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Women's Self-Management of Urinary Incontinence: A Qualitative Study Using the Proactive Health Behavior Framework
Xiaotong Zhong1,2, Kailun Gao1,2, Yingying Zhang3
1Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, 518101, China.
International Urogynecology Journal
|January 22, 2026
Summary
Urinary incontinence self-management in older women is hindered by misconceptions, low perceived effectiveness, and inadequate support. Interventions should address individual, social, and systemic factors for better adherence.
Area of Science:
- Gerontology
- Urology
- Health Behavior
Background:
- Urinary incontinence (UI) affects many middle-aged and older women.
- Patient adherence to conservative UI treatment guidelines is often suboptimal.
- A gap exists between recommended UI management and its practical application.
Purpose of the Study:
- To explore factors influencing self-management behaviors in middle-aged and older women with UI.
- To apply the Proactive Health Behavior (PHB) framework to understand UI self-management.
- To identify barriers and facilitators to effective UI self-care.
Main Methods:
- Qualitative descriptive study design.
- Semi-structured interviews with 21 middle-aged and older women diagnosed with UI.
- Data analysis using inductive and deductive methods guided by the PHB framework.
Main Results:
- Seven themes identified, including misconceptions, diminished agency, inadequate standardized management, lack of social support, life pressures, lifestyle patterns, and historical constraints.
- Most participants showed low adherence to self-management and limited willingness for medical treatment.
- Self-management factors operate at micro (cognitive/motivational), meso (social support), and macro (healthcare system) levels.
Conclusions:
- UI self-management in older women is multifactorial.
- Comprehensive, multi-level interventions are necessary to improve UI management.
- Interventions should enhance patient awareness, competencies, and promote behavioral change.
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