Middle-aged And Old Women With Stress Urinary Incontinence In The Community Of Shanghai: Cross-sectional Study And Intervention Study

Objective:To investigate the related factors and prevalence of stress urinary incontinence in middle-aged and old women; to explore the effects of community intervention on improving knowledge, symptoms and condition-specific quality of life in women diagnosed with stress urinary incontinence.Method:This research project is carried on by two stages.The First Stage:In the cross-sectional study,1500 Shanghai women aged over 45 years were interviewed through questionnaires including International Consultation on Incontinence Questionnaire(ICI-Q-SF), SUI knowledge questionnaire and Incontinence QOL Instrument(I-QOL).The Second Stage:60 women from the first stage who met the inclusion criteria were randomly assigned into ether the intervention group(PFMT and daily life management) or the control group(no intervention). In term of population sociology, disease conditions, knowledge of SUI and severity of SUI, there were no significant differences between the two groups (P>0.05). Subjects of the intervention group received 2 collective education sessions and individual instructions(eg:telephone consultation). A 1-hour pad test, ICI-Q-SF, SUI knowledge questionnaire and I-QOL were used for repeat measurements before intervention, at 1 and 3 months after intervention.Results:The First Stage:①The prevalence of SUI was 21.6%. In multiple logistic models, body mass index, number of children deliver, level of education, income, respiratory disorder, urinary disorder and constipation were related factors for SUI(P<0.05).②The knowledge of SUI was at low level and the mean correct rate was 19.4%. In multiple regression models, educational status was related factor for knowledge level (P<0.001).③The mean QOL score was 79.11±14.91,3 subscale scores which from low to high were avoidance and limiting behaviors, social embarrassment and psychosocial effects. In multiple regression models, severity of SUI, educational status and income were related factors for QOL.The Second Stage:①The results of repeated measures ANOVA showed that the scores of SUI knowledge, daily life management knowledge and PFMT knowledge existed the interaction effect between time factor and group factor (P<0.001). As is indicated by multivariate ANOVA, the scores of SUI knowledge, daily life management knowledge and PFMT knowledge were significantly different between the intervention group and the control goup at 1 month and 3 months after intervention respectively (P<0.001).②The result of Mann-Whitney U test showed that at 3 months after intervention,1-hour pad test of the intervention group were lower compared with the control goup (P<0.001).The result of Wilcoxon test showed that 1-hour pad test of the intervention group were declined remarkably compared with the beginning (P<0.001).③The results of repeated measures ANOVA showed that the scores of ICI-Q-SF existed the interaction effect between time factor and group factor (P<0.001). As is indicated by multivariate ANOVA, the scores of ICI-Q-SF were significantly different between the intervention group and the control goup at 3 months after intervention (P<0.001), yet no statistic difference was found at 1 month (P>0.05).④The results of repeated measures ANOVA showed that the scores of QOL existed the interaction effect between time factor and group factor (P<0.001). As is indicated by multivariate ANOVA, the scores of QOL were significantly different between the intervention group and the control goup at 3 months after intervention (P<0.001), yet no statistic difference was found at 1 month (P>0.05).⑤The results of spearman correlation showed that the practice of PFMT was positively related to the severity of SUI (P<0.001). And the practice of PFMT was positively related to the improvement of 1-hour pad test (P <0.001)Conclusion:SUI has become a common disease among middle and old women. It is harmful to the physiological and mental health and affects QOL. Nowadays, the community people have little knowledge about SUI. A community intervention which including PFMT and daily life management was effective in improving knowledge, symptoms and QOL.