Urinary Incontinence Self-Management in Rural Midlife Women: A Mixed Methods Study

Urinary incontinence (UI) affects over half of adult women in the United States and negatively impacts physical and psychological health. Our understanding of UI self-management is limited to older, urban women despite the prevalence of UI in all women, particularly during the midlife period.

The purpose of this study was to examine how contextual factors influence UI self-management behaviors of rural, midlife women with UI.

A convergent, mixed-methods study was conducted with 31 rural women aged 30-60 years who were recruited via social media. Participants completed a demographics questionnaire, individual interview, and questionnaires to assess contextual factors: UI subtype, incontinence severity, access to care, and quality of life (QOL) impact. Analyses included qualitative description, descriptive statistics and correlations, and data integration to assess for convergence.

Qualitative interview results have been published. The strongest correlation was seen between incontinence severity and QOL impact. Significant correlations were found between postmenopausal status, UI subtype, incontinence severity, and QOL impact. Integration of qualitative and quantitative data revealed difference between incontinence severity and the qualitative themes self-management behaviors and medical encounters. As incontinence severity increased, the intensity of self-management behaviors increased. Lacking knowledge about symptom reduction and providers' fatalistic attitudes were barriers to improving UI self-management in this rural sample.

Findings demonstrate a need for specific health care educational resources and supportive interactions to reduce the QOL impact of UI in rural midlife women.