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Pierce H.1,2, Perry L.1, Gallagher R.3, Chiarelli P.4
1University of Technology Sydney, Faculty of Health, Sydney, Australia, 2Western Sydney Local Health District, Physiotherapy, Sydney, Australia, 3University of Sydney, Charles Perkins Centre, Sydney, Australia, 4University of Newcastle, School of Health Sciences, Newcastle, Australia
Background: Urinary incontinence (UI) is a condition prevalent in women, with negative impact on psychosocial health and quality of life. UI at work has been associated with altered concentration and a reduced ability to complete tasks, and may affect decisions about work hours and type of work undertaken.
Purpose: The aim of this study was to determine the prevalence and severity of UI in women in the Australian nursing and midwifery workforce; and to describe the work characteristics of those nurses and midwives with UI.
Methods: This research formed part of a cross sectional observational study examining the health of the nursing and midwifery workforce in New South Wales. An electronic survey was distributed between May 2014 and February 2015. Urinary incontinence was investigated using the International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form (ICIQUI-SF). Female respondents comprised the present investigation. Investigated work characteristics included: work role, location, setting, contract, shift, job satisfaction and plans to leave current job. Reproductive health questions known to influence the reporting of UI were collected. Respondents reporting a current pregnancy or urine infection sometimes or often in the past 12 months were excluded from analyses. Data were analysed using Chi Square, t tests and logistic regression with SPSS version 22.
Results: Of a total 5,041 responses to the survey, 68.5% (n=3,454) answered the question on urine leakage. Females comprised 90.6% (n=3,093) of the response sample with 1.5% reporting a current pregnancy and 4.7% a urine infection. Following exclusions, the final sample size for analyses was 2,907. The mean age of females was 47.35 years (19-74 ± 11.58); mean Body Mass Index 28.09 kg/m2 (15-57± 6.41); and 69.9% were parous.
The prevalence of any UI in the past 4 weeks was 32.0% (n=930): of these, 46.2% had stress UI, 23.1% urgency UI, 22.7% mixed UI, and 7.9% other UI. UI was more likely to be reported in those working part-time, days only (not shifts), in aged or community care (p 0.001). Slight severity of UI (ICIQUI-SF score 0-5) was present in 55.2%, moderate UI (6-12) in 40.5% and severe or very severe (13-21) UI in 4.4% nurses and midwives. Those with severe or very severe UI were more dissatisfied with their work (p=0.001) and more likely to intend to leave their current position in the next 12 months than those with slight or moderate symptoms (OR: 2.26; 95% CI: 1.02-5.01) after accounting for age, Body Mass Index, parity, anxiety, depression, work contract, shift and job satisfaction.
Conclusion(s): UI is a health concern for women in the workforce, associated with reduced job satisfaction and an intention to leave their current job. Further research is required to explore the relationship of UI symptoms to work environments, job demands and work productivity.
Implications: UI is a treatable and preventable condition. The findings of this study flag the need to raise the awareness of this common condition in the workplace, with workers, employers and policy makers. Strategies for continence promotion should be considered in occupational health programs.
Funding acknowledgements: Australian Research Council (ARC) Linkage Scheme Grant no: LP130100694
NSW Nurses & Midwives Association (NSWNMA)
NSW Nurses & Midwives Association (NSWNMA)
Topic: Occupational health & ergonomics
Ethics approval: University of Technology Sydney HREC 2013000741
South Eastern Sydney Local Health District HREC: Ref No. 11/148(LNR 11/POWH/242).
All authors, affiliations and abstracts have been published as submitted.
