Beliefs and strategies about urinary incontinence: a possible moderation role between symptoms and sexual function, and quality of life

Marta Porto; Filipa Pimenta; Teresa Mascarenhas; João Marôco

doi:10.3389/fpsyg.2023.1252471

Beliefs and strategies about urinary incontinence: a possible moderation role between symptoms and sexual function, and quality of life

Front Psychol. 2023 Nov 30:14:1252471. doi: 10.3389/fpsyg.2023.1252471. eCollection 2023.

Authors

Marta Porto¹, Filipa Pimenta¹, Teresa Mascarenhas², João Marôco^{1

3}

Affiliations

¹ William James Center for Research, Lisbon, Portugal.
² Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
³ FLU Pedagogy, Nord University, Bodø, Norway.

Abstract

Background: Urinary Incontinence (UI) has numerous repercussions in women's lives, and it is underreported/underdiagnosed.

Objective: The present study aimed to understand: (1) the differences between women with and without urine loss regarding Quality of Life (QoL) and Sexual Function (SF); (2) the possible moderation role of UI-related beliefs and strategies on the relationship between UI-symptom severity and SF and QoL, in women with UI.

Methods: Cross-sectional Design. Participants: Primary aim: Overall, 2,578 women aged 40-65 (M_age = 49.94, DP_age = 6.76) were collected online. Secondary aim: 1,538 women who self-reported having urine loss occasionally/frequently (M_age = 50.19, DP_age = 6.58). All data analyses were done with IBM SPSS Statistics and R statistical system 4.0 through RStudio. Statistical Path analysis was performed with the lavaan package to study the hypothetical association and moderating effects between the variables.

Results: Primary aim: women without UI had a better SF [t(2576) = 3.13, p = 0.002; 95% C.I., 0.18 to 0.80] and QoL [t(2576) = 7.71, p < 0.001; 95% C.I., 3.14 to 5.28] than their counterparts with UI. Secondary aim: UI-related coping strategies attenuated the impact of UI-symptom severity on SF(β = -0.07; p = 0.041); the more dysfunctional the UI-related beliefs were, the poorer QoL was (β = -0.06; p = 0.031); the more frequent the UI-related hiding/defensive strategies were, the poorer QoL was (β = -0.26; p < 0.001).

Discussion: Limitations: online data collection, which thwarted the clarification of participants, if needed; absence of a UI medical diagnosis (only self-reported measures were used). Strengths and practical implications: (i) the crucial role of UI-related beliefs and strategies in the QoL of women with UI; (ii) the impact that UI-concealing/defensive strategies have in attenuating the impact of UI-symptom severity on SF, which might be perceived as a short-term benefit and hence contribute to maintaining the UI condition and constitute a barrier to help-seeking, (iii) impact of UI-symptom severity on QoL and SF (including a comparison group entailing women without UI, which is scarcely used); and (iv) the use of gold-standard and psychometrically robust instruments.

Conclusion: Changing dysfunctional UI-related beliefs and strategies in clinical settings may improve the QoL; UI-concealing strategies may reinforce themselves by immediate effects on SF, but are not functional in the long term.

Keywords: beliefs; female urinary incontinence; functional urology; moderation; quality of life; sexual function; strategies.

Grants and funding

The William James Center for Research has received a research grant attributed by the Portuguese Foundation for Science and Technology (grant reference UIDB/04810/2020). MP has received a research grant attributed by the Portuguese Foundation for Science and Technology (grant reference 2020.05710.BD). The authors declare that this study received funding from Tena Lady to pay for publication costs. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article, or the decision to submit it for publication.