AUTHOR=Porto Marta , Marôco João , Mascarenhas Teresa , Pimenta Filipa 

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

JOURNAL=Frontiers in Psychology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2023.1252471

DOI=10.3389/fpsyg.2023.1252471

ISSN=1664-1078

ABSTRACT=<sec id="sec1"><title>Background</title><p>Urinary Incontinence (UI) has numerous repercussions in women’s lives, and it is underreported/underdiagnosed.</p></sec><sec id="sec2"><title>Objective</title><p>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.</p></sec><sec id="sec3"><title>Methods</title><p>Cross-sectional Design. Participants: Primary aim: Overall, 2,578 women aged 40–65 (<italic>M</italic><sub>age</sub> = 49.94, <italic>DP</italic><sub>age</sub> = 6.76) were collected online. Secondary aim: 1,538 women who self-reported having urine loss occasionally/frequently (<italic>M</italic><sub>age</sub> = 50.19, <italic>DP</italic><sub>age</sub> = 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.</p></sec><sec id="sec4"><title>Results</title><p>Primary aim: women without UI had a better SF [<italic>t</italic>(2576) = 3.13, <italic>p</italic> = 0.002; 95% C.I., 0.18 to 0.80] and QoL [<italic>t</italic>(2576) = 7.71, <italic>p</italic> &lt; 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(<italic>β</italic> = −0.07; <italic>p</italic> = 0.041); the more dysfunctional the UI-related beliefs were, the poorer QoL was (<italic>β</italic> = −0.06; <italic>p</italic> = 0.031); the more frequent the UI-related hiding/defensive strategies were, the poorer QoL was (<italic>β</italic> = −0.26; <italic>p</italic> &lt; 0.001).</p></sec><sec id="sec5"><title>Discussion</title><p>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.</p></sec><sec id="sec6"><title>Conclusion</title><p>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.</p></sec>