title: Female urinary incontinence and wellbeing: results from a multi-national survey.
abstract: BACKGROUND
  Previous research has shown that the severity of symptoms of urinary incontinence impacts on quality of life and wellbeing. The aim of this article is to investigate the relationship between female urinary incontinence and mental wellbeing. This involved analyses comparing those with UI and those without to determine whether any differences in wellbeing were modified by demographic factors, specific wellbeing domain, or exercise and frequency of sex. Following this, further analyses compared sub-groups of those with UI (based on the impact of the UI) to determine which characteristics were important in influencing wellbeing.
  
  
  METHODS
  An internet survey of women with UI, aged between 45 and 60 years, has been previously reported and this article reports secondary analyses of that data. A sample from 4 countries: the UK, France, Germany and the USA. Two thousand four hundred three women completed the survey, 1203 with UI and 1200 who did not report UI. The main outcome measures were the scores from the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS).
  
  
  RESULTS
  The results showed that lower wellbeing is observed in UI. This effect is observed in all aspects of wellbeing and most sub-groups of UI sufferers. Lifestyle influences wellbeing and those with UI who exercise less frequently or have sex infrequently are especially likely to report lower wellbeing. Wellbeing decreases as a function of the indirect measures of severity of UI and reductions in HRQol. Again, these changes reflect all aspects of wellbeing measured by WEMWBS.
  
  
  CONCLUSIONS
  The results show that women with UI, aged 45-60 years, report lower wellbeing. This effect was not modified by demographic factors and was apparent in most of the domains measured by the WEMWBS. The reduced wellbeing was related to the impact of the UI on behaviour, embarrassment associated with it, and frequency of leakage.
authors.affiliation: Centre for Occupational and Health Psychology, School of Psychology, Cardiff University, 63 Park Place, Cardiff, CF10 3AS, UK. smithap@cardiff.ac.uk.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Smith
mesh_terms: D015444:Exercise / Q000502:physiology / Q000523:psychology*; D005260:Female; D005602:France / Q000453:epidemiology; D005858:Germany / Q000453:epidemiology; D019538:Health Care Surveys; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012725:Sexual Behavior / Q000523:psychology*; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000523:psychology*; D016387:Women's Health / Q000706:statistics & numerical data*
keywords: Exercise; Female; Quality of life; Sex; Urinary incontinence; Wellbeing