The Effect of Urinary Incontinence on the Quality of Life and the Spiritual Dimension of Life of Women

Yıl 2020, Cilt: 5 Sayı: 1, 50 - 58, 26.06.2020

Şebnem Rüzgar , Nebahat Özerdoğan , Ömer Yalçın

Öz

Aim: The cross-sectional hospital-based research was conducted to examine the effect of types of urinary incontinence (UI) on the quality of life and the spiritual dimension of life of women
Method: The study was conducted with 65 women who appliying a university hospital because of urinary incontinence symptoms, matching the inclusion criteria and participating voluntarily in the study. In data collecting; personal information form, Incontinence Quality of Life (I-QOL) and 1-hour Pad test were used. The data were obtained through face to face interviews in the room reserved for patients. High I-QOL scores scale indicate that the quality of life is better than the low scores. Data was analyzed by percentage, chi-square, One Way Anova and Mann Whitney U test.
Results: The mean age of women was 50.15±11.16 (min:23, mak:79). Among women 49.2% had mixed, 32.3% had stress, 18.5% had urge UI. 78.5% of women reported experiencing urinary leakage once and 44.6% use more than one pad per day. Types of incontinence of women and I-QOL scores difference was not significant (p>0.05). According to the pad test, women with ≥10grams urinary leakage had significantly lower I-QOL total and subscale scores compared with <10grams group (p<0.001). Women with ≥10grams urinary leakage more frequently cannot maintain ablution and pray, daily and spiritual lifes are negatively affected (p<0.05). Prevalance of women praying (namaz) sitting, restricting fluid intake and going toilet was significantly higher among women ≥10grams urinary leakage (p<0.05).
Conclusion: According to objective pad test results of women, increasing urinary leakage amount are negatively affected the quality of life and spiritual dimension of life. It was found that women with higher amount of leakage had more limiting behaviors and social isolation. Due to the UI problem women can use various coping methods to perform their religious beliefs.

Anahtar Kelimeler

Urinary incontinence, Quality of life, Religious beliefs, Spirituality

ÜRİNER İNKONTİNANSIN KADINLARIN YAŞAM KALİTESİ VE YAŞAMLARININ SPİRİTÜEL BOYUTUNA ETKİSİ

Öz

Amaç: Kesitsel tipteki hastane merkezli araştırma, üriner inkontinans tiplerinin kadınların yaşam kalitesi ve yaşamlarının spirütüel boyutuna etkisini incelemek amacıyla yapılmıştır.
Yöntem: Araştırma, bir üniversite hastanesi polikliniğine üriner inkontinans semptomları ile başvuran, çalışmanın dahil edilme kriterlerine uygun olan ve araştırmaya katılmayı kabul eden 65 kadın ile yapılmıştır. Verilerin toplanmasında; kişisel bilgi formu, İnkontinans Yaşam Kalitesi Ölçeği (I-QOL) ve 1 saatlik Ped testi kullanılmıştır. Veriler hastalar için ayrılan odada yüz yüze yapılan ikili görüşmelerle elde edilmiştir. I-QOL ölçeğinden alınan yüksek puanlar, düşük puanlara göre yaşam kalitesi düzeyinin daha iyi olduğunu göstermektedir. Veriler; sayı-yüzde dağılımı, ki-kare, Tek Yönlü Varyans Analizi ve Mann Whitney U testi ile analiz edilmiştir.
Bulgular: Araştırmaya alınan kadınların yaş ortalaması 50.15±11.16 (min:23, mak:79)’dir. Kadınların %49.2’si miks, %32.3’ü stres, %18.5’i urge inkontinans tipine sahiptir. Kadınların %78.5’i günde birden fazla sıklıkta idrar kaçırdığını, %44.6’sı günde bir adetten fazla ped/bez kullandığını ifade etmiştir. Kadınların inkontinans tiplerine göre I-QOL puanları anlamlı düzeyde farklılık göstermemiştir (p>0.05). Ped test sonucuna göre 10gr’dan fazla miktarda idrar kaçıran kadınların, 10gr’dan daha az kaçıranlarla karşılaştırıldığında I-QOL toplam ve alt boyut puan ortalamalarının anlamlı düzeyde daha düşük olduğu belirlenmiştir (p<0.001). Ped ağırlığı 10gr’dan fazla olan kadınların, daha yüksek oranda abdesti uzun süre tutamadığı, namaz kılamadığı, günlük ve dini yaşamlarının olumsuz etkilendiği belirlenmiştir (p<0.05). İdrar kaçırma problemi ile baş etmek için oturarak namaz kılan, sıvı alımını kısıtlayan ve duadan önce mesanesini boşaltan kadınların sıklığının, 10gr’dan fazla idrar kaçıranlar arasında anlamlı düzeyde daha yüksek olduğu görülmüştür (p<0.05).
Sonuçlar ve Öneriler: Kadınların objektif ped test sonuçlarına göre kaçırılan idrar miktarı arttıkça yaşam kalitesi ve yaşamlarının spiritüel boyutunun olumsuz etkilendiği belirlenmiştir. Kaçırılan idrar miktarının artmasıyla kadınların daha fazla davranışlarını sınırlandırdıkları ve sosyal izolasyon yaşadıkları görülmüştür. İdrar kaçırma problemi nedeniyle kadınlar dini ibadetlerini yerine getirebilmek için çeşitli baş etme yöntemlerine başvurabilmektedirler. 

Anahtar Kelimeler

Üriner inkontinans, yaşam kalitesi, dini inanışlar

Kaynakça

• Abrams, P., Andersson, K. E., Birder, L., Brubaker, L., Cardozo, L., Chapple, C., … Wyndaele, J. J. (2010). Fourth international consultation on incontinence recommendations of the international scientific committee: Evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourology and Urodynamics, 29, 213–240. https://doi.org/10.1002/nau.20870
• Cetinel, B., Demirkesen, O., Tarcan, T., Yalcin, O., Kocak, T., Senocak, M., & Itil, I. (2007). Hidden female urinary incontinence in urology and obstetrics and gynecology outpatient clinics in Turkey: What are the determinants of bothersome urinary incontinence and help-seeking behavior? Int Urogynecol J Pelvic Floor Dysfunct, 18(6), 659–664. https://doi.org/10.1007/s00192-006-0223-6
• Chaliha, C., & Stanton, S. L. (1999). The ethnic cultural and social aspects of incontinence - A pilot study. International Urogynecology Journal, 10(3), 166–170. https://doi.org/10.1007/s001920050039
• Çiloğlu, D., & Zaybak, A. (2020). Üriner İnkontinanslı Bireylerde Baş Etme Davranışları ve Yaşam Kalitesi. Türkiye Klinikleri Hemşirelik Bilimleri Dergisi, 12(1), 64–71. https://doi.org/10.5336/nurses.2019-70330
• Dursun, P., Dogan, N. U., Kolusari, A., Dogan, S., Ugur, M. G., Komurcu, O., … Yigit, F. A. (2014). Differences in geographical distribution and risk factors for urinary incontinence in Turkey: Analysis of 6,473 women. Urologia Internationalis, 92(2), 209–214. https://doi.org/10.1159/000353347
• El-Azab, A. S., Mohamed, E. M., & Sabra, H. I. (2007). The prevalence and risk factors of urinary incontinence and its influence on the quality of life among Egyptian women. Neurourology and Urodynamics, 26(6), 783–788. https://doi.org/10.1002/nau.20412
• Firdolas, F., Onur, R., Deveci, S. E., Rahman, S., Sevindik, F., & Acik, Y. (2012). Effect of urinary incontinence and its subtypes on quality of life of women in Eastern Turkey. Urology, 80(6), 1221–1226. https://doi.org/10.1016/j.urology.2012.08.023
• Ghafouri, A., Alnaimi, A. R., Alhothi, H. M., Alroubi, I., Alrayashi, M., Molhim, N. A., & Shokeir, A. A. (2014). Urinary incontinence in Qatar: A study of the prevalence, risk factors and impact on quality of life. Arab Journal of Urology, 12(4), 269–274. https://doi.org/10.1016/j.aju.2014.08.002
• Gökşin, İ., Aşiret, G. D., & Yılmaz, C. K. (2020). Usage of complementary and alternative medicine in women with urinary incontinence in one Turkish hospital. Integrative Medicine Research. https://doi.org/10.1016/j.imr.2020.100403
• Hamid, T. A., Pakgohar, M., Ibrahim, R., & Dastjerdi, M. V. (2015). “Stain in life”: The meaning of urinary incontinence in the context of Muslim postmenopausal women through hermeneutic phenomenology. Archives of Gerontology and Geriatrics, 60(3), 514–521. https://doi.org/10.1016/j.archger.2015.01.003
• Haylen, B. T., De Ridder, D., Freeman, R. M., Swift, S. E., Berghmans, B., Lee, J., … Schaer, G. N. (2010). An international urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J, 21, 5–26. https://doi.org/10.1002/nau.20798
• Higa, R., Lopes, M. H. B. de M., & Turato, E. R. (2008). Psychocultural meanings of urinary incontinence in women: a review. Revista Latino-Americana de Enfermagem, 16(4), 779–786. https://doi.org/10.1590/s0104-11692008000400020
• Ilce, A., & Ayhan, F. (2011). The identification of urinary and fecal incontinence in older people and its effects over life quality: briefing and training. Anatolian J Clin Invest, 5(1), 15–23.
• Karaca, B. Ş., & Nur Demir, A. (2019). Üriner İnkontinansın Kadın Hastalarda Yaşam Kalitesi ve Duygu Durum Üzerine Etkisi ve Hastaların Egzersiz Farkındalık Düzeyleri. Ankara Eğt. Arş. Hast. Derg., 52(2), 133–137.
• Kocak, I., Okyay, P., Dundar, M., Erol, H., & Beser, E. (2005). Female urinary incontinence in the west of Turkey: Prevalence, risk factors and impact on quality of life. European Urology, 48(4), 634–641. https://doi.org/10.1016/j.eururo.2005.04.017
• Kocaöz, S., Talas, M. S., & Atabekoǧlu, C. S. (2012). Urinary incontinence among Turkish women: An outpatient study of prevalence, risk factors, and quality of life. Journal of Wound, Ostomy and Continence Nursing, 39(4), 431–439. https://doi.org/10.1097/WON.0b013e318259c42b
• Lasserre, A., Pelat, C., Guéroult, V., Hanslik, T., Chartier-Kastler, E., Blanchon, T., … Bloch, J. (2009). Urinary Incontinence in French Women: Prevalence, Risk Factors, and Impact on Quality of Life. European Urology, 56(1), 177–183. https://doi.org/10.1016/j.eururo.2009.04.006
• Lucas, M. G., Bedretdinova, D., Bosch, J. L. H. R., Burkhard, F., Cruz, F., Nambiar, A. K., … Pickard, R. S. (2014). Guidelines on Urinary Incontinence. European Association of Urology, 1–120. https://doi.org/10.1016/j.acuro.2011.03.012
• Miller, K. L. (2005). Stress urinary incontinence in women: Review and update on neurological control. Journal of Women’s Health, 14(7), 595–608. https://doi.org/10.1089/jwh.2005.14.595
• Milsom, I., & Gyhagen, M. (2019). The prevalence of urinary incontinence. Climacteric, 22(3), 217–222. https://doi.org/10.1080/13697137.2018.1543263
• Minassian, V. A., Drutz, H. P., & Al-Badr, A. (2003). Urinary incontinence as a worldwide problem. International Journal of Gynecology and Obstetrics, Vol. 82, pp. 327–338. https://doi.org/10.1016/S0020-7292(03)00220-0
• Nager, C. W., Schulz, J. A., Stanton, S. L., & Monga, A. (2001). Correlation of urethral closure pressure, leak-point pressure and incontinence severity measures. International Urogynecology Journal, 12, 395–400. https://doi.org/10.1007/s001920170020
• Onur, R., Deveci, S. E., Rahman, S., Sevindik, F., & Acik, Y. (2009). Prevalence and risk factors of female urinary incontinence in eastern Turkey. International Journal of Urology, 16(6), 556–569. https://doi.org/10.1111/j.1442-2042.2009.02311.x
• Özerdoğan, N., Beji, N. K., & Yalçın, Ö. (2004). Urinary Incontinence: Its Prevalence, Risk Factors and Effects on the Quality of Life of Women Living in a Region of Turkey. Gynecologic and Obstetric Investigation, 58(3), 145–150. https://doi.org/10.1159/000079422
• Park, E., & K, K. (2014). Factors Affecting the Incontinence-Quality of Life Among Women with Urinary Incontinence. International Journal of Applied Engineering Research, 9(24), 25097–25108.
• Rizk, D. E. E., Shaheen, H., Thomas, L., Dunn, E., & Hassan, M. Y. (1999). The prevalence and determinants of health care-seeking behavior for urinary incontinence in United Arab Emirates women. International Urogynecology Journal, 10(3), 160–165. https://doi.org/10.1007/s001920050038
• Samuelsson, E., Victor, A., & Svärdsudd, K. (2000). Determinants of urinary incontinence in a population of young and middle-aged women. Acta Obstetricia et Gynecologica Scandinavica, 79(3), 208–215. https://doi.org/10.1034/j.1600-0412.2000.079003208.x
• Sange, C., Thomas, L., Lyons, C., & Hill, S. (2008). Urinary incontinence in Muslim women. Nurs Times, 104(25), 49–52.
• Siddiqui, N. Y., Levin, P. J., Phadtare, A., Pietrobon, R., & Ammarell, N. (2014). Perceptions about female urinary incontinence: a systematic review. International Urogynecology Journal, 25(7), 863–871. https://doi.org/10.1007/s00192-013-2276-7
• Stach-Lempinen, B., Kirkinen, P., Laippala, P., Metsanoja, R., & Kujansuu, E. (2004). Do objective urodynamic or clinical findings determine impact of urinary incontinence or its treatment on quality of life? Urology, 63, 67–71.
• Sykes, D., Castro, R., Pons, M. E., Hampel, C., Hunskaar, S., Papanicolaou, S., … Monz, B. U. (2005). Characteristics of female outpatients with urinary incontinence participating in a 6-month observational study in 14 European countries. Maturitas, 30(52), 13–23. https://doi.org/10.1016/j.maturitas.2005.09.003
• van den Muijsenbergh, M. E. T. C., & Lagro-Janssen, T. A. L. M. (2006). Urinary incontinence in Moroccan and Turkish women: A qualitative study on impact and preferences for treatment. British Journal of General Practice, 56(533), 945–949.
• Wilkinson, K. (2001). Pakistani women’s perceptions and experiences of incontinence. Nursing Standard (Royal College of Nursing (Great Britain) : 1987), 16(5), 33–39. https://doi.org/10.7748/ns2001.10.16.5.33.c3099