Prevalence, awareness and determinants of health care-seeking behaviour for urinary incontinence in Qatari women: a neglected problem?

Abstract

Objectives: The aim of this study was to determine the prevalence, awareness and determinants of urinary incontinence (UI) among Qatari women and the sociodemographic factors involved in their health care-seeking behaviour. Design: A cross-sectional study was used to determine the symptoms of UI experienced by Arabian Gulf women. Setting: Primary Health Care (PHC) Centres and community-based study in Qatar. Subjects: A multistage sampling design was used and a representative sample of 1000 Qatari women aged 45 years and above were included from January to June 2003. Measurements: Participants completed a questionnaire assessing UI in the previous 12 months and health care-seeking behavior for urinary symptoms. Results: Of 1000 women living in urban and semiurban areas who were asked, 798 (79.8%), representing the study sample, agreed to participate and completed the questionnaire. Of these, 164 (20.6%) were found to have UI. Overall, the reason for not seeking medical attention was mainly embarrassment (40.6%) at having to speak with doctor. Of the total study sample, 562 subjects (70.4%) believed that UI was abnormal and worth reporting to a doctor. Coping mechanisms among incontinent women included frequent washing (58.3%) and wearing a protective perennial pad (42.4%), changing underwear frequently (41.3%), decreasing fluid intake (19.8%) and stopping all work (4.9%). Sufferers were most troubled by their inability to pray (64%) and their marital relationship (47%), limitation of their social activities (20%), difficulty in doing housework (14%) and inconvenience during shopping (13%). Most (71.9%) of the incontinent subjects were self-conscious, ashamed of themselves and troubled by guilt ( P < 0.001); 56% found it most embarrassing to discuss UI with their husbands. The majority of women (51.9%) believed child birth to be the major cause of UI, followed by ageing (49.5%), menopause (34.2%) and paralysis (25.3%). Most of the subjects (62.3%) believe that UI can cause infection, some (20.5%) believe that it can cause skin allergy and very few think that it can cause cancer or other disorders. Conclusions: Our findings indicate that although UI is relatively common in the community, it is underreported by Qatari women because of social and cultural attitudes and—most importantly—lack of information. This findings suggest that strategies to promote care-seeking for incontinence must be developed and employed in the community.