The many facets of perceived bladder health in women: Absence of symptoms and presence of healthy behaviors across the life course
Lisa Kane Low,
Beverly Rosa Williams,
Diane K. Newman,
Jeni Hebert-Beirne,
Sonya S. Brady,
Deepa R. Camenga,
Aimee S. James,
Jean F. Wyman,
D. Yvette Lacoursiere,
Kathryn L. Burgio
Affiliations
Lisa Kane Low
Departments of Nursing, Women’s and Gender Studies, and Obstetrics and Gynecology, University of Michigan, 400 N. Ingalls St. Ann Arbor, MI 48109, USA; Correspondence to: 400 North Ingalls Suite 3160, Ann Arbor MI, 48109, USA.
Beverly Rosa Williams
Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, University of Alabama at Birmingham (UAB), 510 20th Street South, Birmingham, AL 35294, USA; Birmingham/Atlanta Geriatric Research, Education and Clinical Center, Department of Veterans Affairs, 700 19th St., S., Birmingham, AL 35233/3101 Clairmont Road, Brookhaven, GA 30319, USA
Diane K. Newman
Department of Surgery, Perelman School of Medicine, University of Pennsylvania, 8th & Walnut Street, Philadelphia, PA 19107, USA
Jeni Hebert-Beirne
Community Health Sciences, School of Public Health, University of Illinois Chicago, 1603 W Taylor St, Chicago, IL 60612, USA
Sonya S. Brady
Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware St SE, Suite 166, Minneapolis, MN 55414, USA
Deepa R. Camenga
Department of Emergency Medicine (Pediatrics), Section of Research, Yale School of Medicine, 464 Congress Ave, New Haven, CT 06519, USA
Aimee S. James
Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 S. Euclid Ave, MSC: 8100-0094-2200, St. Louis, MO 63110, USA
Jean F. Wyman
School of Nursing, University of Minnesota, 5-140 Weaver Densford Hall, 308 Harvard Street, SE. Minneapolis, MN, 55455, USA
D. Yvette Lacoursiere
Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Diego School of Medicine, 9500 Gilman Dr, La Jolla, CA 92093, USA
Kathryn L. Burgio
Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, University of Alabama at Birmingham (UAB), 500 22nd Street South, Birmingham, AL 35233, USA; Birmingham/Atlanta Geriatric Research, Education and Clinical Center, Department of Veterans Affairs, 700 19th St., S., Birmingham, AL 35233/3101 Clairmont Road, Brookhaven, GA 30319, USA
Purpose:: Qualitative studies exploring bladder health are rare compared to research focusing on lower urinary tract symptoms (LUTS). Our aim was to explore adolescent and adult women’s perceptions about what constitutes a healthy bladder. Methods:: We conducted a 7-site focus group study of bladder health with adolescent and adult women across six age categories (11–14 to 65+ years). Transcripts were analyzed using transdisciplinary, directed content analysis and an iterative interpretive consensus building approach to identify key constructs, focusing on “healthy bladder” and “unhealthy bladder” codes. Results:: Forty-four focus groups with 360 participants were completed. Three thematic categories were identified: (1) concept of a healthy bladder (conceptual abstraction); (2) experience of a healthy bladder (subjective experience); and (3) lifestyle and life course considerations (bladder health in context). Participants struggled to define the unfamiliar concept of healthy bladder and relied on contextualized experiences and behaviors for characterizing bladder health. They described the concept of a healthy bladder as something that you did not need to think about but did require attention to healthy habits to maintain. Other features of a healthy bladder discussed include having bladder control despite urgency and environmental constraints on voiding, normal voiding frequency, and qualities of urine and urination. Participants struggled with lack of information about healthy bladder habits and noted absence of routine bladder health screening. Discussion:: Findings identify need to promote public education and information sharing in health care visits about bladder health. Further they can inform bladder health promotion and clinical research on LUTS prevention.
