Psychometric Evaluation of the Toileting Behaviors: Women's Elimination Behaviors Scale in a Sample of College Women.

BACKGROUND: Lower urinary tract symptoms in women including urinary incontinence and overactive bladder are common women's health conditions with negative financial, health, and quality of life consequences. Certain behaviors are associated with symptom presentation. Identifying and modifying these behaviors could decrease symptom presentation and progression. The Toileting Behaviors: Women's Elimination Behaviors (TB-WEB) scale is the only known theory-based tool to date designed to assess urinary toileting behaviors in women. It has been validated in middle-aged women, but it has not been validated in a younger population. OBJECTIVES: The purpose of this study was to assess the psychometric properties of the TB-WEB in a sample of college-aged women. METHODS: Surveys were sent to senior-level undergraduates electronically via university email addresses. One hundred ninety-three women responded to the survey. Those who had missing responses on the TB-WEB were excluded from psychometric analyses. Demographic characteristics from those with missing data were not statistically different from those with complete responses. RESULTS: The total Cronbach α for the 18-item TB-WEB was 0.846, and the 5 previously identified subscales ranged between 0.528 and 0.919. A 5-factor structure was identified, similar to previous testing of the TB-WEB. Higher scores were significantly correlated with frequency of urinary incontinence episodes (rs= 0.311; P < 0.001). CONCLUSIONS: The validated TB-WEB can be used reliably in a younger sample of women (mean age, 22 years) enrolled in college. It may be useful to identify problematic toileting behaviors and women at risk for having or developing lower urinary tract symptoms.

Decision Making about Hospital Arrival among Low-Risk Nulliparous Women after Spontaneous Labor Onset at Home.

INTRODUCTION: Postponing hospital admission until the active phase of labor is a recommended strategy to safely reduce the incidence of primary cesarean births. Success of this strategy depends on women's decisions about when to transfer from home to the hospital, a process that is largely absent from research about childbirth. This study aimed to determine the decision-making criteria used by women about when to go to the hospital after the self-identification of labor onset at home. METHODS: A qualitative study was conducted at an academic medical center with a sample of 21 nulliparous women who went into spontaneous labor at home and had term, singleton, and vertex-presentation births. The purposive sample consisted of women who decided to stay at home or go to the hospital in early labor. Birth narratives from in-depth interviews conducted in the postpartum period using a semistructured interview guide were subjected to content analysis. The verbatim transcriptions of the interviews were coded and categorized into a set of decision criteria. RESULTS: Criteria used by women in deciding to go to the hospital or stay at home in early labor included the degree of certainty with the self-identification of labor onset, ability to cope with labor pain, influence of social network members, health care provider advice, and concerns about travel to the hospital. Perception of childbirth risk and the need for reassurance about the normalcy of symptoms and fetal well-being also influenced women's decisions. DISCUSSION: Women use a common set of criteria in deciding when to arrive at the hospital during labor. Antenatal education and telephone triage interventions that incorporate the considerations of women deciding to seek or delay hospital admission in childbirth may facilitate health seeking in more advanced labor. Symptom recognition education about early labor onset and progression could reduce decisional uncertainty.

An Integrative Review of Current Research on the Role of the Female Urinary Microbiota in Overactive Bladder Symptoms.

This integrative review explores current evidence on microbiota of the female urinary tract as it relates to overactive bladder (OAB) symptoms. Six articles were identified for review. Findings suggest a possible link between the female urinary microbiome and OAB symptom presentation.