Faglig rapport 2005 - Helse Vest

Forskerutdanning - dr.grad 911067:Legesøkningsatferd og pasientpreferanser for valg avbehandling belyst ved tilstanden urinkontinens hos kvinnerProsjektansvarlig: Máire O`Donnell (maire.odonnell@isf.uib.no), Universitetet i BergenUrinary incontinence: studies in treatment decisionsThe purpose of this study is to increase our knowledge about help-seeking behaviour andpreferences for involvement in treatment decision-making among women with urinaryincontinenceThe purpose of this study is to increase our knowledge about help-seeking behaviour and preferencesfor involvement in treatment decision-making among women with urinary incontinence.Urinary incontinence (UI) is a common condition among women with as many as 25-40% of adultwomen having UI. UI can be treated successfully leading to an improvement in the quality of life ofthose with the condition. Different treatment options exist which can be provided either in a generalpractice or hospital setting depending on the type of treatment proposed.Despite treatment options being available only a fourth of women with UI have consulted a doctorabout their condition. Many of the explanations given to explain why women do not seek help for UIrelate to women’s lack of knowledge of UI and treatment options. It is important for clinicians andhealth care planners to know how many women seek help about their UI and what factorscharacterise them as a group so that they can estimate patient load and consider more active ways ofinforming women with UI about their condition and treatment options.In recent years there has been a move towards involving patients more in decisions about their healthcare. Previous research on people’s preferences for involvement in health-care decisions has providedconflicting results. Some studies have found that people want to be more involved in treatmentdecision-making and others have reported that many people prefer to leave treatment decisions totheir doctors. It is therefore important to ask people if they want to be involved in decisions abouttheir health care and what factors might influence people’s preferences for involvement. Health careprofessionals’ awareness of patients’ preferences for involvement in decision-making can help improvecommunication between doctors and patients and the quality of care provided.In this study, using data collected from postal questionnaires in different European countries we planto look at:The number of women with UI who consult a doctor about their condition and factors associated withhelp-seeking behaviour, the types of health care professionals women consult about their UI; andPatients’ preferences for involvement in treatment decision-making and factors associated with thesepreferences.Completed research:Help-seeking behaviour and associated factors: In a study of help-seeking behaviour in women withurinary incontinence in France, Germany, Spain and the UK we found that 31% of women hadconsulted a doctor about their UI. More women consulted a doctor in France and Germany than inthe UK and Spain. Previous studies have shown that women are more likely to consult a doctor abouttheir UI as they get older or as the problem gets worse and more ‘bothersome’. We found that inaddition to these factors that women’s general health care behaviour was also associated with helpseekingwith women who had visited their doctor more often, were more likely to make regular checkup appointments with their doctor, and were willing to take long term medication were also morelikely to see a doctor about their UI. Women who had discussed their UI with others were also morelikely to have seen a doctor about their UI.305