SpringerLink
Log in

Factors Influencing Autonomy in Middle-Aged and Elderly Women with Urinary Incontinence

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

Urinary incontinence (UI) is relatively common among middle-aged and elderly women and can have significant impacts on patients' physiological, psychological, and quality-of-life aspects. A higher level of autonomy can encourage better health behaviors in patients, so as to promote rehabilitation of the disease and improve their quality of life. The study is aimed at exploring the level of autonomy and influencing factors among middle-aged and elderly women with UI.

Methods

A cross-sectional study was conducted at a tertiary hospital in Shenzhen, China. Middle-aged and elderly women were asked to complete the Index of Autonomous Functioning scale (IAF), the International Consultation on Incontinence Questionnaire—Urinary Incontinence Short Form (ICIQ-UI SF), and the Urinary Incontinence Quality of Life (I-QOL) scale. Data were collected in January 2024 to March 2024. Descriptive statistics, univariate analysis, bivariate correlation and multivariate linear regression were used to analyze data.

Results

A total of 646 women completed the questionnaire. The means and standard deviations (SD) of the IAF section were 45.40 ± 8.92, those of the ICIQ-UI SF section were 11.54 ± 3.67, and those of the I-QOL section were 43.95 ± 9.83. Multivariate linear regression models for the IAF revealed that questionnaire scores were independently associated with family's monthly income, education level, regular exercise, UI severity, and I-QOL score (p < 0.05).

Conclusions

The factors influencing the level of autonomy among middle-aged and elderly women with UI include family's monthly income, education level, regular exercise, UI severity, and I-QOL score. Higher levels of autonomy were observed among women with high family income, high education level, regular exercise habits, mild to moderate UI, and high quality of life.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price includes VAT (Germany)

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Russo E, Caretto M, Giannini A, et al. Management of urinary incontinence in postmenopausal women: an EMAS clinical guide. Maturitas. 2021;143:223–30.

    Article  CAS  PubMed  Google Scholar 

  2. Sussman RD, Syan R, Brucker BM. Guideline of guidelines: urinary incontinence in women. BJU Int. 2020;125(5):638–55.

    Article  PubMed  Google Scholar 

  3. Sedighe B, Rostam J, Masoud M, et al. Prevalence and factors related to urinary incontinence in older adults women worldwide: a comprehensive systematic review and meta-analysis of observational studies. BMC Geriatr. 2021;21(1):212.

    Article  Google Scholar 

  4. Zahra N, Mohammad AM, Sara J, et al. Urinary incontinence and related quality of life among elderly women in Tabas, South Khorasan, Iran. BMC Urol. 2022;22(1):214.

    Article  Google Scholar 

  5. Sorur J, Mahin G, Fatemeh S, et al. Psychosocial experiences of older women in the management of urinary incontinence: a qualitative study. Front Psychol. 2022;13:785446.

    Article  Google Scholar 

  6. Roberta PG, Larissa CP, Rose ARD, et al. Hospital care and urinary incontinence in the elderly. Rev Bras Enferm. 2019;72(Suppl 2):284–93.

    Article  Google Scholar 

  7. Fahimeh RF, Sepideh H, Soodabeh D, et al. Explaining factors affecting help-seeking behaviors in women with urinary incontinence: a qualitative study. BMC Health Serv Res. 2021;21(1):60.

    Article  Google Scholar 

  8. Aydin Aİ, Öz YÖ, Yildirim E, et al. Non-medication co** strategies for urinary incontinence in older adults: factors associated with frequency of use. Int Urogynecol J. 2022;33(5):1259–65.

    Article  Google Scholar 

  9. Huang H, Wang H, Donaghy E, et al. Using self-determination theory in research and evaluation in primary care. Health Expect. 2022;25(6):2700–8.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Flannery M. Self-determination theory: intrinsic motivation and behavioral change. Oncol Nurs Forum. 2017;44(2):155–6.

    PubMed  Google Scholar 

  11. Mingqiang X, Gengqiu H. The intervention model of health behavior based on self-determination theory. Chin J Health. 2010;26(04):306–9.

    Google Scholar 

  12. Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55(1)::68–78.

    Article  CAS  PubMed  Google Scholar 

  13. Ntoumanis N, Ng J, Prestwich A, et al. A meta-analysis of self-determination theory-informed intervention studies in the health domain: effects on motivation, health behavior, physical, and psychological health. Health Psychol Rev. 2021;15(2):214–44.

    Article  PubMed  Google Scholar 

  14. Avery K, Donovan J, Peters TJ, et al. ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourol Urodyn. 2004;23(4):322–30.

    Article  PubMed  Google Scholar 

  15. Linghua Z, Junqiao W, JiaojIao B, et al. Effects of community-wide behavioral intervention for middle-aged or elderly women with stress urinary incontinence on their knowledge and severity of symptoms. J Nurs Sci. 2011;26(15):1–4.

    Google Scholar 

  16. Weinstein N, Przybylski AK, Ryan RM. The index of autonomous functioning: development of a scale of human autonomy. J Res Pers. 2012;46(4):397–413.

    Article  Google Scholar 

  17. Jiayu W, Lei L, Cao H, et al. Chinese version of autonomic function index and its reliability and validity test. Chin Nurs Res. 2023;37(24):4413–6.

    Google Scholar 

  18. Patrick DL, Martin ML, Bushnell DM, et al. Quality of life of women with urinary incontinence: further development of the incontinence quality of life instrument (I-QOL). Urology. 1999;53(1):71–6.

    Article  CAS  PubMed  Google Scholar 

  19. Zhang D, Gao L, Jia Y, et al. Construction of progress prediction model of urinary incontinence in elderly women: protocol for a multi-center, prospective cohort study. Int J Environ Res Public Health. 2022;19(2):734.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Erekson E, Hagan KA, Austin A, et al. Outpatient evaluation and management visits for urinary incontinence in older women. J Urol. 2019;202(2):333–8.

    Article  PubMed  PubMed Central  Google Scholar 

  21. O’Reilly N, Nelson HD, Conry JM, et al. Screening for urinary incontinence in women: a recommendation from the women’s preventive services initiative. Ann Intern Med. 2018;169(5):320–8.

    Article  PubMed  Google Scholar 

  22. Esparza AO, Tomás M, Pina-Roche F. Experiences of women and men living with urinary incontinence: a phenomenological study. Appl Nurs Res. 2018;40:68–75.

    Article  PubMed  Google Scholar 

  23. Bannink R, Pearce A, Hope S. Family income and young adolescents’ perceived social position: associations with self-esteem and life satisfaction in the UK Millennium Cohort Study. Arch Dis Child. 2016;101(10):917–21.

    Article  PubMed  Google Scholar 

  24. Puciato D, Rozpara M, Bugdol M, et al. Quality of life of low-income adults. Work. 2023;74(2):631–48.

    Article  PubMed  Google Scholar 

  25. Yao L, Fang H, Leng W, et al. Effect of aerobic exercise on mental health in older adults: a meta-analysis of randomized controlled trials. Front Psychiatry. 2021;12:748257.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Lisa MG, Andy JK, Jakob DJ, et al. Self-efficacy, health literacy, and nutrition and exercise behaviors in a low-income, Hispanic population. J Immig Minor Health. 2017;19(2):489–93.

    Article  Google Scholar 

  27. Lövdén M, Fratiglioni L, Glymour MM, et al. Education and cognitive functioning across the life span. Psychol Sci Public Interest. 2020;21(1):6–41.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Hastaoglu F, Mollaoglu M. The effects of activities of daily living education on the independence and life satisfaction of elders. Perspect Psychiatr Care. 2022;58(4):2978–85.

    Article  PubMed  Google Scholar 

  29. Jianjuan D, Wei W, Boer Y, et al. Quality of work and life and its influencing factors in lung cancer patients returning to work. Chin J Gen Pract. 2024;22(03):513–6.

    Google Scholar 

  30. Javanmardifard S, Gheibizadeh M, Shirazi F, et al. Experiences of urinary incontinence management in older women: a qualitative study. Front Public Health. 2021;9:738202.

    Article  PubMed  Google Scholar 

  31. ÖzYıldırım Ö, Aydın Avci İ, Yıldırım E, et al. The effect of the Incontinence Health Belief Development Program on women’s urinary incontinence awareness and health beliefs: a randomized controlled trial. Int Urogynecol J. 2023;34(7):1385–93.

    Article  Google Scholar 

Download references

Acknowledgements

We would like to thank all the participants with urinary incontinence who participated in this study from January 2024 to March 2024 and thank the hospitals in Shenzhen, China.

Funding

This work was supported by the Shenzhen Municipal Science and Technology Innovation Commission Basic Research Program (Grant No.: JCYJ20230807142259030).

Author information

Authors and Affiliations

  1. Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, 518101, Guangdong, China

    Yingying Zhang, Jie Li, Yingjie Hu, Ling Chen, Wenzhi Cai & Wei Ren

  2. School of Nursing, Southern Medical University, Guangzhou, 510515, China

    Yingying Zhang, Jie Li, Yingjie Hu, Ling Chen, Wenzhi Cai & Wei Ren

Authors
  1. Yingying Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jie Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yingjie Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ling Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Wenzhi Cai
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Wei Ren
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Y.Z.: conceptualization, methodology, data curation, formal analysis, investigation, writing of original draft, review and editing; J.L.: conceptualization, methodology, data curation, formal analysis, investigation, writing of original draft, review and editing; Y.H.: conceptualization, methodology, project Coordination; L. C.: supervision, project administration; W.C.: supervision, project administration; W.R.: supervision, project administration.

Corresponding authors

Correspondence to Ling Chen, Wenzhi Cai or Wei Ren.

Ethics declarations

Ethical Approval

Ethical approval was received from the Ethics Committees of Shenzhen Hospital, Southern Medical University (No. NYSZYYEC20240001). The data obtained in interviews were anonymized and safely kept to protect the privacy of study subjects.

Conflicts of Interest

None.

Additional information

Handling Editor: G. Alessandro Digesu

Editor in Chief: Maria A. Bortolini

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Yingying Zhang and Jie Li are co-first authors.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, Y., Li, J., Hu, Y. et al. Factors Influencing Autonomy in Middle-Aged and Elderly Women with Urinary Incontinence. Int Urogynecol J (2024). https://doi.org/10.1007/s00192-024-05838-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00192-024-05838-9

Keywords

Search

Navigation