title: Toileting behaviours and lower urinary tract symptoms among female nurses: A cross-sectional questionnaire survey.
abstract: Unhealthy toileting behaviours exist among women, and lower urinary tract symptoms have a high prevalence and significant effects on quality of life. However, the relationship between toileting behaviours and lower urinary tract symptoms is unclear.
  
  
  
  This study aimed to investigate the prevalence of lower urinary tract symptoms among female nurses, and the association between toileting behaviours and lower urinary tract symptoms.
  
  
  
  A cross-sectional stratified cluster sampling study.
  
  
  
  A total of 636 female clinical nurses from tertiary hospitals in Jinan (the capital city of Shandong Province, China).
  
  
  
  The Toileting Behaviour-Women's Elimination Behaviours and the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms scales were used to assess the participants' toileting behaviours and lower urinary tract symptoms, respectively. Multiple linear regression analysis was used to evaluate the association between toileting behaviours and lower urinary tract symptoms.
  
  
  
  Unhealthy toileting behaviours were common among the female nurses, with delayed voiding being the unhealthiest toileting behaviour, which was followed by place and position preference for voiding. Nearly 68% of the female nurses had at least one lower urinary tract symptom, nearly 50% had incontinence symptoms, 40% had filling symptoms, and 18% had voiding symptoms. Unhealthy toileting behaviours (premature voiding, delayed voiding, and straining to void) were positively associated with lower urinary tract symptoms. However, lower urinary tract symptoms were not significantly associated with voiding place or position preference. Among the control variables, being married or having a history of a urinary tract infection was associated with lower urinary tract symptoms. Having a higher income and regular menstrual period were negatively associated with lower urinary tract symptoms. Compared with vaginal delivery, caesarean delivery had a protective association with lower urinary tract symptoms.
  
  
  
  Lower urinary tract symptoms among female nurses should not be overlooked, because their prevalence among female clinical nurses exceeded that among the general population of women. These findings highlight the importance of avoiding unhealthy toileting behaviours (especially premature voiding, delayed voiding, and straining to void), as these unhealthy toileting behaviours were significantly associated with susceptibility to lower urinary tract symptoms.
authors.affiliation: School of Nursing, Shandong University, Jinan, Shandong Province, China; School of Nursing, Yangzhou University, Yangzhou, China.
authors.forename: Xiaojuan
authors.initials: X
authors.lastname: Wan
authors.affiliation: School of Nursing, Binzhou Medical University, Binzhou, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Wu
authors.affiliation: School of Nursing, Shandong University, Jinan, Shandong Province, China; School of Nursing, Purdue University, West Lafayette, USA.
authors.forename: Dongjuan
authors.initials: D
authors.lastname: Xu
authors.affiliation: School of Nursing, Shandong University, Jinan, Shandong Province, China.
authors.forename: Liqun
authors.initials: L
authors.lastname: Huang
authors.affiliation: School of Nursing, Shandong University, Jinan, Shandong Province, China. Electronic address: wangkf@sdu.edu.cn.
authors.forename: Kefang
authors.initials: K
authors.lastname: Wang
keywords: Female; Lower urinary tract symptoms; Nurses; Toileting behaviour