Guest Editorial: Promoting Continence Awareness and Community Education

      Urinary incontinence and overactive bladder (OAB) occur in epidemic proportions in men and women. According to Wein and Rovner,1 OAB is second only to arthritic symptoms as the leading chronic health condition in American adults. Despite these statistics, urinary incontinence remains an under-reported, under-diagnosed, under-treated condition erroneously thought to be a normal part of aging. The stigmatization of “wetting” as an adult has placed major social and economic burdens on women with bladder control problems.

In a recent study2 of women ages 25 to 80 years in a managed care population, 53% self-reported urinary incontinence in the past year but nothing was documented in their medical record by their provider. Of those 53%, 65% reported moderate to severe urinary incontinence, which was noted to be an interruption in quality of life. Based on its substantial impact, this is no trivial matter.

     The National Association For Continence (NAFC) is a private, nonprofit organization dedicated to improving the lives of people with incontinence and other bladder problems. Its mission is to educate the public, network for visibility of these conditions, and advocate on behalf of consumers. The NAFC offers opportunities for clinicians specializing in bladder problems to expand their own practices and resources by becoming a part of community education.

     My clinic is in a city and state with two of the highest unemployment rates. Being out of work and out of health insurance precludes treatment for issues that are “frustrating or embarrassing”. Although not a life-threatening illness, OAB is a chronic problem where, according to OWM’s monthly column “Continence Coach,” “even mild symptoms affect social, sexual, interpersonal and professional function.” We as clinicians have the opportunity to offer help to these people by promoting public awareness, education, and a means of treatment to our communities. Have you thought about options in your community to educate the public with the simple goal of decreasing frustration and embarrassment? Free options abound — public service announcements, radio spots, newspaper articles, library talks, free clinic bladder screenings, and the like. This may sound like a marketing strategy within a business plan, but it is also a first step in helping people with bladder issues overcome misinformation associated with their conditions within their own communities.

     As employers and independent practitioners, we do not always have the luxury of available dollars to develop materials and implement programs. What we do have is knowledge and expertise. Our responsibility as specialists is to bring that knowledge to the consumer. Utilizing the resources the NAFC provides offers opportunities to the public they would not otherwise enjoy without the intervention of continence nurses. In our clinic, the NAFC Quality Care newsletter is available for all of our patients. They can read while waiting or copy articles containing information relevant to their condition. Patients also receive instruction on how to access the NAFC website for information and support. In addition, downloadable versions (in PDF format) of the most popular patient education materials are available to professional members of the NAFC at no charge and can be copied and distributed to patients.

     This year, before we recognize how far we have to go, let’s celebrate how far we have come. Let us be thankful for those who have paved the way — the courageous who have demanded and won better education, better training, and better care provision for us and our patients. And finally, let’s remember it is up to us to carry on the work of those who have gotten us this far.

This article was not subject to the Ostomy Wound Management peer-review process.

1. Wein AJ, Rovner ES. Definition and epidemiology of overactive bladder. Urology. 2002;60(suppl 5A):S7–S12.

2. Wallner LP, Porten S. Meenan RT, et al. Prevalence and severity of undiagnosed urinary incontinence in women. Am J Med. 2009;122(11):1037–1042.