title: Understanding help-seeking in older people with urinary incontinence: an interview study.
abstract: The prevalence of urinary incontinence (UI) increases with age and can negatively affect quality of life. However, relatively few older people with UI seek treatment. The aim of this study was to explore the views of older people with UI on the process of seeking help. Older people with UI were recruited to the study from three continence services in the north of England: a geriatrician-led hospital outpatient clinic (n = 18), a community-based nurse-led service (n = 22) and a consultant gynaecologist-led service specialising in surgical treatment (n = 10). Participants took part in semi-structured interviews, which were transcribed and underwent thematic content analysis. Three main themes emerged: Being brushed aside, in which participants expressed the feeling that general practitioners did not prioritise or recognise their concerns; Putting up with it, in which participants delayed seeking help for their UI due to various reasons including embarrassment, the development of coping mechanisms, perceiving UI as a normal part of the ageing process, or being unaware that help was available; and Something has to be done, in which help-seeking was prompted by the recognition that their UI was a serious problem, whether as a result of experiencing UI in public, the remark of a relative, the belief that they had a serious illness or the detection of UI during comprehensive geriatric assessment. Greater awareness that UI is a treatable condition and not a normal part of ageing is needed in the population and among health professionals. Comprehensive geriatric assessment appeared an important trigger for referral and treatment in our participants. Screening questions by healthcare professionals could be a means to identify, assess and treat older people with UI.
authors.affiliation: Barnsley Hospital, Barnsley, UK.
authors.forename: Natalie
authors.initials: N
authors.lastname: Vethanayagam
authors.affiliation: School of Social Sciences, Bangor University, Bangor, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Orrell
authors.affiliation: School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.|Aging Research Center, Karolinska Institutet & Stockholm University, Stockholm, Sweden.
authors.forename: Lena
authors.initials: L
authors.lastname: Dahlberg
authors.affiliation: School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: McKee
authors.affiliation: Barnsley Hospital, Barnsley, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Orme
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle, UK.
authors.forename: Stuart G
authors.initials: SG
authors.lastname: Parker
authors.affiliation: Department of Clinical Sciences, Brunel University London, London, UK.
authors.forename: Mary
authors.initials: M
authors.lastname: Gilhooly
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D005260:Female; D058006:General Practice; D015577:Geriatric Assessment; D000066505:Help-Seeking Behavior; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D011788:Quality of Life; D006113:United Kingdom; D014549:Urinary Incontinence / Q000453:epidemiology / Q000523:psychology*
keywords: attitudes to ageing; comprehensive geriatric assessment; general practice; help-seeking behaviour; older people; urinary incontinence