"Stain in life": the meaning of urinary incontinence in the context of Muslim postmenopausal women through hermeneutic phenomenology

Introduction: UI is a worldwide chronic condition among postmenopausal women. Little is known about the meaning of lived experiences of urinary incontinence of these women's viewpoints in their context. Objective: The aim of this study was to illuminate the experience of Muslim community-dwelling postmenopausal women who were living with urinary incontinence (UI). Methods: Seventeen women with UI (range: 52-68 years) who had experienced it for more than ten years were interviewed. A phenomenological hermeneutic method was used to analyze and interpret the interview texts. Results: The women's experiences of living with urinary incontinence have been presented in terms of three main themes: disruption of normal functioning, self-imposed restriction, and feelings of despair. Disruption of normal functioning meant emotional, spiritual, physical, and daily life disruption. Self-imposed restriction meant suppression of delights and needs and avoidance of social interactions. Feelings of despair referred to predictions of a bad and dark future of living with urinary incontinence, ambiguity, and hopelessness. The meaning of living with UI has been considered a 'stain in life'. Health care providers should be familiar with the different manifestations of urinary incontinence for early diagnosis and prevention of the negative effects of this condition to improve quality of life. In addition, symbolic interactionism theory can help health care providers to understand the meaning of urinary incontinence for women

Portrait representation of postmenopausal women's experiences of living with urinary incontinence

This study explored the meaning of the experiences of community-dwelling postmenopausal women who were born and grew up in a Muslim country when drawing a picture about their lived experiences of urinary incontinence. Hermeneutic phenomenology underpinned the study’s interpretive research approach. In-depth, semistructured interviews were conducted in two sessions with nine postmenopausal women. The participants were asked to draw a picture about their lived experiences of urinary incontinence in a self-portrait. Three themes emerged to illuminate the meaning of urinary incontinence, including “disruption of normal functioning,” “self-imposed restrictions,” and “feeling of despair.” Discussion of these themes was presented, and practice and research implications were suggested

Priority Setting for Improvement of Cervical Cancer Prevention in Iran

Background: Cervical cancer is the fourth most common cancer among women worldwide. Organized cervical screening and vaccination against human papilloma virus (HPV) have been successful interventions for prevention of invasive cervical cancer (ICC). Because of cultural and religious considerations, ICC has low incidence in Iran and many other Muslim countries. There is no organized cervical screening in these countries. Therefore, ICC is usually diagnosed in advanced stages with poor prognosis in these countries. We performed a priority setting exercise and suggested priorities for prevention of ICC in this setting. Methods: We invited experts and researchers to a workshop and asked them to list important suggestions for ICC prevention in Iran. After merging similar items and removing the duplicates, we asked the experts to rank the list of suggested items. We used a strategy grid and Go-zone analysis to determine final list of priorities for ICC prevention in Iran. Results: From 26 final items suggested as priorities for prevention of ICC, the most important priorities were developing national guidelines for cervical screening and quality control protocol for patient follow-up and management of precancerous lesions. In addition, we emphasized considering insurance coverage for cervical screening, public awareness, and research priorities, and establishment of a cervical screening registry. Conclusion: A comprehensive approach and implementation of organized cervical screening program is necessary for prevention of ICC in Iran and other low incidence Muslim countries. Because of high cost for vaccination and low incidence of cervical cancer, we do not recommend HPV vaccination for the time being in Iran

Experiences of postmenopausal Iranian women living with urinary incontinence using hermeneutic phenomenology

The aim of this study was to explore experiences of living with urinary incontinence (UI) among postmenopausal Iranian women. Specifically, this research focuses on (1) the meaning of living with UI, (2) experiences of sexuality, and (3) experiences of seeking or not seeking treatment. Hermeneutic phenomenology underpinned the studies interpretive research approach. In-depth and semi-structured interviews were conducted in two sessions with 17 postmenopausal women aged between 52 to 68 years old. Interviews were conducted in participant‟s home and lasted 60-90 minutes per session. Verbatim transcriptions from audio-taped interviews were translated from Persian to English and formatted for data analysis. Emerging themes identified as the meaning of UI were disruption of normal functioning,self-imposed restrictions, and feelings of despair. „Disruption of normal functioning” signifies how UI intruded the women‟s personal life space; namely, emotional, spiritual, physical, and daily tasks. Self-imposed restrictions means that the women had to suppress their pleasures and needs as well as avoiding social relationship. Feelings of despair symbolizes adverse experiences that women had related to uncertainty about future, dependency, loneliness, hopelessness, and desire for death. Two dominant themes emerged in relations to experiencing sexuality: dependent upon husbands reaction to UI and redefining sexuality as intimacy. These themes indicate that womens experiences of sexuality were dependent upon husbands reaction and intimacy was more important than sexual intercourse. Experiences of for not seeking treatment were depicted by three themes including: developing daily management strategies, developing self perspective on urinary incontinence and establishing patient-doctor relationship. Two themes for experiences of seeking treatment were apparent: overcoming the barriers and anticipation of the future. Participants did not seek treatment due to taboos surrounding UI which lead them either to self manage or neglect UI. In addition, health care professionals were not open to discussing the subject. However, if participants could overcome the barriers,perceive potential risk of UI, and had high expectations of treatment then treatment seeking would follow. The findings reflect the need to educate the women on UI and to seek help as this condition can be treated. Health care providers need to be aware of the manifestations of UI among this vulnerable population for early diagnosis and improving their quality of life

Sexual Function in Woman with Urinary Incontinence: A Cross-Sectional Study from Iran

Abstract Ob jective: Urinary incontinence is a co mmon problem throughout the world that affects wo men fro m all cultures, ages and ethnic groups. This study aimed to assess the impact of different type of urinary incontinence on sexual function. Methods: This cross-sectional study was performed fro m April 2012 to October 2012 among wo men co mplaining of urinary incontinence who were referred to a large teaching hospital, in Teh ran, Iran. Sexual function was measured with Pelvic organ pro lapse/ urinary incontinence sexual questionnaire (PISQ). Urinary incontinence was determined with Questionnaire for Urinary Incontinence Diagnose (QUID). Participants were divided into three groups of stress urinary incontinence (SUI), urge urinary incontinence (UUI) and mixed urinary incontinence (MUI) and then sexual function was compared among these groups. Results: In all, 400 wo men were entered into the study. Among the whole participants, 223 patients (55.8%) co mplained of SUI, 97 patients (24.2%) of UUI and 80 patients (20%) of M UI. There was significant association between sexual function and type of urinary incontinence (P<0.001). Mixed urinary incontinence had a greater disruptive effect on sexual function compared to other groups. Among other groups, scores in UUI group were lower than SUI. Higher age groups had lower sexual function scores and there were significant differences among age g roups (P<0.001). The results obtained from mu ltip le logistic regression analysis showed that the most significant contributing factor to total PISQ scores was age. Conclusions: The findings fro m th is study suggest that UI affect sexual function and that MUI has a greater effect on sexual function than the other two types of incontinence

Lifestyle of Elderly People With Osteoporosis and Its Related Factors

Objectives Given the aging process of the population and the important role of lifestyle in common and chronic diseases, especially osteoporosis in the elderly, this study was conducted to evaluate the lifestyle of elderly people with osteoporosis. Methods & Materials This cross sectional (descriptive-analytic) study was carried out in 2013 on 300 osteoporotic elderly people who were referred to the bone densitometry centers of Tehran University of Medical Sciences, Tehran, Iran. Convenience sampling method was used, and the data were collected using a questionnaire for measuring healthy lifestyle in Iranian elderly. The collected data were analyzed by descriptive statistics including ANOVA and t-test by using SPSS-PC (V. 21) and P≤0.05. Results Results showed that the lifestyle of most osteoporotic elderly people (71.3%) was moderate, 10.7% of them had a desirable lifestyle, and 18% had an undesirable lifestyle. There was no statistically significant difference between the overall average score of lifestyle with age (P=0.499) and sex (P=0.176) in older adults with osteoporosis, but significant difference was statistically observed between the overall average score of lifestyle and marital status (P=0.001), educational level (P=0.027), and chronic disease (P=0.009). Conclusion Due to the increasing elderly population and the prevalence of osteoporosis in them, it is recommended that health officials and policy makers in the country should pay more attention in this area to prevent the occurrence of the disease as well as improve the lifestyle of elderly people with osteoporosis

Elderly Community Dwelling Women\'s Experiences of Managing Strategies for Urinary Incontinence (UI): A Qualitative Research

Introduction: Urinary incontinence (UI) is high prevalent in older women. Little is known about how they manage with this chronic condition from their points of view. The aim of this study was to explore older women’s experiences of management strategies in dealing with urinary incontinence.  Methods: Eight community dwelling women aged 60 and over, with long term UI participated in this qualitative study. After conducting semi-structured interviews, we transcribed the participants’ responses, and analyzed them using Van-Mannen hermeneutic phenomenological method.  Results: One theme emerged from the data which is labeled as strategies adopted to combat the urinary incontinence.  Conclusion: Results indicated that women needs to inform that there exist various treatment for UI and encourage them to seek treatment for UI