template design © 2008 a preliminary study of urinary incontinence in women using questionnaire...
Post on 12-Jan-2016
220 Views
Preview:
TRANSCRIPT
TEMPLATE DESIGN © 2008
www.PosterPresentations.com
A PRELIMINARY STUDY OF URINARY INCONTINENCE IN WOMEN USING QUESTIONNAIRE URINARY INCONTINENCE DIAGNOSIS (QUID)
Dhillon HK1, Gurpreet Kaur2 Anuar Zaini Md Zain1, Rusli Bin Nordin3
1 Jeffrey Cheah School of Medicine & Health Sciences, Monash University Sunway Campus , 46150, Bandar Sunway Malaysia. 2Institute for Public Health, Ministry of Health, Jalan Bangsar, 50590, Kuala Lumpur, Malaysia. 3Jeffrey Cheah School of Medicine & Health Sciences, Clinical School Johor Bahru, Monash University Sunway Campus, Johor Bharu, Malaysia
Introduction and Objectives
Introduction: Urinary incontinence (UI) is a well recognised but under-
diagnosed complaint in women, which still remains poorly documented in many
communities. Its prevalence values of between 14.51-2 and 40%6 have been
reported in Malaysian women, however the reason for this wide range in
prevalence is unclear.
A cross-sectional survey of 5,506 Asian women by The Asian Society for
Female Urology (ASFU) was conducted to determine the prevalence of UI in
11 Asian countries, including Malaysia. The prevalence of overactive bladder
was documented as 13.1% in Malaysian women2-3. In addition, the study was
criticised for leading toward an answer favouring urge urinary incontinence 3.
Low et al.5 using the Bristol Female Lower Urinary Tract Symptoms
Questionnaire reported that 19% of women in North Malaysia attending health
clinics had lower urinary tract symptoms.
A study on menopausal women living in Kelantan found that up to 40%6 of
women complained of having occasional stress incontinence and at least 24%
of the women complained of having weak bladder control 6.
Zalina et al.7 using an International Consultation on Incontinence
Questionnaire (ICIQ)-FLUTS on a cohort of medical and nursing student
population in Ipoh Perak documented the prevalence of UI at 34.9%.
Similar trends were also reported in Australian studies8. The reason/s for this
wide variability in prevalence rate was not clear. But it might result from
differences in the definitions used, duration of the reference period, or even the
design of the questionnaire8.
Hempel et al.4 in their attempt to document the different types of incontinence
experienced by Asian and Caucasian women found that the most common type
of incontinence in Asian women was mixed incontinence (63.8%), followed by
stress incontinence (13.1%). Comparatively, Caucasian women experienced
more of stress incontinence (50%) followed by mixed incontinence (29%)4.
However, no local studies have been conducted to verify this and/or even
identify the possible reasons for this.
The wide ranging prevalence of UI together with incomplete validated
information on the type of urinary incontinence and the associated risk factors
in Malaysian women has significant implications on the diagnosis and
management of UI. There is therefore a need to ascertain the exact prevalence
and types of UI and the associated risk factors in Malaysian women using a
standardized diagnostic tool.
After reviewing various questionnaires used in both local and international
studies for the diagnosis of UI, Questionnaire Urinary Incontinence Diagnosis
(QUID)9 was considered user friendly due to its availability in English, Malay,
Tamil and Mandarin language. QUID is a six item questionnaire which can be
easily used as a screening tool by various health professionals within any
healthcare settings and homes in Malaysia. In addition its primary version had
been used in studies in other countries and its usage here will help provide data
that would permit better comparison of UI between the different communities of
the world.
Objective: To determine the prevalence of UI and its risk factors in Malaysian women using QUID
Methods
Results Conclusions
References
Conclusion: Of the 109 respondents, 60.6% (n=66) had reported some degree
of urine leakage. Obesity, smoking, alcohol consumption, caffeine consumption,
physical activities, education, ethnicity, socio economic status, menopause and
age, were cross tabulated with respondents reporting urine incontinence. The
result from the pilot study confirms that the prevalence of urine incontinence is
higher in Malaysian women than previously reported by local studies. Also
women with tertiary education were more likely to report urine incontinence
than women with secondary education and less. The reason/s for this could be
many fold, including a common view shared by both public and health workers
that incontinence is associated with ageing, which may prevent its early
recognition and therefore its early management or may even prevent many
younger women with urinary incontinence from seeking medical treatment.
Currently, a larger scale study using QUID is in progress in Selangor and it is
expected to provide detailed information on UI in the female Malaysian
population.
OPTIONALLOGO HERE
OPTIONALLOGO HERE
Table 1: Association between Urinary Incontinence and Socio-demographic Characteristics
VariablesUrinary
incontinence No Urinary
incontinenceP value
n % n %Level of education (n=109) 0.035
Tertiary 47 55.3 38 44.7
Secondary and below 19 79.2 5 20.8
Age (years) (n=106) 0.696
<50 45 59.2 31 40.8
50 19 63.3 11 36.7
In menopause (n=109) 0.984
Yes 17 60.7 11 39.3No 49 60.5 32 39.5
Ethnicity (n=109) 0.875
Malay 19 59.4 13 40.6
Chinese 22 59.5 15 40.5
Indian 22 64.7 12 35.3
Income level (RM) (n= 87) 0.208
<1000 17 51.5 16 48.5
1000-<3000 22 71.0 9 29.0
3000 16 69.6 7 30.4
Work status (n= 110) 0.277
Working 46 64.8 25 35.2
Not working 20 54.1 17 45.9
Coffee consumption (n=109) 0.886
Yes27 61.4 17 38.6
No39 60.0 26 40.0
Alcohol consumption (n= 111) 0.239
Yes 24 68.6 11 31.4
No 42 56.8 32 43.2
Physical Activity (n= 109) 0.635
Yes 56 61.5 35 38.5
No 10 55.6 8 44.4
Smoking (n= 111) 0.150
Yes 66.0 61.7 41 38.3
No 0 0.0 2 100.0
BMI (n=106) 0.682
Normal BMI (18.5 – 25kg/m2) 39 62 24 38.1
Abnormal BMI (≥ 25kg/m2) 25 58 18 42
Marital status (n= 109)
Married 28 60.9 18 39.1 0.982
Single 37 60.7 24 39.3
Table 3 : Alcohol consumption and types of urinary incontinence
Variables
Types of UI
No UrineIncontinence
Stress Incontinence
Urge Incontinence
Mixed Incontinence
P value
n % n % n % n %
Overall 43 39.4 19 17.4 19 17.4 28 25.7
Alcohol consumption (n=111) 0.028
Yes 11 31.4 11 31.4 3 8.6 10 28.6
No 32 43.2 8 10.8 16 21.6 18 24.3
Note: The only variable significant with types of UI was alcohol consumption.
Methodology
Study Design: Cross-sectional Pilot study
Study Period: September 2011 - February 2012
Sample size & Study Population : 111 Malaysian women living inSelangor
The English version of Questionnaire for Urinary Incontinence Diagnosis was administered to women who fulfilled the eligibility
Inclusion criteria:
Healthy women age 18 years and above with well controlled non-
communicable diseases such as diabetes and hypertensionExclusion criteria:
Pregnant women and women who had delivered within the last two years
Women who have had an abortion within the year
Women who had undergone recent operation on their reproductive tract or had undergone cancer treatment in the last six months
Statistical Methods: Descriptive and inferential statistical analyses were used
Majority of the respondents were aged between 19 and 29 years. 33.3% were
Chinese, 56.9% were single and 78.4% had received tertiary education. More
than two-thirds were working (65.5%), more than half (37.9%) were earning
less than RM 1,000 per month. The only variable significant from bivariate
analysis was level of education (p=0.035) (Table 1).
Multinomial logistic regression analysis revealed that women who consumed alcohol were 4 times more likely to report stress incontinence compared to those who did not consume alcohol. There was no similar association with other types of UI (Table 4).
Among respondents having some type of UI, majority (42.2%) had mixed type UI, followed by an equal proportion (29%) reporting stress and urge UI. Alcohol consumption was the only significant variable associated with type of UI (Table 3).
Reference is no urinary incontinence † 95%CI for OR
Table 2: Association between Level of education and Urinary incontinence
Variables B S.E. Wald OR CI 95%
P value
Level of Education
Lower Upper
Tertiary 1.122 0.548 4.196 3.072 1.050 8.992 0.041
Constant -1.335 0.503 7.055 0.263 - - 0.008
Logistic regression analysis revealed that women with tertiary education had 3.1 times the odds of reporting UI compared to those with lower education (OR 3.073; 95%CI 1.050-8.992).
top related