Mental Health and Quality of Life among Women with Incontinence

Abstract

Incontinence is an individual's involuntary incontinence of urine and/or feces. It is a serious health problem that significantly affects the individual's mental health and quality of life. Women experience incontinence 3-4 times higher than men, and the prevalence of incontinence continuously increases with age in both sexes. The diagnosis, treatment, and rehabilitation process affect an individual psychologically, physically, socially, and emotionally. Women who suffer from incontinence restrict daily life, such as not exercising, traveling, and having social and emotional interactions. Over time women socially isolated and may lose their self-confidence. It decreases the quality of life with feelings of shame, depression, anxiety, and discomfort. This process affects women's mental health. The review aims to examine the effects of incontinence on women's mental health and quality of life in line with current researches and suggestions that women's health and psychiatric nurses implement in the clinic areas.

Keywords

• mental health
• depression
• quality of life
• women
• incontinence

Mental Health and Quality of Life among Women with Incontinence

Abstract

İnkontinans, bireyin istemsiz bir şekilde idrar ve/veya feçes kaçırma durumudur. Bu durum bireyin ruh sağlığını ve yaşam kalitesini etkileyen ciddi bir sağlık sorunudur. Kadınlarda, erkeklere oranla 3-4 kat daha fazla görülür ve yaşla birlikte her iki cinste de artar. Birey, tanı, tedavi ve rehabilitasyon sürecinde psikolojik, fiziksel, sosyal ve emosyonel yönden olumsuz şekilde etkilenmektedir. Kadın inkontinans sorunu nedeniyle, fiziksel aktivite yapmak, seyahat etmek, sosyal ve duygusal ilişkiler kurmak istemez. Günlük yaşam aktivitelerini kısıtlayan, sosyal aktivitelere katılmayan kadın zamanla kendisine olan güvenini kaybeder. Utanma, depresyon, anksiyete ve rahatsızlık hisleriyle yaşam kalitesini düşürür. Bu süreç kadının ruh sağlığını etkilemektedir. Bu derlemenin amacı, inkontinansın kadının ruh sağlığı ve yaşam kalitesi üzerindeki etkisini güncel çalışmalar doğrultusunda incelemek ve bu süreçte kadın doğum ve psikiyatri hemşirelerinin uygulayabileceği öneriler sunmaktır.

Keywords

• ruh sağlığı
• depresyon
• yaşam kalitesi
• kadın
• inkontinans

References

1. Haylen BT, de Ridder D, Freeman RM, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29(1):4-20. doi:10.1002/nau.20798
2. Sountoulidis P. Stress urinary incontinence definition https://www.ics.org/committees/standardisation/terminologydiscussions/sui
3. Meijlink, J. Urgency urinary incontinence definition https://www.ics.org/committees/standardisation/terminologydiscussions/urgency
4. Rademarkers, K. Mixed ürinary incontinence definition https://www.ics.org/committees/standardisation/terminologydiscussions/femalemixedurinaryincontinencemui
5. Ertem G. Pelvik taban disfonksiyonu, epidemiyolojisi, risk faktörleri ve yaşam kalitesi üzerine etkisi. In: Pelvik Taban Disfonksiyonu, Tanı, Tedavi ve Bakımda Güncel Yaklaşımlar. Nezihe KB, Gülsen Ç, eds. Istanbul: Nobel Tıp Kitabevi; 2020.
6. Zago AC, Fambrini Maria AS, Silva Elaine PG, et al. Prevalence and knowledge of urinary incontinence and possibilities of treatment among low-income working women. Fisioter. Mov, 2017;30(1): 151-159. doi:10.1590/1980-5918.030.s01.ao15
7. Zengin N. Urinary incontinence prevalence and risk factors in women. Firat Saglik Hizmetleri Dergisi, 2010;5(13):45–60.
8. Stickley A, Santini ZI, Koyanagi A. Urinary incontinence, mental health and loneliness among community-dwelling older adults in Ireland. BMC Urol. 2017;17(1):29. doi:10.1186/s12894-017-0214-6

9. Kwon BE, Kim GY, Son YJ, Roh YS, You MA. Quality of life of women with urinary incontinence: a systematic literature review. Int Neurourol J. 2010;14(3):133-138. doi:10.5213/inj.2010.14.3.133
10. Wu JM, Vaughan CP, Goode PS, et al. Prevalence and trends of symptomatic pelvic floor disorders in U.S. women. Obstet Gynecol. 2014;123(1):141-148. doi:10.1097/AOG.0000000000000057
11. Kwak Y, Kwon H, Kim Y. Health-related quality of life and mental health in older women with urinary incontinence Aging Ment Health. 2016;20(7):719-726. doi:10.1080/13607863.2015.1033682
12. Mishra GD, Barker MS, Herber-Gast GC, Hillard T. Depression and the incidence of urinary incontinence symptoms among young women: Results from a prospective cohort study. Maturitas. 2015;81(4):456-461. doi:10.1016/j.maturitas.2015.05.006
13. Zhu L, Lang J, Liu C, et al. Epidemiological study of urge urinary incontinence and risk factors in China. Int Urogynecol J. 2010;21(5):589-593. doi:10.1007/s00192-009-1041-4
14. Baykuş N, Yenal K. Prevalence of urinary incontinence in women aged 18 and over and affecting factors. Journal of Women & Aging. 2019;1-13. doi: 10.1080/08952841.2019.1682923
15. Yılmaz B, Aslan E. Fecal Incontinence and Nursing Approach. Suleyman Demirel University The Journal of Health Science. 2018;9(3):39-44. doi: 10.22312/sdusbed.362880
16. Yılmaz E, Muslu A, Özcan E. Quality of life at women with urinary incontinence. ERÜ Sağlık Bilimleri Fakültesi Dergisi. 2014;2(2):1-14.
17. Terzi H, Terzi R, Kale A. Urinary incontinence frequency and affecting factors in women aged over 18. Ege Journal of Medicine 2013;52:15-9.
18. Çiftçi Ö, Günay O. Prevalence of Urinary Incontinence and Affecting Factors Among the Women Attending Gynaecology Clinics of Kayseri Education and Research Hospital. Erciyes Med J. 2011; 33(4): 301-308
19. Koloski NA, Jones M, Kalantar J, Weltman M, Zaguirre J, Talley, NJ. Psychological impact and risk factors associated with new-onset fecal incontinence. Journal of Psychosomatic Research. 2012;73(6):464–68. doi: 10.1016/j.jpsychores.2012.07.013
20. Sinclair AJ, Ramsay IN. The psychosocial impact of urinary incontinence in women. The Obstetrician & Gynaecologist. 2013; 13: 143-148. doi:10.1576/toag.13.3.143.27665
21. Amanak K , Sevi̇l Ü . Comparison of Life Satisfaction and Social Anxiety Levels in Women with and without Urinary Incontinenceı. J DU Health Sci Inst. 2020; 10(2): 217-222. doi: 10.33631/duzcesbed.552334
22. Demir S, Beji, NK. Quality of life and health seeking behaviors of women with urinary incontinence. Florence Nightingale Journal of Nursing. 2015;23(1):23-31.
23. Öztürk GZ, Toprak D, Basa E. The frequency and the affecting factors of urinary incontinence in women over 35 years old. SETB 2012;46(4):170-6.
24. Howard, S. Urinary incontinence in women: quality of life and help-seeking faith. British Journal of Nursing 2010;19(12):742-9.
25. WHO. Depression definition. https://www.who.int/news-room/fact-sheets/detail/depression
26. Elenskaia K, Haidvogel K, Heidinger C, Doerfler D, Umek W, Hanzal E. The greatest taboo: urinary incontinence as a source of shame and embarrassment. Wien Klin Wochenschr. 2011;123(19-20):607-610. doi:10.1007/s00508-011-0013-0
27. Çayan S, Yaman Ö, Orhan İ, et al. Prevalence of sexual dysfunction and urinary incontinence and associated risk factors in Turkish women. Eur J Obstet Gynecol Reprod Biol. 2016;203:303-308. doi:10.1016/j.ejogrb.2016.06.030
28. Avery, J.C., Stocks, N.P., Duggan, P. et al. Identifying the quality of life effects of urinary incontinence with depression in an Australian population. BMC Urol 2013;13(11):1-9. doi: 10.1186/1471-2490-13-11
29. Can T, Yağcı N, Cavlak U. Effects of urinary incontinence on depressive symptoms and quality of life in women with reproductive age. Fizyoter Rehabil. 2012;23(2):83-9.
30. İrer B, Şen V, Demir Ö, Bozkurt O, Esen A. The effects of urinary incontinence subtypes on quality of life: does it matter urinary incontinence subtype on doctor consultation. Ortadogu Medical Journal 2018;10(1):12-8. doi: 10.21601/ortadogutipdergisi.330654
31. Felde G, Bjelland I, Hunskaar S. Anxiety and depression associated with incontinence in middle-aged women: a large Norwegian cross-sectional study. Int Urogynecol J. 2012;23(3):299-306. doi:10.1007/s00192-011-1564-3
32. Yazdany T, Bhatia N, Reina A. Association of depression and anxiety in underserved women with and without urinary incontinence. Female Pelvic Med Reconstr Surg. 2014;20(6):349-353. doi:10.1097/SPV.0000000000000071
33. Bilge Ç, Beji NK. Life Quality Scales Used for Evaluating Urinar Symptoms in Women. J Female Funct Urol 2015;1-2-3-4:41-5. doi: 10.4274/kiud.98608J
34. Coyne KS, Kvasz M, Ireland AM, Milsom I, Kopp ZS, Chapple CR. Urinary incontinence and its relationship to mental health and health-related quality of life in men and women in Sweden, the United Kingdom, and the United States. Eur Urol. 2012;61(1):88-95. doi:10.1016/j.eururo.2011.07.049.
35. Lim YM, Lee SR, Choi EJ, Jeong K, Chung HW. Urinary incontinence is strongly associated with depression in middle-aged and older Korean women: Data from the Korean longitudinal study of ageing. Eur J Obstet Gynecol Reprod Biol. 2018;220:69-73. doi:10.1016/j.ejogrb.2017.11.017
36. Riss P, Kargl J. Quality of life and urinary incontinence in women. Maturitas. 2011;68(2):137-142. doi:10.1016/j.maturitas.2010.11.006
37. Mitchell J, et al. Institute for clinical systems improvement. Adult depression in primary care. 2016. https://www.icsi.org/wp-content/uploads/2019/01/Depr.pdf.
38. Coğupligil E, Yıldırım İ. Yaşam kalitesi değerlendirme araçları. In: Pelvik Taban Disfonksiyonu: Multidisipliner Bir Yaklaşım. B. Seçkin, A. Ergen, E. Aydur, K. İnci, eds. Ankara: Türkiye Klinikleri; 2006.
39. Öztürk O, Uluşahin A, eds. Ruh Sağlığı ve Bozuklukları 15th ed.. Ankara: Nobel Tıp Kitabevi; 2015.
40. Başoğul C, Buldukoğlu K. Psychosocial Interventions in Depressive Disorders. Current Approaches in Psychiatry 2015;7(1):1-15. doi: 10.5455/cap.20140426072955.
41. Forsman AK, Nordmyr J, Wahlbeck K. Psychosocial interventions for the promotion of mental health and the prevention of depression among older adults. Health Promot Int. 2011;26(1):i85-i107. doi:10.1093/heapro/dar074
42. Ertekin PŞ, Tel, H. Individual with a diagnosis of depression and nursing approach. Journal of Psychiatric Nursing 2012;3(2):86-91.
43. Bilgic D, Beji NK, Ozbas A, Cavdar İ, Yalcin O. Approaches to cope with stress and depression in individuals with urinary incontinence. Gynecol Obstet Invest. 2017;82:181-7.
44. WHO. Health definition. https://www.who.int/about/who-we-are/frequently-asked-questions
45. Çam Ç. Yaşam kalite testleri. In: Temel Ürojinekoloji. Önay Y, ed. İstanbul: Nobel Tıp Kitabevi; 2009.
46. Demirci N, Başar F, Süzer F, Aba YA, Ataman H. Urinary Incontinence in Women in Nursing Homes and Its Effect on Life Quality. Fırat Sağlık Hizmetleri Dergisi 2011;18:85-101.
47. Kaya S, Akbayrak T, Orhan C, Beksaç S. A comparison of patient characteristics and urinary parameters in women with various types of urinary incontinence: a retrospective study. Journal of Exercise Therapy and Rehabilitation 2015;2(3):93-100.
48. Krhut J, Gärtner M, Mokris J, et al. Effect of severity of urinary incontinence on quality of life in women. Neurourol Urodyn. 2018;37(6):1925-1930. doi:10.1002/nau.23568
49. Mallah F, Montazeri A, Ghanbari Z, Tavoli A, Haghollahi F, Aziminekoo E. Effect of Urinary Incontinence on Quality of Life among Iranian Women. J Family Reprod Health. 2014;8(1):13-19.
50. Smith TM, Menees SB, Xu X, Saad RJ, Chey WD, Fenner DE. Factors associated with quality of life among women with fecal incontinence. Int Urogynecol J. 2013;24(3):493-499. doi:10.1007/s00192-012-1889-6.