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Research
project
Dr
Pauline Chiarelli
DipPhysio, GradDipHlthSocSci, MMedSci(HProm), PhD
Doctoral
Thesis: Female urinary incontinence in Australia:
prevalence and prevention in postpartum women
Supervisor: Professor
Jill Cockburn
University:
Faculty of Medicine and Health Sciences, University
of Newcastle, Australia
Underpinning this PhD is an examination of the basic science
of continence and a review of the international and Australian
literature pertaining to the prevalence of urinary incontinence.
Although there have been few studies that have evaluated the
prevalence of female urinary incontinence in the Australian
population, the available studies suggest that incontinence
is a morbid and costly condition.
The Women's Health Australia project provided an opportunity
to obtain current data on the prevalence of leaking urine
and associated factors in a large representative sample of
Australian women. The prevalence of leaking urine in cohorts
of women aged 18-23, 45-50 and 70-75 years was estimated to
be 12.8% (CI: 12.2 - 13.3), 36.1% (CI: 35.2 - 37.0), and 35%
(CI: 34.1 - 35.9) respectively.
Despite the burden of illness imposed by urinary incontinence,
to date there has been no evidence to support the concept
of primary continence promotion as an effective method of
preventing urinary incontinence. Therefore, a major aim of
this thesis was to examine this. Given that trauma to the
pelvic floor following childbirth appears to be related to
the development of incontinence, postpartum women were chosen
as the target group.
Evidence from the literature and expert opinion were combined
with the conceptual framework of the Health Belief Model to
develop the components of a continence promotion program.
The effectiveness of an intervention delivered by physiotherapists
to postpartum women was evaluated using a randomised controlled
trial among 720 women. Multivariate analyses, that controlled
for potential residual confounding effects of maternal, delivery,
and continence variables, indicated that women in the intervention
group were 40% less likely to report incontinence at three-months
postpartum than women in the control group (Odds ratio=0.6,
95% CI: 0.5 - 0.9, p=0.01). Women in the intervention group
were more likely than women in the control group to report
that they were performing the recommended pelvic floor exercises
(p=0.001).
The intervention was also found to be acceptable to women
and its components were well utilised. This suggests that
the intervention could feasibly be provided for women who
deliver in hospitals where physiotherapists are employed.
Click here for more information
about Pauline Chiarelli.
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