuff pressure, use of oral chlorhexidine and recording the endotracheal tube fixation number. VAP incidence remained unchanged throughout the study. However, a trend towards lower incidence of late (>4 days after intubation) VAP was observed (4·6 versus 3·1 episodes/1000 ventilation days, p = 0·37). Conclusion: The programme improved both knowledge of and compliance with VAP preventive measures, although improved knowledge did not always result in improved compliance.     

Participation in health-promoting behaviour: influences on community-dwelling older Chinese people

Aim. This paper reports a study to determine the factors affecting community‐dwelling older Chinese people's health‐promoting behaviour in the domains of physical activity, healthy dietary practices and stress management, and to identify any barriers to these behaviours. Background. Previous studies have identified factors affecting different types of health‐promoting behaviours, including perceived self‐efficacy, perceived benefits and five individual characteristics (age, sex, marital status, education and perceived health) of older non‐Chinese people. However, few studies have simultaneously taken these factors into account in examining community‐dwelling Chinese older people's health‐promoting behaviour. Method. Individual face‐to‐face interviews were completed in 2002–2003 with a convenience sample of 896 community‐dwelling older Chinese people in Hong Kong aged between the ages of 60 and 98 (years mean 76). Participants had no apparent communication and cognition impairments. A structured interview schedule was used to collect the data. Results. Multiple regression analysis showed that perceived self‐efficacy, perceived benefits and sex together explained 38·4% of health‐promoting behaviour among community‐dwelling older Chinese people in Hong Kong. Fatigue during and after physical activity, enjoyment of unhealthy foods and inadequate family and peer support were the most frequently reported barriers to health‐promoting behaviour. Conclusion. When developing health promotion programmes to motivate community‐dwelling older Chinese clients to participate in health‐promoting behaviour and to minimize barriers, community nurses should include some activities to increase both the perceived self‐efficacy and perceived benefits of health‐promoting behaviour. Future studies should include more critical factors based on theories, empirical evidence and knowledge of culture with samples that are random and from more diverse community settings.     

The effectiveness of an osteoporosis prevention education programme for women in Hong Kong: a randomized controlled trial

Aims. The purpose of this study was to evaluate whether a nurse‐initiated education programme on four specific osteoporosis‐prevention related behaviours leads to their adoption or positive attitude changes compared with women who did not participate in this programme. Research method. The design was a randomized controlled design and the setting was a local private beauty clinic. Outcome measures. Pre‐, post‐ and follow‐up education data compared attitudes and consumption frequency before and after the education programme. Results. The results showed significant increases in the reported follow‐up for each behaviour: consumption of soya foods (mean = 4·3, SD = 0·5), milk (mean = 4·2, SD = 0·8), more exercise (mean = 4·3, SD = 0·5) and vitamin D/exposure to sunlight (mean = 4·2, SD = 0·9) for subjects in the case group compared with control group subjects (soya foods: mean = 3·3, SD = 0·9, P < 0·001; milk: mean = 3·0, SD = 0·9, P < 0·001; more exercise: mean = 3·4, SD = 1·0, P = 0·003; vitamin D/sunlight: mean = 2·7, SD = 0·9, P < 0·00). Most of the participants either disagreed (n = 11, 55·0%) or strongly disagreed (n = 9, 45·0%) that there was not enough information provided in the education programme to motivate them to change. On the satisfaction score, they rated the nurse's performance as either satisfactory (n = 11, 55·0%) or very satisfactory (n = 9, 45·0%) on presentation and ability to answer their questions and either satisfactory (n = 12, 60·0%) or very satisfactory (n = 8, 40·0%) on ability to describe each behaviour clearly. Conclusion. A targeted education programme conducted with Hong Kong women resulted in significantly increased consumption of calcium including soya‐based foods, milk and vitamin D. According to the reported attitudinal and behavioural intentions, participants’ positive feedback suggests that women who participated in this educational programme were motivated to make changes and benefited from the support of this nurse‐initiated education programme. Relevance to clinical practice. Osteoporosis was a serious health concern that most commonly affected women. As indicated by the results of this study, this educational programme can act as simple but effective nursing intervention to promote women's attitudinal and behavioural intentions towards osteoporosis‐prevention.     

Impact of cough and urinary incontinence on quality of life in women and men with chronic obstructive pulmonary disease

Aims and objectives. The aim of this study was to investigate the impact of cough and urinary incontinence on quality of life in women and men with chronic obstructive pulmonary disease in primary health care. Background. Existing information on the impact of cough and urinary incontinence on quality of life in patients with chronic obstructive pulmonary disease is scant. Design. A questionnaire survey. Method. The study included 391 women and 337 men, aged 50–75 years, with chronic obstructive pulmonary disease. A self‐administered questionnaire consisted of CCQ and SF‐12 questionnaires. A response rate of 66% was obtained. Most patients had been diagnosed with moderate (Stage II) chronic obstructive pulmonary disease. Results. Women and men with urinary incontinence showed a significantly higher presence of symptomatic cough and phlegm production than did women and men without incontinence. Women with incontinence had a significantly higher burden of CCQ symptoms, functional and mental state than did women without incontinence. Concerning quality‐of‐life scores, women with incontinence had lower physical state scores (37·6 ± 10·4 vs. 41·4 ± 9·9; p < 0·001) and mental state scores (44·3 ± 10·2 vs. 47·1 ± 10·5; p < 0·007) than did women without incontinence. Men with incontinence had a significantly higher burden of CCQ symptoms and mental state than did men without incontinence. When examining the quality‐of‐life scores, men with incontinence had lower mental state scores than did men without incontinence (46·0 ± 9·7 vs. 49·8 ± 9·7; p < 0·001). Conclusion. The present results indicate that cough and urinary incontinence lead to poor quality of life in women and men with chronic obstructive pulmonary disease. Relevance to clinical practice. In the context of primary health care, appropriate questions concerning urinary incontinence and quality of life should be included in care plans for women and men living with chronic obstructive pulmonary disease.