Urinary Incontinence in Women: 5 Reasons Why They Don’t Seek Health Care

Literature Review Reveals Five Major Reasons

While urinary incontinence (UI) affects about half of all women, especially as they age, many older women do not seek care for UI. In a recent literature review, the author looked for answers by examining the care-seeking behavior of older community-dwelling women. The author noted older women (greater than 50 years of age who are post-menopausal) “may visit health care providers less frequently than during child-bearing or pre-menopausal years.”¹ In addition, community dwelling women have more challenges seeking healthcare than those living in long-term care or rehabilitation facilities.

The study reviewed 18 articles related to women with UI and their health care-seeking behavior for the years 2001 through 2012. Five major reasons emerged for women not seeking care.

Severity and Relativity – The research revealed a woman’s perception and symptom interpretation play a big role in care-seeking behavior. “Women who perceive the symptoms of their UI to be mild or not very bothersome are less likely to seek care.”¹ Women may also frame the severity of their UI symptoms relative to other illnesses and consider UI not important enough to seek care. Yet the author noted, “An increase in severity can result in an increase in care-seeking behavior.”¹

Normal Part of Aging – Studies also noted many women perceive UI to be a normal part of aging or “being a woman”. Of course, the author pointed out, “UI is not a normal part of aging … aging may result in an increased risk of UI.”¹ Here health care providers can help patients understand this distinction and urge them to seek care when symptoms arise.

Self-Care and Coping – Many women in the studies also described UI as an illness that requires coping and self-care to be managed. Women tend to see themselves as caretakers, able to determine when they can cope with a health problem and when it needs professional care. Throughout the literature, “women described various methods of self-care, including pads, fluid restriction, pelvic floor muscle exercises, regular toileting, and immediately locating bathrooms when outside their homes.”¹

Knowledge Regarding Treatment Options – The research also showed that women do not seek care due to limited knowledge of treatment options.1 However this limited knowledge was often related to women thinking UI was a normal process or not severe enough to need treatment. This being the case, they are unlikely to discuss the problem or learn about treatment.

Relationship and Rapport With Provider – The literature review also highlighted the value of a good patient provider relationship. Women cited difficulties with scheduling appointments, how much could be discussed during an appointment, providers that do not stay with a practice, and other concerns that kept them from seeking care. As the author commented, “Relationships between patients and providers can have a substantial impact on the care-seeking behavior of patients.”¹

The findings in this study support a clear opportunity for more education and outreach to community dwelling women who may be experiencing UI – and understanding why they choose not to seek health care. In conclusion, the author stated, “It is crucial that policies, practice guidelines, and educational institutions prepare and support nurses in screening and providing appropriate treatment for UI.”¹

¹ Strickland, R. (2014) Reasons for not seeking care for urinary incontinence in older community-dwelling women: A contemporary review. Urologic Nursing, 34(2), 63-68.