Strategies for daily-living management of urinary incontinence in the community

People with urinary incontinence use adaptive daily-living strategies to help normalise urinary incontinence in their daily lives. The aims of this multi-method project were to:
i) identify symptoms and situations that are the most bothersome;
ii) explore strategies for daily-living self-management of persistent urinary incontinence used by community-dwelling, working-age women, retired-aged women and men.

Methods
To explore the perspectives of people who live with incontinence, 310 community-dwelling women and men and were surveyed and 29 participants were interviewed. The questionnaire included items related to: demographic information, activity level, severity and duration of urinary incontinence, impact on daily life, daily-living strategies, and management difficulties experienced. Interviews explored clients’ perspectives on how and why they developed strategies for managing urinary incontinence. A survey of 84 continence nurse specialists was conducted to explore current best practice for client advice on daily-living self management of urinary incontinence.

Results
The most difficult incontinence symptoms to manage were those that: occur frequently, publicly, have social stigma, or over which there is limited control. To prevent, reduce or manage urinary incontinence episodes, participants used modifying, concealing, containing and restricting strategies applied to everyday functions including: planning, routines, toileting, using pads and aids, adjusting diet and fluids, body care and hygiene, physical activity and exercise, modifying the environment, and managing social situations. Participants distinguished between treatment and managing socially, and strategies used at home and when out. Health professional advice could be ignored, if short-term social continence could be maintained.

Conclusions
Understanding the strategies that women and men use to manage incontinence in their daily lives will enable nurses to assist people with urinary incontinence to develop effective daily-living continence management strategies and provide differentiated advice, based on clients’ settings and activities.

Acknowledgement: Project Funded by an Australian Federal Government National Continence Management Strategy Innovative Grant.