Constructs of suffering and life satisfaction in female patients with urinary incontinence
Paquet A, Rammal A, Elshatanoufy S, and Richardson DA. Constructs of suffering and life satisfaction in female patients with urinary incontinence. Female Pelvic Med Reconstr Surg 2019; 25(5):S299.
Female Pelvic Med Reconstr Surg
Objective: Although a goal for physicians is the alleviation of suffering, suffering itself is rarely addressed in the FPMRS literature. Our aims were: 1) Determine how measures of suffering and satisfaction with life (SWL) compared to incontinence severity and quality of life (QOL) measures and 2) Determine how measures of psychological flexibility related to measures of suffering, SWL and incontinence QOL. Methods: Questionnaires were given to 77 patients presenting to our FPMRS clinic complaining of incontinence. Incontinence severity was measured by the International Consultation on Incontinence Questionnaire- Short Form (ICIQ). Incontinence QOL was assessed with the Urinary Incontinence Quality of Life (IQOL) and Incontinence Impact Questionnaire (IIQ). Life satisfaction was assessed by the Satisfaction with Life scale (SWL). Measures of suffering included the Perceived Stress Scale (PSS), Pictorial Representation of Illness and Self Measure (PRISM), and the Distress Thermometer (DT). PRISM measure was the distance between self to incontinence. Measures of psychological flexibility included the Cognitive Fusion Questionnaire (CFQ), the Acceptance and Action Questionnaire - II (AAQ) and the Self-Compassion Scale -short form (SCS). Spearman rank correlations was used to determine whether there were associations between the different measures. Results: Measures of suffering and SWL were significantly correlated to incontinence severity. (Table 1) Strong correlations were seen between incontinence QOL measures and SWL, DT and PSS. PRISM tended to show weaker correlations to both QOL and severity measures. Correlations between measures of suffering and SWL were strong except for PRISM. All Measures of psychological flexibility (AAQ, CFQ, SCS) significantly correlated to DT, PSS and SWL (p<.0001). Incontinence severity, incontinence QOL, and PRISM did not have a significant correlation to psychological flexibility. Conclusions: Measures of suffering and SWL strongly correlated with the incontinence severity with the exception of PRISM. The strong correlation of psychological flexibility with suffering and SWL but not with current measures of incontinence QOL suggests that aspects of suffering and SWL may be lacking in our current QOL measures. To alleviate suffering requires awareness of that suffering in the patients we treat. (Figure Preseted).