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  • 1.
    Andersson, Gunnel
    Örebro universitet, Hälsoakademin.
    Urinary incontinence: prevalence, treatment seeking behaviour, experiences, and perceptions among persons with and without urinary leakage2009Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    The overall aim of this thesis is to describe urinary incontinence (UI) from a population perspective and to describe experiences and perceptions of UI from an individual perspective. This includes assessing the prevalence of urinary incontinence as well as describing treatment seeking and experiences of living with UI. A secondary aim was to describe the perception of UI among cultures other than the Swedish mainstream, exemplified in this case by Syrian women living in Sweden. Both quantitative and qualitative methods were used, including questionnaires and interviews.

    Studies I and II were quantitative studies based on a population-based study. Together with a postal survey on general health and living conditions “Life & Health”, a questionnaire on urinary incontinence was sent out to 15 360 randomly-selected residents aged 18-79 in Orebro County, Sweden. In Study I, UI was found to affect 19%. The majority of the respondents experienced minor problems, and only 18% of those reporting UI wanted treatment. However, there was also a group who reported severe problems, but despite this 42% of them did not want treatment. Study II investigated why people with UI refrain from seeking care and treatment. It was found that the desire for treatment was regulated by the frequency of UI, being restricted from participating in various activities, the degree of inconvenience, and the type of UI.

    Studies III and IV were both qualitative interview studies, describing older women’s experiences of living with UI (Study III) and Syrian women’s perceptions of UI (Study IV). There were similarities between the results of these two studies; the women described UI as a normal and expected problem, and they knew that the district nurse could prescribe incontinence protections and that treatments existed. In both studies, the women expressed difficulties in making contact with the health care service, while the women who did not speak Swedish (Study IV) also had difficulties due to different communication problems.

    In conclusion, it is important that health care resources are optimized to identify and meet the needs of those who experience major problems with UI, and that there is awareness of the communication difficulties that can be present in meeting with people who speak other languages. However it is also important not to medicalize those who experience minor problems and who have the desire to manage on their own.

    Delarbeid
    1. Urinary incontinence prevalence, impact on daily living and desire for treatmentt: a population-based study
    Åpne denne publikasjonen i ny fane eller vindu >>Urinary incontinence prevalence, impact on daily living and desire for treatmentt: a population-based study
    2004 (engelsk)Inngår i: Scandinavian journal of urology and nephrology, ISSN 0036-5599, Vol. 38, nr 2, s. 125-130Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    OBJECTIVE:

    To investigate the prevalence of urinary incontinence in a representative population in Sweden, and to assess to what extent the condition affects daily life and to what degree those afflicted desire treatment.

    MATERIAL AND METHODS:

    In a population-based study, a postal questionnaire comprising 12 questions on urinary incontinence was sent to a representative sample of 15 360 randomly selected residents (aged 18-79 years) of Orebro County, Sweden. This was a supplement to a comprehensive survey of public health and general living conditions.

    RESULTS:

    The response rate was 64.5%. The prevalence of urinary incontinence was 19% when defined as "any leakage" and 7% when defined as "at least once a week". Women were more afflicted than men, and the proportion of people with urinary incontinence increased markedly with increasing age. Most considered their problems to be minor, having little impact on daily life, which was reflected by the fact that only 18% of those with urinary incontinence desired treatment. About 17% of those with urinary incontinence reported severe problems that interfered with daily life. Of respondents with severe problems, 42% did not want treatment.

    CONCLUSION:

    According to this population-based study, urinary incontinence is not a major problem for most people in the community. Although a considerable proportion of the population report urinary incontinence, the majority experience minor problems and only 18% desire treatment. For a limited group of people, urinary incontinence is a severe problem. It is important that healthcare resources are optimized to identify and meet the needs of those who are most afflicted.

    sted, utgiver, år, opplag, sider
    Taylor & Francis, 2004
    Emneord
    impact on daily life, population‐based study, prevalence, urinary incontinence Read More: http://informahealthcare.com/doi/abs/10.1080/00365590310022608
    HSV kategori
    Forskningsprogram
    Vårdvetenskap
    Identifikatorer
    urn:nbn:se:oru:diva-3043 (URN)10.1080/00365590310022608 (DOI)000221058000005 ()15204395 (PubMedID)2-s2.0-1942422250 (Scopus ID)
    Tilgjengelig fra: 2009-01-12 Laget: 2009-01-12 Sist oppdatert: 2018-11-16bibliografisk kontrollert
    2. Urinary incontinence - why refraining from treatment?: a population based study
    Åpne denne publikasjonen i ny fane eller vindu >>Urinary incontinence - why refraining from treatment?: a population based study
    Vise andre…
    2005 (engelsk)Inngår i: Scandinavian Journal of Urology and Nephrology, ISSN 0036-5599, E-ISSN 1651-2065, Vol. 39, nr 4, s. 301-307Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    OBJECTIVE: To investigate why persons with urinary incontinence (UI) refrain from seeking care and treatment.

    MATERIAL AND METHODS: A population-based study was undertaken in which a public health survey and a specific UI questionnaire were sent to 15 360 randomly selected residents (age 18-79 years) of Orebro County, Sweden. For all persons reporting UI, the expressed wish for treatment or no treatment was analyzed in relation to relevant variables from both inquiry forms using binary logistic regression analysis.

    RESULTS: The response rate was 64.5%. UI was reported by 2194 persons, 1724 of whom comprised the study population. A statistically significant association was found between the degree of UI and a desire for treatment. Persons who did not experience daily leakage and those who did not perceive the leakage as troublesome or having an affect on their daily life mostly stated that they did not desire treatment. Socioeconomic or other health-related factors were not associated with desiring or not desiring treatment for UI.

    CONCLUSIONS: Our results show that it is the perceived severity of UI that determines whether afflicted persons desire treatment or not. Other factors, relating to seeking healthcare in general, were not found to be of importance. Interventions to identify those in need of treatment for UI should primarily be directed towards those with severe symptoms.

    sted, utgiver, år, opplag, sider
    London: Taylor & Francis, 2005
    Emneord
    : Healthcare-seeking behavior, population-based study, urinary incontinence
    HSV kategori
    Forskningsprogram
    Medicin; Vårdvetenskap
    Identifikatorer
    urn:nbn:se:oru:diva-4540 (URN)10.1080/00365590510031129 (DOI)000231453100007 ()16118105 (PubMedID)2-s2.0-27144476977 (Scopus ID)
    Merknad

    Part of thesis: http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-2713

    Tilgjengelig fra: 2008-04-14 Laget: 2008-04-14 Sist oppdatert: 2017-12-14bibliografisk kontrollert
    3. Accepting and adjusting: Older women's experiences of living with urinary incontinence
    Åpne denne publikasjonen i ny fane eller vindu >>Accepting and adjusting: Older women's experiences of living with urinary incontinence
    2008 (engelsk)Inngår i: Urologic Nursing, ISSN 1053-816X, Vol. 28, nr 2, s. 115-121Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    In-depth interviews were performed with 11 Swedish women who contacted a district nurse to obtain sanitary protection. Three key constituents (themes) emerged: "learning to live with it despite difficulties," "other illnesses are more important," and "reluctance to seek care." The essence of the phenomenon of living with urinary incontinence (Ul) was expressed as "a situation to accept and adjust to."

    HSV kategori
    Forskningsprogram
    Vårdvetenskap
    Identifikatorer
    urn:nbn:se:oru:diva-3045 (URN)- ()18488587 (PubMedID)2-s2.0-45849087670 (Scopus ID)
    Merknad

    Part of thesis: http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-2713

    Funding agency:Orebro CountyCouncil's Research Fund

    Tilgjengelig fra: 2009-01-12 Laget: 2009-01-12 Sist oppdatert: 2019-05-22bibliografisk kontrollert
    4. Perceptions of urinary incontinence among syrian Christian women living in Sweden
    Åpne denne publikasjonen i ny fane eller vindu >>Perceptions of urinary incontinence among syrian Christian women living in Sweden
    2009 (engelsk)Inngår i: Journal of Transcultural Nursing, ISSN 1043-6596, E-ISSN 1552-7832, Vol. 20, nr 3, s. 296-303Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    The purpose of this study was to describe the perception of urinary incontinence (UI) among Syrian women living in Sweden. DESIGN: A qualitative, descriptive design with focus group discussions (FGDs) was used and analyzed with content analysis. Fourteen Syrian women were interviewed in three FGDs. FINDINGS: Three categories emerged, "Thoughts on UI," "Managing UI," and "Communication With the Health Care System." Among the interviewees, UI was a common, and expected, problem, which could be managed. However, some expressed shame and embarrassment. Some talked about communication problems with health care. DISCUSSION: and Implications for Practice: The health care system should be adjusted to the women's needs, with awareness of the communication difficulties, which could result in misunderstanding and neglected treatments.

    Emneord
    urinary incontinence, ethnic group, interpreter, focus group discussion, psychosocial factors
    HSV kategori
    Forskningsprogram
    Vårdvetenskap
    Identifikatorer
    urn:nbn:se:oru:diva-7355 (URN)10.1177/1043659609334850 (DOI)000267504000005 ()19372538 (PubMedID)2-s2.0-67650503250 (Scopus ID)
    Tilgjengelig fra: 2009-06-22 Laget: 2009-06-22 Sist oppdatert: 2017-10-18bibliografisk kontrollert
    Download (pdf)
    COVER01
  • 2.
    Andersson, Gunnel
    et al.
    Örebro universitet, Hälsoakademin. Department of Clinical Medicine and Section of Urology Örebro University Hospital, Örebro University, Örebro, Sweden; Centre for Evidence Based Medicine, Assessment of Medical Technology, Örebro County Council, Örebro, Sweden.
    Johansson, Jan-Erik
    Örebro universitet, Hälsoakademin. Department of Clinical Medicine and Section of Urology Örebro University Hospital, Örebro University, Örebro, Sweden; Centre for Evidence Based Medicine, Assessment of Medical Technology, Örebro County Council, Örebro, Sweden.
    Garpenholt, Örjan
    Örebro universitet, Institutionen för vårdvetenskap och omsorg. Department of Clinical Medicine and Section of Urology Örebro University Hospital, Örebro University, Örebro, Sweden; Centre for Evidence Based Medicine, Assessment of Medical Technology, Örebro County Council, Örebro, Sweden.
    Nilsson, Kerstin
    Centre for Evidence Based Medicine, Assessment of Medical Technology, Örebro County Council, Örebro, Sweden; Department of Obstetrics and Gynaecology, Örebro University Hospital, Örebro, Sweden.
    Urinary incontinence prevalence, impact on daily living and desire for treatmentt: a population-based study2004Inngår i: Scandinavian journal of urology and nephrology, ISSN 0036-5599, Vol. 38, nr 2, s. 125-130Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE:

    To investigate the prevalence of urinary incontinence in a representative population in Sweden, and to assess to what extent the condition affects daily life and to what degree those afflicted desire treatment.

    MATERIAL AND METHODS:

    In a population-based study, a postal questionnaire comprising 12 questions on urinary incontinence was sent to a representative sample of 15 360 randomly selected residents (aged 18-79 years) of Orebro County, Sweden. This was a supplement to a comprehensive survey of public health and general living conditions.

    RESULTS:

    The response rate was 64.5%. The prevalence of urinary incontinence was 19% when defined as "any leakage" and 7% when defined as "at least once a week". Women were more afflicted than men, and the proportion of people with urinary incontinence increased markedly with increasing age. Most considered their problems to be minor, having little impact on daily life, which was reflected by the fact that only 18% of those with urinary incontinence desired treatment. About 17% of those with urinary incontinence reported severe problems that interfered with daily life. Of respondents with severe problems, 42% did not want treatment.

    CONCLUSION:

    According to this population-based study, urinary incontinence is not a major problem for most people in the community. Although a considerable proportion of the population report urinary incontinence, the majority experience minor problems and only 18% desire treatment. For a limited group of people, urinary incontinence is a severe problem. It is important that healthcare resources are optimized to identify and meet the needs of those who are most afflicted.

  • 3.
    Andersson, Gunnel
    et al.
    Department of Urology. Department oí Clinical Medioine. Örebro University Hospital, Örebro, Sweden, Centre for Evidence-Based Medicine and Assessment of Medical Technology, Örebro, Sweden.
    Johansson, Jan-Erik
    Department of Urology. Department oí Clinical Medioine. Örebro University Hospital, Örebro, Sweden, Centre for Evidence-Based Medicine and Assessment of Medical Technology, Örebro, Sweden.
    Nilsson, Kerstin
    Department of Obstretics andGynaecology, Örebro University Hospital, Örebro, Sweden; Department of Clinical Medicine, Örebro, Sweden; Centre for Evidence-Based Medicine and Assessment of Medical Technology, Örebro, Sweden.
    Sahlberg-Blom, Eva
    Örebro universitet, Hälsoakademin.
    Accepting and adjusting: Older women's experiences of living with urinary incontinence2008Inngår i: Urologic Nursing, ISSN 1053-816X, Vol. 28, nr 2, s. 115-121Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In-depth interviews were performed with 11 Swedish women who contacted a district nurse to obtain sanitary protection. Three key constituents (themes) emerged: "learning to live with it despite difficulties," "other illnesses are more important," and "reluctance to seek care." The essence of the phenomenon of living with urinary incontinence (Ul) was expressed as "a situation to accept and adjust to."

  • 4.
    Andersson, Gunnel
    et al.
    Örebro University Hospital, Sweden.
    Johansson, Jan-Erik
    Örebro University Hospital, Sweden.
    Nilsson, Kerstin
    Örebro University Hospital, Sweden.
    Sahlberg-Blom, Eva
    Örebro University Hospital, Sweden.
    Perceptions of urinary incontinence among syrian Christian women living in Sweden2009Inngår i: Journal of Transcultural Nursing, ISSN 1043-6596, E-ISSN 1552-7832, Vol. 20, nr 3, s. 296-303Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The purpose of this study was to describe the perception of urinary incontinence (UI) among Syrian women living in Sweden. DESIGN: A qualitative, descriptive design with focus group discussions (FGDs) was used and analyzed with content analysis. Fourteen Syrian women were interviewed in three FGDs. FINDINGS: Three categories emerged, "Thoughts on UI," "Managing UI," and "Communication With the Health Care System." Among the interviewees, UI was a common, and expected, problem, which could be managed. However, some expressed shame and embarrassment. Some talked about communication problems with health care. DISCUSSION: and Implications for Practice: The health care system should be adjusted to the women's needs, with awareness of the communication difficulties, which could result in misunderstanding and neglected treatments.

  • 5.
    Andersson, Gunnel
    et al.
    Örebro universitet, Institutionen för klinisk medicin. Department of Urology, Örebro University Hospital, Örebro, Sweden; Centre for Evidence Based Medicine and Assessment of Medical Technology, Örebro, Sweden.
    Johansson, Jan-Erik
    Örebro universitet, Institutionen för klinisk medicin. Department of Urology, Örebro University Hospital, Örebro, Sweden; Centre for Evidence Based Medicine and Assessment of Medical Technology, Örebro, Sweden.
    Sahlberg-Blom, Eva
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Pettersson, Nicklas
    Department of Public Health, O¨ rebro County Council, O¨ rebro, Sweden.
    Nilsson, Kerstin
    Örebro universitet, Institutionen för klinisk medicin. Centre for Evidence Based Medicine and Assessment of Medical Technology, O¨ rebro, Sweden; Department of Obstetrics and Gynaecology, Örebro University Hospital, Örebro, Sweden.
    Urinary incontinence - why refraining from treatment?: a population based study2005Inngår i: Scandinavian Journal of Urology and Nephrology, ISSN 0036-5599, E-ISSN 1651-2065, Vol. 39, nr 4, s. 301-307Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To investigate why persons with urinary incontinence (UI) refrain from seeking care and treatment.

    MATERIAL AND METHODS: A population-based study was undertaken in which a public health survey and a specific UI questionnaire were sent to 15 360 randomly selected residents (age 18-79 years) of Orebro County, Sweden. For all persons reporting UI, the expressed wish for treatment or no treatment was analyzed in relation to relevant variables from both inquiry forms using binary logistic regression analysis.

    RESULTS: The response rate was 64.5%. UI was reported by 2194 persons, 1724 of whom comprised the study population. A statistically significant association was found between the degree of UI and a desire for treatment. Persons who did not experience daily leakage and those who did not perceive the leakage as troublesome or having an affect on their daily life mostly stated that they did not desire treatment. Socioeconomic or other health-related factors were not associated with desiring or not desiring treatment for UI.

    CONCLUSIONS: Our results show that it is the perceived severity of UI that determines whether afflicted persons desire treatment or not. Other factors, relating to seeking healthcare in general, were not found to be of importance. Interventions to identify those in need of treatment for UI should primarily be directed towards those with severe symptoms.

  • 6.
    Andersson, Gunnel
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Kaboru, Berthollet Bwira
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Adolfsson, Annsofie
    Örebro universitet, Institutionen för hälsovetenskap och medicin. The Centre for Women’s, Family and Child Health, Faculty of Health Sciences, Buskerud & Vestfold University, College, Kongsberg, Norway.
    Namegabe, Edmond Ntabe
    Faculty of Community Health and Development, Université Libre des Pays des Grands Lacs, Goma, Congo Democratic Republic.
    Health Workers’ Assessment of the Frequency of and Caring for Urinary and Fecal Incontinence among Female Victims of Sexual Violence in the Eastern Congo: An Exploratory Study2015Inngår i: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, s. 354-360Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Throughout the long war that the Democratic Republic of Congo (DRC) has endured,women and children have been depicted as the primary victims of widespread sexual violence. Insome settings women have been raped in entire villages, with devastating physical and psychologicalconsequences, which include sexually transmitted infections such as HIV, trauma and fistulas,as well as social isolation and involuntary pregnancies. The aim of this study was to assess theprevalent perceptions of health professionals on the magnitude of urine and/or fecal incontinenceamong assaulted women, caused by sexual violence, as well as the opinions regarding the type ofcare provided to affected women.

    Methods: The study was part of a larger pilot study that had across-sectional design and a descriptive approach, which explored health professionals’ views regarding their own levels of competence at responding to the health needs of victims of sexual violence, in the form of a semi-structured questionnaire.

    Results: 104 health workers responded to the questionnaire. Nurses reported seeing raped women more frequently on a day-to-day basis (69.2%), in comparison to medical doctors and social workers (11.5%). Urinary incontinence was common according to 79% of health workers, who estimated that up to 15% of the women affected experienced huge amounts of urine leakage. Only 30% of the care seekers underwent in depth investigations, but the majority of the victims were not offered any further examination or appropriate treatments.

    Conclusion: Urinary and fecal incontinence due to urogenital or colorectalfistulas among women exposed to sexual violence is a common in the specified setting, but lack of systematic investigation and appropriate treatment means that the quality of life of the victims may be negatively affected. An improvement in the ability of health workers to manage these complex diagnoses is urgently needed, as well as adequately equipping health services in the affected settings.

    Fulltekst (pdf)
    fulltext
  • 7.
    Engelholm, Anders
    Kommunförbundet i Västernorrland, Härnösand, Sverige.
    Blusi, Madeleine
    FOU, Kommunförbundet i Västernorrland, Härnösand, sverigeVästernorrland.
    Lauritzen, Märta ()
    Karolinska Universitetssjukhuset, Stockholm, Sverige.
    Sandberg, Agneta ()
    Landstinget Blekinge, Karlskrona, Sverige.
    Malmsten, Kristina
    Blåsdysfunktion hos äldre personer: Indikatorer vid urininkontinens och andra symtom vid vård av äldre personer i särskilt boende eller hemsjukvård2016Rapport (Annet vitenskapelig)
    Fulltekst (pdf)
    fulltext
  • 8.
    Franzén, Karin
    et al.
    Department of Clinical Medicine and Section of Obstetrics and Gynaecology, Örebro University Hospital, Örebro, Sweden.
    Johansson, Jan-Erik
    Department of Clinical Medicine and Section of Urology, Örebro University Hospital, Örebro, Sweden; Centre for Assessment of Medical Technology, Örebro County Council, Örebro, Sweden.
    Andersson, Gunnel
    Department of Clinical Medicine and Section of Urology, Örebro University Hospital, Örebro, Sweden; Centre for Assessment of Medical Technology, Örebro County Council, Örebro, Sweden.
    Nilsson, Kerstin
    Department of Clinical Medicine and Section of Obstetrics and Gynaecology, Örebro University Hospital, Örebro, Sweden.
    Urinary incontinence: evaluation of an information campaign directed towards the general public2008Inngår i: Scandinavian Journal of Urology and Nephrology, ISSN 0036-5599, E-ISSN 1651-2065, Vol. 42, nr 6, s. 534-538Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective. To study and evaluate the effect of an information campaign in the form of a brochure on urinary incontinence (UI) directed towards the general public, concerning knowledge, individual health behaviour, self-reported healthcare utilization and how the information was perceived.

    Material and methods. Within a community in central Sweden a random sample of the population, in age groups from 18 years upwards, was selected from the population registry, resulting in a total sample of 3658 people. The study group was sent the brochure "Treatment of urinary incontinence", produced by SBU (Swedish Council on Technology Assessment in Health Care) in March 2003 and a questionnaire 1–2 months after the brochure was received.

    Results. The overall response rate was 47.5%. Eighty per cent of the responders stated UI as an important health problem in society and 66% that they had gained new knowledge on UI. Twenty-eight per cent of the responders reported a current or previous history of UI, of whom 49% felt that they had received useful information for self-treatment and 21% had begun self-treatment.

    Conclusion. This population-based study found that the distribution of a brochure on UI to the general public was well received and can be an efficient method to spread knowledge and encourage self-management. 

  • 9.
    Franzén, Karin
    et al.
    Örebro universitet, Hälsoakademin. 2 Obstetrics and Gynaecology, Örebro County Council, Örebro, Sweden.
    Johansson, Jan-Erik
    Örebro universitet, Hälsoakademin. Urology, Örebro University Hospital, Örebro, Sweden; Centre for Assessment of Medical Technology, Örebro County Council, Örebro, Sweden.
    Andersson, Gunnel
    Örebro universitet, Hälsoakademin. Urology, Örebro University Hospital, Örebro, Sweden.
    Pettersson, Nicklas
    Department of Statistics, Stockholm University, Stockholm, Sweden.
    Nilsson, Kerstin
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Obstetrics and Gynaecology,Örebro County Council, Örebro, Sweden; Centre for Assessment of Medical Technology, Örebro County Council, Örebro, Sweden.
    Urinary incontinence in women is not exclusively a medical problem: a population-based study on urinary incontinence and general living conditions2009Inngår i: Scandinavian Journal of Urology and Nephrology, ISSN 0036-5599, E-ISSN 1651-2065, Vol. 43, nr 3, s. 226-232Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: The aim of the study was to analyse differences in general health and general living conditions between women with and without urinary incontinence (UI).

    MATERIAL AND METHODS: This cross-sectional population-based study was conducted in Orebro County, Sweden. A public health questionnaire, "Life and Health", was sent to a randomly selected sample of the population. The questionnaire consisted of 87 questions on broad aspects of general and psychiatric health. An additional questionnaire was enclosed for those respondents who reported experiencing UI. The data were analysed using binary logistic regression. The final study population constituted 4609 women, 1332 of whom had completed both questionnaires. The remaining 3277 had completed only the Life and Health questionnaire. Effect measures were odds ratios (ORs) with corresponding 95% confidence intervals (CIs).

    RESULTS: Statistically significant associations were found between UI and the occurrence of musculoskeletal pain (OR 1.45, 95% CI 1.20-1.76), fatigue and sleeping disorders (OR 1.59, 95% CI 1.30-1.95), feelings of humiliation (OR 1.29, 95% CI 1.12-1.50), financial problems (OR 1.36, 95% CI 1.11-1.66), and reluctance to seek medical care (OR 1.43, 95% CI 1.21-1.68).

    CONCLUSION: UI among women is commonly associated with a number of different psychosocial problems as well as an expressed feeling of vulnerability.

  • 10.
    Franzén, Karin M
    et al.
    Örebro universitet, Institutionen för läkarutbildning. Region Örebro län. Department of Obstetrics and Gynecology, Örebro University Hospital, Örebro, Sweden.
    Andersson, Gunnel
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Odeberg, Jenny
    Swedish Council on Health Technology Assessment (SBU), Stockholm, Sweden.
    Midlöv, Patrik
    Center for Primary Health Care Research, Lund University, Malmö, Sweden.
    Samuelsson, Eva
    Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Stenzelius, Karin
    Department of Care Science, Malmö University, Malmö, Sweden.
    Hammarström, Margareta
    Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
    Surgery for urinary incontinence in women 65 years and older: a systematic review2015Inngår i: International Urogynecology Journal, ISSN 0937-3462, E-ISSN 1433-3023, Vol. 26, nr 8, s. 1095-1102Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction and hypothesis: Urinary incontinence (UI) is common among the elderly, but the literature is sparse on the surgical treatment of UI among the elderly. This systematic review aims to assess the effectiveness of surgical interventions as treatment for urinary incontinence in the elderly population ≥65 years of age.

    Methods: Randomized controlled trials (RCT) and prospective nonrandomized studies (NRS) were included. The databases PubMed (NLM), EMBASE (Elsevier), Cochrane Library (Wiley), and Cinahl (EBSCO) were searched for the period 1966 up to October 2013. The population had to be ≥65 years of age and had to have undergone urethral sling procedures, periurethral injection of bulking agents, artificial urinary sphincter surgery, bladder injection treatment with onabotulinumtoxin A or sacral neuromodulation treatment. Eligible outcomes were episodes of incontinence/urine leakage, adverse events, and quality of life.

    The studies included had to be at a moderate or low risk of bias. Mean difference (MD) or standard mean difference (SMD)as well as risk difference (RD) and the 95 % CI were calculated.

    Results: Five studies-all on the suburethral sling procedure in women- that fulfilled the inclusion criteria were identified. The proportion of patients reporting persistent SUI after surgery ranged from 5.2 to 17.6 %. One study evaluating quality of life (QoL) showed a significant improvement after surgery. The complication rates varied between 1 and 26 %, mainly bladder perforation, bladder emptying disturbances, and de novo urge.

    Conclusion: The suburethral sling procedure improves continence as well as QoL among elderly women with SUI; however, evidence is limited.

  • 11.
    Jerlström, Tomas
    et al.
    Örebro University Hospital, Örebro, Sweden.
    Andersson, Gunnel
    Örebro University Hospital, Örebro, Sweden.
    Carringer, Malcolm
    Örebro University Hospital, Örebro, Sweden.
    Functional outcome of orthotopic bladder substitution: a comparison between the S-shaped and U-shaped neobladder2010Inngår i: Scandinavian Journal of Urology and Nephrology, ISSN 0036-5599, E-ISSN 1651-2065, Vol. 44, nr 4, s. 197-203Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To compare the functional outcome of two types of orthotopic bladder substitution, the S-shaped and the U-shaped neobladder, with respect to leakage, functional capacity and quality of life.

    MATERIAL AND METHODS: Between 1999 and 2007, 45 male patients with urinary bladder cancer were treated with cystectomy and orthotopic bladder substitution; 23 with the S-shaped bladder ad modum Schreiter and 22 with the U-shaped bladder ad modum Studer. Patients were followed up by a urologist and a specialized nurse (urotherapist) at 1, 3 and 6 months. At each visit the patient completed a voiding chart, a weighted pad test and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Differences between the groups in functional outcome and quality of life variables were analysed by Student's t test using SPSS software.

    RESULTS: Mean maximum bladder capacity increased over time. At 6 months, the S-bladder had a larger capacity than the U-bladder (525 ml vs 423 ml). Patients with an S-bladder had less urine leakage at all follow-ups, although this was statistically significant only at 6 months regarding day-time incontinence and at all visits regarding night-time incontinence. The mean urine leakage at 6 months was 7 g (day) and 30 g (night) in the S-bladder group and 50 g (day) and 250 g (night) in the U-bladder group. However, quality of life did not differ between the groups.

    CONCLUSION: The S-bladder had better bladder capacity and less leakage than the U-bladder, but these differences did not translate into differences in quality of life. The results should be confirmed in larger prospective studies.

  • 12.
    Kaboru, Berthollet Bwira
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Andersson, Gunnel
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Borneskog, Catrin
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Adolfsson, Annsofie
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Namegabe, Edmond Ntabe
    Faculté de Santé et Développement Communautaires, Université Libre des Pays des Grands Lacs (ULPGL), Goma, Democratic Republic of the Congo.
    Knowledge and attitudes towards sexual violence in conflict-affected rural communities in the Walikale District, DR Congo: implications for rural health services2014Inngår i: Annals of Public Health and Research, ISSN 2378-9328, Vol. 1, nr 2, s. 1009-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Sexual violence has become endemic in the Democratic Republic of Congo (DRC), but the perspectives of rural communities of the scourge remain poorly researched. This study aims to describe the attitudes and knowledge of rural communities in regard to sexual violence, its occurrence and associated problems in rural communities in the Itebero/Walikale district in the DRC. A descriptive cross-sectional design was adopted, and a structured questionnaire used. Four hundred respondents participated, representing a group of ten villages populated by a total of 10,000 inhabitants. The respondents stated that perpetrators were often men from their own village. The fields were cited as being the place where most of the assaults occurred. A substantial proportion of the respondents lacked sufficient knowledge of the health outcomes of sexual violence. HIV infection and unwanted pregnancies were the most feared consequences. The victims of violence either experienced compassion or suffered rejection, depending on the community groups. Victims were mostly supported by women from their community, followed by husbands, relatives and authorities. Health facilities were the primary sources of support for victims. Rural health facilities need to revolutionise their health education strategies to improve the current situation.

    Fulltekst (pdf)
    fulltext
  • 13.
    Kaboru, Berthollet Bwira
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Borneskog, Catrin
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Adolfsson, Annsofie
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Namegabe, Edmond Ntabe
    Faculté de Santé et Développement Communautaires, Université Libre des Pays des Grands Lacs (ULPGL), Goma, Democratic Republic of the Congo.
    Andersson, Gunnel
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    “Qualified but not competent enough”: Healthworkers’ assessment of their competence in relation to caring for sexually abused women in Eastern Democratic Republic of Congo2015Inngår i: Journal of Nursing Education and Practice, ISSN 1925-4040, E-ISSN 1925-4059, Vol. 5, nr 8, s. 26-32Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to assess health professionals’ opinions of their competence levels in responding to health needs of victims of sexual violence. This study used a cross-sectional design with a descriptive approach. A total of 104 physicians, nurses and social workers participated in the study. The data was collected using a questionnaire consisting of open and close-ended questions.  Overall, 75% of the respondents were university graduates, but only a quarter of them felt they have adequate competence to care for these women; 36% had difficulties with general health assessment of assaulted women. The results indicated that nurses are critical professionals in caring for victims of sexual violence, that they see these women more than any other professional category. However, they are more likely than other categories to report being incompetent. Access to continued education was difficult, and more so for clinically-oriented health professionals than for others social professionals. Human resources capacity strengthening and particularly that of nurses will be the key investment in addressing assaulted women’s health needs in this region. Clinical researchers are called to identify rapid methods to reinforce nurses’ capacity and role in such a context with deprived health systems.

    Fulltekst (pdf)
    fulltext
  • 14.
    Katshiete Mbuisi Eale, Brigitte
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper.
    Andersson, Gunnel
    Örebro universitet, Institutionen för hälsovetenskaper.
    Ntabe Namegabe, Edond
    Université libre des Pays des Grands Lacs, Goma, Democratic Republic of the Congo.
    Kaboru, Berthollet Bwira
    Adolfsson, Annsofie
    Örebro universitet, Institutionen för hälsovetenskaper.
    Ordeals of sexually violated women and access to comprehensive healthcare: A case study of victims of sexual violence in North Kivu, Eastern Congo2018Inngår i: Journal of women´s reproductive health, ISSN 2381-862X, Vol. 2, nr 1, s. 23-34Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The impact of sexual violence in any community is extremely devastating and women in the Eastern part of the Congo are no exception. Sexual violence not only affects the health of women, but it impacts their social life within the community too.

    Objective: The study aims to investigate the experiences of female victims of sexual violence in accessing medical care in North Kivu.

    Design: An interpretive, phenomenological approach was used for this inductive and qualitative study. In-depth informant interviews were the main data collection tool. Open-ended questions were used during the interviews in order to garner more information from the interviewees. Heidegger’s approach was utilized in analyzing the collected data.

    Results: The analyzed and interpreted results of the data indicated that survivors of sexual violence are engaged in an ongoing struggle. The victims demonstrated immense resilience despite the lack of comprehensive medical care and have continued to reassemble their broken lives. In order to present the outcomes of the research in a succinct and coherent manner, the outcomes are categorized into five sub-themes: managing worries and shame; regaining happiness; healing and restoration; the need for professional assistance and struggles in daily life.

    Conclusion: The study provides an understanding of the recovery processes of survivors of sexual violence in North Kivu, with important insights into dimensions that rehabilitation programs should take into consideration.

  • 15.
    Ohlsson Nevo, Emma
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper. Region Örebro län. Department of Surgery.
    Andersson, Gunnel
    Örebro universitet, Institutionen för hälsovetenskaper.
    Nilsing Strid, Emma
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. University Health Care Research Centre.
    In the hands of nurses: A focus group study of how nurses perceive and promote inpatients' needs for physical activity2020Inngår i: Nursing Open, E-ISSN 2054-1058, Vol. 7, nr 1, s. 334-344Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims: To describe how nurses perceive and promote inpatients' needs for physical activity during their stay at the ward.

    Design: A qualitative descriptive design was employed providing an exploration of how nurses perceive and promote inpatients' need for physical activity.

    Methods: Seven semi-structured focus group discussions were held between November 2016 and February 2017 with 29 nurses in three hospitals in Sweden. Both interaction analysis and content analysis of the data were conducted.

    Results: Patients are dependent on nurses' prioritizations and promotions to be sufficiently physically active during their stay at the ward. The external environment and the integration of physical activity affected the promotion of physical activity. The nurses perceived that understanding the patient's expectations was important and that promotion of physical activity was a joint responsibility of patient, relatives and healthcare professionals. The interaction analysis revealed no clear hierarchical pattern as all members in each focus group took initiative to open the discussions. The Registered Nurses contributed with more new ideas.

  • 16.
    Ohlsson Nevo, Emma
    et al.
    Centre for Health Care Sciences, Örebro County Council, Örebro, Sweden.
    Andersson, Gunnel
    Örebro universitet, Institutionen för hälsovetenskaper.
    Nilsing Strid, Emma
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Centre for Health Care Sciences.
    Nurses’ perceptions of hospitalized patients’ need for progressed physical activity: a focus group study2018Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background: Patients enrolled in wards at hospitals spend time in bed even if rest is not medically indicated. The inactivity in the hospital reduces muscle strength and can create a need for assistants that did not exist before or justified by the treated condition. Early and progressive mobilization is a key factor to maintain physical functioning during the care period in hospital. Despite the knowledge of the importance of physical activity, patients are not sufficiently mobilized. Reasons why patients are not mobilized are related to organizational factors as well as patient and nurse personal characteristics. With an understanding of nurses’ experiences, interventions to enhance patients’ physical activity can be develop aiming at reducing the risk of physical deterioration due to inactivity.

    Objective: The aim of the study was to describe how nurses perceive hospitalized patients’ needs for progressed physical activity during their stay at the wards.

    Method: A total of seven focus group discussions were conducted in seven wards at three different hospitals in Sweden. A total of 16 nurses and 14 nurse assistants participated. The analysis was conducted in two steps; First an interaction analysis of the communication and respond pattern in the focus groups and thereafter a content analysis of the transcribed text.

    Results: The analysis is in progress and the results will be presented at the conference.

  • 17.
    Samuelsson, Eva
    et al.
    Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Odeberg, Jenny
    Swedish Council on Health Technology Assessment (SBU), Stockholm, Sweden .
    Stenzelius, Karin
    Department of Care Science, Malmö University, Malmö, Sweden.
    Molander, Ulla
    Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Hammarström, Margareta
    Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden .
    Franzén, Karin M
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Andersson, Gunnel
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Midlöv, Patrik
    Center for Primary Health Care Research, Lund University, Malmö, Sweden .
    The effect of pharmacological treatment for urinary incontinence in the elderly and frail elderly: a systematic review2015Inngår i: Geriatrics & Gerontology International, ISSN 1444-1586, E-ISSN 1447-0594, Vol. 15, nr 5, s. 521-534Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: The prevalence and severity of urinary incontinence (UI) increase with age and comorbidity. The benefits ofpharmacotherapy for UI in the elderly are questionable. The aim of the present study was to systematically review theefficacy of pharmacological treatment for UI in the elderly and frail elderly.

    Methods: We searched PubMed, EMBASE, Cochrane library and Cinahl databases through October 2013 toidentify prospective controlled trials that evaluated pharmacological treatment for UI in persons aged ≥65 years.Elderly persons living in nursing homes were regarded as frail elderly. Outcomes were urinary leakage, quality of lifeand adverse events.

    Results: We screened 1038 abstracts and assessed 309 full-text articles. We identified 13 trials of high or moderatequality; 11 evaluated anticholinergic drugs and two evaluated duloxetine. Oxybutynin, the only drug studied in thefrail elderly population, had no effect on urinary leakage or quality of life in elderly with urgency UI (UUI). Seven trialsevaluated the effects of darifenacin, fesoterodine, solifenacin, tolterodine or trospium. Urinary leakage decreased(standard mean difference: −0.24, 95% confidence interval −0.32–0.15), corresponding to a reduction of half a leakageper 24 h. Common side-effects of treatment were dry mouth and constipation. Data were insufficient for evaluationof the effect on quality of life or cognition. The evidence was insufficient to evaluate the effects of duloxetine. Noeligible studies on mirabegron and estrogen were found.

    Conclusions: Anticholinergics have a small, but significant, effect on urinary leakage in older adults with UUI.Treatment with drugs for UUI in the frail elderly is not evidence based.

  • 18.
    Santini, Sara
    et al.
    Istituto Nazionale di Riposo e Cura per Anziani (INRCA), Ancona, Italy.
    Andersson, Gunnel
    Department of Urology, Örebro University Hospital, Örebro, Sweden.
    Lamura, Giovanni
    Istituto Nazionale di Riposo e Cura per Anziani (INRCA), Ancona, Italy.
    Impact of incontinence on the quality of life of caregivers of older persons with incontinence: a qualitative study in four European Countries2016Inngår i: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 63, s. 92-101Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to assess the impact of incontinence management on informal caregivers of older persons with incontinence. In order to investigate this phenomenon in different welfare systems via qualitative interviews and a content analysis methodology, the study was carried out in four European countries (Italy, the Netherlands, Slovak Republic and Sweden). To this purpose, 50 semi-structured interviews were conducted with spouses and children of older people receiving their help to manage the consequences of involuntary urinary and/or faecal leakage. Findings show that incontinence has a remarkably strong effect on caregivers’ quality of life, because it results in progressive social isolation, causing them financial problems as well as psychological and physical exhaustion. The lack of appropriate support and the general silence regarding the problem, which is still considered a taboo by many, aggravate thecaregivers’ situation. It is therefore crucial that caregivers can count on a strong public andprivate support network, appropriate information and suitable incontinent products, in orderto better handle incontinence and care tasks in general.

  • 19.
    Stenzelius, Karin
    et al.
    Faculty of Health and Society, Malmö University, Skåne University Hospital, Malmö, Sweden.
    Molander, Ulla
    Sahlgrenska University Hospital, Gothenburg, Sweden.
    Odeberg, Jenny
    SBU-The Swedish Council on Health Technology Assessment, Stockholm, Sweden.
    Hammarström, Margareta
    Department of Gynecology and Obstetrics, Childrens and Youth Hospital of Queen Silvia, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Franzen, Karin M.
    Örebro universitet, Institutionen för läkarutbildning. Department of Gynecology and Obstetrics, Örebro University Hospital, Örebro, Sweden.
    Midlöv, Patrik
    Clinical Research Centre (CRC), Skåne University Hospital, Malmö, Sweden.
    Samuelsson, Eva
    Family Medicine, Department of Public Health and Clinical medicine, Umeå University, Umeå, Sweden.
    Andersson, Gunnel
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    The effect of conservative treatment of urinary incontinence among older and frail older people: a systematic review2015Inngår i: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 44, nr 5, s. 736-744Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: urinary incontinence (UI) is a common symptom among older people, with a higher prevalence among frail older persons living in nursing homes. Despite consequences such as reduced health and quality of life, many older people do not seek help for their symptoms, resulting in missed opportunity for treatment.

    Objective: the aim of this study was to investigate the evidence and the effect of conservative treatment of UI and the quality of life among older and frail older persons.

    Methods: a systematic review of randomised controlled studies and prospective, non-randomised studies was conducted, evaluating interventions of conservative treatment of UI in an older population (65 years or older). A total of 23 studies fulfilled the inclusion criteria and 9 were of high or moderate quality. Fourteen studies were of low quality and were therefore excluded from the analysis.

    Results: documented and effective conservative treatments are available even for older persons with UI. Pelvic muscle exercise, physical training in combination with ADL, prompted voiding and attention training, and help to toilet are important treatments. In some studies, however, the evidence of effectiveness is limited.

    Conclusions: this systematic review concludes that there are conservative treatments for UI for older and frail older persons that reduce leakage and increase quality of life. There is however a need for further high-quality studies.

  • 20.
    van de Veen, Roelf
    et al.
    Center of Expertise for Long Term Care, Vilans, Utrecht, The Netherlands.
    Versteeg, Marleen
    Center of Expertise for Long Term Care, Vilans, Utrecht, The Netherlands.
    Mak, Sabina
    Center of Expertise for Long Term Care, Vilans, Utrecht, The Netherlands.
    Bodnarova, Bernadina
    Institute for Labour and Family Research, Staré Mesto, Slovakia.
    Selestiakova, Katarina
    Institute for Labour and Family Research, Staré Mesto, Slovakia.
    Hanson, Elizabeth
    The Swedish National Family Care Competence Centre, Kalmar, Sweden.
    Andersson, Gunnel
    Department of Urology, Örebro University Hospital, Örebro, Sweden.
    Santini, Sara
    INRCA, Italian National Research Centre on Aging, MOPACT EU FP7, University of Sheffield, Sheffield, UK.
    Quattrini, Sabrina
    INRCA, Italian National Research Centre on Aging, MOPACT EU FP7, University of Sheffield, Sheffield, UK.
    Lamura, Giovanni
    INRCA, Italian National Research Centre on Aging, MOPACT EU FP7, University of Sheffield, Sheffield, UK.
    Quality of life of carers managing incontinence in Europe: SURVEY REPORT May 20112011Rapport (Annet vitenskapelig)
  • 21.
    Hammarström, Margareta ()
    Södersjukhuset, Stockholm, Sweden.
    Andersson, Gunnel ()
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Örebro universitetssjukhus, Örebro, Sweden.
    Anttila, Sten ()
    Statens beredning för medicinsk utvärdering (SBU), Stockholm, Sweden.
    Davidsson, Thomas ()
    Statens beredning för medicinsk utvärdering (SBU), Stockholm, Sweden.
    Franzén, Karin ()
    Örebro universitet, Institutionen för läkarutbildning. Örebro universitetssjukhus, Örebro, Sweden.
    Gustafsson, Elisabeth ()
    Statens beredning för medicinsk utvärdering (SBU), Stockholm, Sweden.
    Gyllensvärd, Harald ()
    Statens beredning för medicinsk utvärdering (SBU), Stockholm, Sweden.
    Malmberg, Lars ()
    Skånes universitetssjukhus, Malmö/Lund, Sweden.
    Midlöv, Patrik ()
    Lunds universitet, Lund, Sweden.
    Molander, Ulla ()
    Sahlgrenska universitetssjukhuset, Göteborg, Sweden.
    Odeberg, Jenny ()
    Statens beredning för medicinsk utvärdering (SBU), Stockholm, Sweden.
    Olofsson, Hanna ()
    Statens beredning för medicinsk utvärdering (SBU), Stockholm, Sweden.
    Sahlin, Nils-Eric ()
    Lunds universitet, Lund, Sweden.
    Samuelsson, Eva ()
    Umeå universitet, Umeå, Sweden.
    Stenzelius, Karin ()
    Skånes universitetssjukhus, Malmö, Sweden; Malmö högskola, Malmö, Sweden.
    Behandling av urininkontinens hos äldre och sköra äldre: en systematisk litteraturöversikt2013Rapport (Fagfellevurdert)
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