Perfil de mulheres incontinentes e conhecimento sobre incontinência urinária / Profile of incontinent women and knowledge about urinary incontinence / Perfil de la mujer incontinente y conocimiento sobre la incontinencia urinaria

Objetivo: Avaliar o perfil de mulheres incontinentes e o conhecimento acerca da Incontinência Urinária. Método: Trata-se de um estudo transversal realizado com mulheres com queixa de perda urinária em uma cidade do interior de Pernambuco, Brasil. Setenta e cinco mulheres incontinentes participaram do estudo, por meio de plataforma online foi aplicado questionário sociodemográfico e instrumento validado para investigar o conhecimento sobre a Incontinência Urinária, o Prolapse and Incontinence Knowledge Quiz (PIKQ). Resultados: A maioria das voluntárias era jovem, com média de idade de 43 anos, casadas, com nível educacional e socioeconômico elevados. Todas as voluntárias apresentaram de alto conhecimento sobre a incontinência urinária, com relação à incidência, fatores de risco, diagnóstico e tratamento, havendo lacunas apenas no conhecimento quanto ao uso de fármacos como preditor para o problema. Conclusão: Nosso estudo mostrou que a incontinência ocorre em mulheres jovens e o conhecimento foi elevado, podendo ter relação com o nível socioeconômico das voluntárias.

Objective: To evaluate the profile and knowledge of incontinent women regarding urinary incontinence. Method: Cross-sectional study performed with women with complaints of urinary loss from a city in the state of Pernambuco, Brazil. Seventy-five incontinent women participated in the study. A sociodemographic and a validated questionnaire regarding the knowledge about urinary incontinence (Prolapse and Incontinence Knowledge Quiz ­ PIKQ) were answered using an online platform. Results: Most participants were young, with a mean age of 43 years, married, and with high educational and socioeconomic levels. All volunteers presented high knowledge regarding the incidence, risk factors, diagnostics and treatment of urinary incontinence, with a gap concerning knowledge regarding the use of drugs as a predictor for the condition. Conclusion: The present study showed that urinary incontinence occurs in young women and that knowledge regarding the issue was high, possibly due to the high socioeconomic status of the participants.

Objetivo: Evaluar el perfil de las mujeres incontinentes y su conocimiento sobre la Incontinencia Urinaria. Método: Se trata de un estudio transversal realizado con mujeres que se quejaban de pérdidas urinarias en una ciudad del interior de Pernambuco, Brasil. Setenta y cinco mujeres incontinentes participaron del estudio, a través de una plataforma en línea se aplicó un cuestionario sociodemográfico y un instrumento validado para indagar el conocimiento sobre la incontinencia urinaria, el Prolapse and Incontinence Knowledge Quiz (PIKQ). Resultados: La mayoría de los voluntarios eran jóvenes, con una edad media de 43 años, casados, con nivel educativo y socioeconómico alto. Todos los voluntarios tenían un alto nivel de conocimiento sobre la incontinencia urinaria, en cuanto a incidencia, factores de riesgo, diagnóstico y tratamiento, con lagunas sólo en el conocimiento sobre el uso de medicamentos como predictor del problema. Conclusión: Nuestro estudio mostró que la incontinencia ocurre en mujeres jóvenes y el conocimiento fue alto, lo que puede estar relacionado con el nivel socioeconómico de las voluntarias

Exploring AIDS-related knowledge, attitudes, and behaviors of female Mexican migrant workers.

AIDS-related knowledge, attitudes, and behaviors were assessed in female Mexican migrant laborers. Thirty-two women were administered a modified version of the Hispanic Condom Questionnaire. Respondents were knowledgeable about the major modes of HIV transmission, but one-third to one-half of the women believed that they could contract AIDS from unlikely casual sources. Although respondents reported few negative beliefs about condom use, actual condom use with sex partners was low and knowledge of proper condom use was problematic. Consequently, 75 percent reported never carrying condoms. Implications of these findings for future research and provision of services for female Mexican migrants are discussed.

PIP: According to US Department of Health and Human Services data for 1990, there are approximately 4.1 million migrant workers in the US, mainly of Mexican background. Half of all Mexican immigrants over the past 2 decades have been women. Findings are presented from a December 1992 assessment of AIDS-related knowledge, attitudes, and behaviors among a sample of female Mexican migrant laborers in Jalisco, Mexico, a small agricultural sending community 210 km from Guadalajara. The 32 women administered a modified version of the Hispanic Condom Questionnaire were of mean age 34.2 years and had lived and worked in the US since 1982. Women currently living in the US were visiting Jalisco for the Christmas holiday. Although the surveyed women were knowledgeable about the major modes of HIV transmission, 33-50% believed that they could contract AIDS from unlikely casual sources. Respondents reported few negative beliefs about condom use, but actual condom use with sex partners was low and knowledge of proper condom use was inadequate. 42% reported ever using a condom and 75% reported almost never carrying condoms. The implications of these findings are discussed with regard to future research and the provision of services to female Mexican migrants.

Integrated use of qualitative and quantitative methods to elicit women's differential knowledge of breastfeeding and lactational amenorrhea in periurban Bolivia.

PIP: Exclusive and extended breast feeding is responsible for much of the fertility limitation and child spacing throughout the world. In many developing countries, where breast feeding is almost universal and of long duration, postpartum amenorrhea protects women from closely spaced subsequent pregnancies. However, at the same time, increased pressures toward modernization, rapid rural-to-urban migration, frequent advertisements of powdered milk substitutes, and the increased employment of women outside of the home are adversely affecting traditional breast feeding practices. In Bolivia, almost all women breast feed their newborn infants, for periods up to 2 years. This paper reports findings which describe and compare patterns of women's differential knowledge of breast feeding and lactational amenorrhea resulting from data collection using a survey instrument and a focus group guide. The findings are part of a larger study on infant feeding and child spacing conducted in periurban communities in Bolivia. Current and historical trends with regard to paradigm and methodology in social science research are reviewed and the survey/focus group research method is described.^ieng

Knowledge and fears among Chilean women with regard to the Papanicolaou test.

The work reported here, which was performed in Santiago, Chile, in 1993, explored factors relating to low Pap test coverage. A survey instrument was prepared and interviews were obtained with 299 women 25-54 years of age who were attending three primary health care clinics in Santiago. Most (at least 87%) of these women had not had a Pap test in three years. Only 28% knew the test's purpose was to detect cervical neoplasia; most (58%) knew the test was related to reproductive health but did not have a clear idea of its purpose; 14% knew nothing of the test or gave completely incorrect answers. Health personnel and the mass media were cited as principal sources of information about the test. Regarding anxieties relating to the test, 60% of the women said they were afraid of being reproached by a health practitioner for failing to come in sooner; 39% said they feared pain resulting from the test; 20% said they feared bleeding; and 14% were afraid they might lose part of the uterus. Also, of the 231 women with intrauterine devices, over 25% said they feared removal of the device. These results suggest a need to improve communication between health care workers and their patients, and to ensure that health personnel respect the rights of women, especially their right to sufficient information enabling them to make their own decisions.

PIP: This exploratory study was conducted among a sample of 299 women out of a total sample of 861 who had attended three primary health care clinics (La Feria, San Jose, and Maipu) in southern and western portions of Santiago, Chile. The interviews were conducted during June, August, and November 1993. The women were aged 25-54 years. Most were overdue for a Pap smear. The women had been seen at these clinics during January 1987 and January 1989. 248 refused to be interviewed, and 314 were lost to follow-up. One question about the purpose of the Pap test was answered only by 199 women. 34% of the 299 women interviewed reported a failure to have a Pap test due to forgetfulness. 27% did not think it was necessary to have the test every 3 years. 8% reported fear of the procedure. This proportion of fearful women remained the same regardless of educational level. The most educated women were the most likely to be up to date with Pap smear testing. 30% of women aged over 45 years were up to date with their Pap tests. 28% had knowledgeable answers about the purpose of the Pap test; 58% gave fair answers and 10% gave incorrect answers. 30% trusted that health care personnel had good quality information. 36% believed that mass media had good quality information, but 12% thought the media also gave incorrect information. 43% of better educated women, 25% of less educated women, and 23% of least educated women had good quality information. The proportion of good quality information was 19% among women aged over 45 years, 30% among women aged 36-45 years, and 27% among women aged under 36 years. 60% of the common fears were blamed on the criticism given by health workers for delaying a Pap test. 39% feared pain. Over 25% feared loss of their IUD during the Pap test.

AIDS: risk behaviors among rural Mexican women married to migrant workers in the United States.

International migration between Mexico and the United States has been acknowledged as a phenomenon that may contribute to the spread of AIDS in rural Mexico. The purpose of this study is to identify the information held by the participants regarding AIDS and to describe selected high-risk behaviors for AIDS transmission among a representative sample of rural women living in Mexico who are married to immigrant temporary workers to the United States. The women who participated in the study were married, of reproductive age, and had active sex lives with their spouses. Results revealed that most of the women interviewed had at least some knowledge about AIDS. Although some misconceptions were evident, most of the information they had was accurate. About one-third of the women felt at risk for AIDS, mostly because they doubted their husbands' fidelity, or because in the last five years they had donated blood, received a blood transfusion, or received an intramuscular or intravenous injection. The results of the study are discussed within the sociocultural context that surrounds the lives of the women interviewed.

PIP: Studies have found that migration and return migration between Mexico and the US among temporary migrant workers contributes to the spread of HIV/AIDS among Mexico's poor, especially in rural communities. The available information about the sexual practices of migrant workers in and out of Mexico is, however, very limited. Indeed, the authors were able to find just one report dealing with the sex practices of seasonal migrant workers in the US. That report describes seasonal migrant workers as maintaining an active, but largely unprotected bisexual life with fellow workers or prostitutes while in the US. Returning home, typically once per year, they tend to have unprotected sexual intercourse with their wives. 100 rural Mexican women of mean age 35.9 years living in Mexico and a mean educational attainment of 5.2 years of schooling, with an average of 5 children, who had been married for an average of 16.2 years to immigrant temporary workers to the US were interviewed to learn what information they had regarding AIDS and which high-risk behaviors they had for the transmission of HIV. The women had active sex lives with their spouses. Most of the women interviewed had at least some knowledge about AIDS. Although the women held some misconceptions, they had mostly accurate AIDS-related information. Approximately one-third of the women felt at risk for AIDS, mostly because they doubted their husbands' fidelity, or because in the last five years they had donated blood, received a blood transfusion, or received an intramuscular or intravenous injection. Study results are discussed.

Women's legal knowledge: a case study of Mexican urban dwellers.

PIP: In Mexico, the nongovernmental organization Sevisio, Desarrollo y Paz, A.C. (SEDEPAC) is helping poor women acquire legal knowledge in an economic climate characterized by the increased feminization of poverty brought about by the Structural Adjustment Program. The Mexican legal system is grounded in a patriarchal tradition, and the codified laws continue to favor men. Women were not granted full citizenship until 1953, and discrimination against women was not addressed in Mexican law until 1974 as the country prepared to host the First UN International Women's Conference. However, legal advances are not being applied in the family or in larger society where men remain in power. Mexico also distinguishes between private law and public law. Because domestic violence falls in the realm of private law, authorities are loathe to follow-up on women's complaints in this area. Since its founding in 1983, SEDEPAC has applied a gender perspective to its activities and programs. SEDEPAC held its first women's legal workshop in 1987 and realized that most poor women have no knowledge of existing laws or their rights, that alternative legal services for women are scarce, that existing laws must be changed, and that the authoritarian and conservative legal system helps maintain cultural stereotypes. Since then, SEDEPAC has held annual workshops, follow-up meetings, and training sessions and has provided counseling. The main topics addressed are women's social conditions; violence and the penal code; civil rights, power, and dependency; women's bodies and reproductive rights; and women's organization and leadership. The workshops use techniques of popular education such as group participation and use of gossip as a communication tool. The workshops have changed participants' lives and led to the formation of an independent Popular Defenders' Coordination.^ieng

Growth charts only marginally improved maternal learning from nutrition education and growth monitoring in Lesotho.

A study done in Lesotho in 1985-1986 assessed whether growth charts increased the impact of nutrition education and growth monitoring on maternal learning about weaning practices and diarrhea. Seven hundred and seventy six mothers were given three monthly sessions of group nutrition education along with growth monitoring of children and individual counseling. Growth charts, which were taught to one of two groups, fostered learning but only on issues related to diarrhea and only among new clinic attendants, mothers with less than secondary schooling and mothers of malnourished children. These benefits, however, were small (differences less than 10%) compared with the overall impact of the nutrition education and growth monitoring intervention (increases between baseline and post-intervention were greater than 50% for some questions). Our findings suggest that well-designed clinic-based nutrition education and growth monitoring can have a significant impact on maternal nutrition knowledge. Teaching growth charts to mothers may not be necessary for obtaining such results in programs conducted under ideal conditions. More research is needed to determine under what circumstances, for what purposes and for whom growth charts may be beneficial.

PIP: Between December 1985 and November 1986, before and after 3 monthly sessions of group nutrition counseling and individual counseling about weaning and diarrhea management at 9 primary health clinics in Lesotho, researchers compared data on 575 mothers who received a growth chart to monitor their 2-year old children's growth with data on 201 mothers of 2-year old children who did not receive a growth chart. They wanted to learn whether growth charts promoted maternal learning and whether the growth charts better served some mothers than other mothers. Growth monitoring intervention improved knowledge of diarrhea management but not weaning practices. This improvement in learning about diarrhea management was limited to new clinic attendants, mothers with less than high school education, and mothers with malnourished children, however. Yet the differences in benefits between these 2 groups were 10% and insignificant. Nutrition education interventions had significantly improved knowledge of weaning practices and diarrhea management for both groups of mothers (range of improvement 3-119.2%; p.05). The greatest improvements occurred in correct responses to continuous feeding of solid foods during diarrhea (119.2% for mothers who did not receive charts and 85.2% for those who did) and to introduction of protein rich vegetables to children's diet (42.6% and 58.9%, respectively). Thus use of growth charts contributed only slightly to increased effectiveness of nutrition education. It appeared that the quality and specificity of educational projects and proper use of weight information during individual counseling contributed the most to improved maternal learning. Nevertheless further research is warranted to learn the circumstances, purposes, and target audience under which use of growth charts would bring the most benefits.

Impact of a clinic-based growth monitoring programme on maternal nutrition knowledge in Lesotho.

An evaluation of the impact of a nationwide clinic-based growth monitoring (GM) programme was done in Lesotho to determine if clinic attendance was associated with improved maternal knowledge of weaning practices and diarrhoea. A total of 907 mothers from eight clinics were included in the study. Our results showed that mothers who had attended the clinics knew more about the appropriate timing for introducing animal protein-rich foods in the child's diet and about the use of oral rehydration salts for diarrhoea, than those who had not. The difference in knowledge between previous clinic attendants and new attendants was particularly marked among mothers with less than secondary schooling and mothers with young babies (less than 6 months). From observation in the clinics, we believe that group nutrition education, although it was not integrated with growth monitoring, was probably responsible for the positive association between clinic attendance and maternal knowledge. Prior clinic attendance was not specifically associated with improved knowledge about feeding during diarrhoea or the need to stop breastfeeding gradually. These need to be better incorporated into present clinic nutrition education. Whether improvements in growth monitoring would further significantly improve nutrition education remains to be seen.

PIP: Between December 1985-November 1986, survey data from 907 mothers of 2-year-old children in 8 Catholic Relief Services (CRS) clinics in Mahale's Hoek and Mafeteng districts in Lesotho were analyzed to determine if attendance at a typical nationwide clinic-based growth monitoring program improved maternal knowledge of weaning practices and diarrhea management. 85% of the mothers were Basotho women. At the clinics, the mothers did not undergo individual counseling or receive training in growth charts. Group nutrition education efforts did occur, however, but separately from the program. Mothers who attended a clinic had a significantly higher increased knowledge of the appropriate timing for introducing animal protein rich foods and about the use of oral rehydration salts than those who did not attend (p.05). This association was especially significant for mothers with only primary education and those with infants 6 months old. The mothers reported breast feeding a mean of 2 years. 85% knew to introduce cereals and liquids between 4-6 months old. Yet few mothers knew how to appropriately stop breast feeding. For example, 50% believed it should stop in 1 day. The researchers believed that the separate group nutrition activities contributed to the positive effect of clinic attendance on maternal knowledge of nutrition and diarrhea management. Other research needs to be done to determine if teaching of growth charts and individual counseling would significantly improve maternal knowledge. Clinic staff delivering improved educational messages could have a significant positive effect on the growth and health of Basotho children who are undergoing weaning.

Weight gain variation in infants of an impoverished community: Bellanse, Haiti.

Maintaining adequate growth remains one of the most difficult tasks for infants in developing countries. A cohort of rural infants (n = 354), median age four months, were weighed every 6-7 weeks over an 18-month period. Some 179 infants (51%) with weight information over at least 12 months were included in the study. The association between weight gain up to 6 months of age, and between 6 and 23 months of age, and factors amenable to prevention were assessed using weighted multiple linear regression. Infants whose mothers understood the 'Road to Health' chart had a weight gain that was 123 g/month (95% confidence interval (CI): 2-245) higher up to six months of age and 31 g/month (95% CI: 6-57) higher between 6 and 23 months of age compared to infants whose mothers did not seem to understand the chart. The weight gain between 6 and 23 months was also 28 g/month (95% CI: 3-54) higher for infants fully vaccinated at 11 months compared to not fully vaccinated children. It was 47 g/month (95% CI: 16-78) higher for infants living in two-parent families compared to children of a single-parent family. The results of the study suggest that maternal comprehension of the 'Road to Health' chart may contribute to more adequate weight gain.

PIP: Maintaining adequate growth remains 1 of the most difficult tasks for infants in developing countries. A cohort of 354 rural infants with a median age of 4 months were weighed every 6-7 weeks over an 18-month period. Some 179 of them (51%) with weight information over at least 12 months were included in the study. The association between weight gain up to 6 months of age and between 6-23 months of age, and factors amenable to prevention were assessed using weighted multiple linear regression. Infants whose mothers understood the "Road to Health" chart had a weight gain that was 123 g/month (95% confidence interval [CI]: 2-245) higher up to 6 months of age and 31 g/month (95% CI: 6-57) higher between 6-23 months of age compared to infants whose mothers did not seem to understand the chart. The weight gain between 6-23 months was also 28 g/month (95% CI: 3-54) higher for infants fully vaccinated at 11 months compared to not fully vaccinated children. It was 47 g/month (95% CI: 16-78) higher for infants living in 2-parent families compared to children from a single-parent household. The results of the study suggest that maternal comprehension of the "Road to Health" chart may contribute to more adequate weight gain.