title: Women's perceptions about the etiology of urinary incontinence.
abstract: OBJECTIVE
  Incontinent women have low rates of care seeking and treatment, some of which may be explained by their beliefs about the causes of their own urine loss. As little is known about these beliefs, our aim was to qualitatively assess what women perceive as the etiology of their urinary incontinence (UI).
  
  
  METHODS
  In a written survey on urinary symptoms administered to female HMO enrollees aged 30-90 years, incontinent women were asked the open-ended question: "Why do you think you lose urine?" Qualitative analyses of the responses identified themes, which were quantified and organized into major categories. Subjects were assigned multiple themes/categories as indicated. Relationships between major categories and subject/incontinence characteristics were explored.
  
  
  RESULTS
  Of the 1458 women with incontinence who completed the survey, 1192 (82%) responded to the open-ended question. Qualitative analyses identified 23 themes, with 5 themes cited by >or=10% of subjects: pelvic floor/bladder muscles (31%), pregnancy/childbirth (18%), age (14%), exertional triggers (12%), and waiting too long to void (10%). The 23 themes were organized into 5 major categories: pelvic floor/bladder related (53%), uncontrollable factors (23%), part of being female (21%), personal/lifestyle attributes (21%), and don't know (12%). Subjects expressed a range of 1-4 themes/categories. Major categories differed by age, and significant associations were seen between major categories and incontinence severity.
  
  
  CONCLUSIONS
  Women attribute their UI to a number of causes, which can be condensed into workable themes and categories. By understanding women's beliefs about the etiology of incontinence, clinicians may improve their ability to educate, counsel, and treat women with incontinence.
authors.affiliation: Department of Obstetrics & Gynecology, University of Washington, Seattle, Washington 98104-2499, USA. jmelvi@u.washington.edu
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Melville
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Wagner
authors.forename: Ming-Yu
authors.initials: MY
authors.lastname: Fan
authors.forename: Wayne J
authors.initials: WJ
authors.lastname: Katon
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Newton
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D014549:Urinary Incontinence / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology*; D014861:Washington / Q000453:epidemiology; D014930:Women / Q000523:psychology*; D016387:Women's Health
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