Incontinence in women prisoners: an exploration of the issues.
OBJECTIVE
This paper is a report of a study exploring the extent and management of bladder and bowel problems in order to inform the provision and practice of prison nursing services and health care services in women's prisons.


BACKGROUND
Nurses and general practitioners provide primary care services inside prisons in the United Kingdom. While high levels of mental health and addiction problems in women prisoners are recognized, there has been less focus on physical problems. Incontinence symptoms are perceived as shameful and stigmatizing, and frequently help is not sought from healthcare professionals. Guidance for assessing prisoner health does not refer to bladder and bowel symptoms.


METHODS
Women prisoners in a large, closed prison in the United Kingdom were surveyed in 2005 using an anonymous self-completed questionnaire. Women resident in the detoxification unit and the hospital unit, absent from their unit at the time of questionnaire distribution or deemed vulnerable by prison health staff were excluded.


RESULTS
Questionnaires were offered to 283 women and 246 agreed to take it. Of those taken, 148 (60%) were returned. Twenty-four per cent indicated that they disclosed information about bladder and bowel problems in the survey not previously disclosed to anyone else. Forty-three per cent reported urinary symptoms. Five per cent reported nocturnal enuresis. The majority of women with symptoms reported using sanitary pads and toilet paper for containment of leakage.


CONCLUSIONS
Prison nurses and nurse practitioners involved in reception into prison assessments should ask direct but sensitive questions about women's bladder and bowel symptoms.
Drennan
Vari
V
Faculty of Health & Social Care Sciences, St George's, University of London & Kingston University, UK. v.drennan@sgul.kingston.ac.uk
Goodman
Claire
C
Norton
Christine
C
Wells
Amanda
A
D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D003248:Constipation / Q000453:epidemiology / Q000523:psychology; D005242:Fecal Incontinence / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005414:Flatulence / Q000453:epidemiology; D006297:Health Services Accessibility / Q000592:standards; D006306:Health Surveys; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D010298:Parity; D011247:Pregnancy; D011320:Primary Health Care / Q000458:organization & administration*; D011329:Prisoners / Q000523:psychology / Q000706:statistics & numerical data*; D011330:Prisons / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014038:Toilet Facilities / Q000592:standards; D006113:United Kingdom / Q000453:epidemiology; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult