Why Are Half of Women Interested in Participating in Group Prenatal Care?

OBJECTIVE: To determine the likelihood of participating in group prenatal care (GPC) and associated factors among low-risk women receiving traditional prenatal care from obstetricians, family physicians or midwives, and to determine factors associated with likelihood of participating. METHODS: Prior to completing a self-administered questionnaire, a 2-min compiled video of GPC was shown to pregnant women receiving traditional prenatal care. Data were collected on opinions of current prenatal care, GPC, and demographics. Biologically plausible variables with a p value ≤0.20 were entered in the multivariable logistic regression model and those with a p value <0.05 were retained. RESULTS: Of 477 respondents, 234 [49.2%, 95% confidence interval (CI) 44.6-53.6%] reported being "definitely" or "probably likely" to participate in GPC. Women were more likely to participate in GPC if they had at least postsecondary education [adjusted odds ratio (aOR) 1.84, 95% CI 1.05-3.24], had not discussed labour with their care provider (aOR 1.67, 95% CI 1.12-2.44), and valued woman-centeredness ("fairly important" aOR 2.81, 95% CI 1.77-4.49; "very important" aOR 4.10, 95% CI 2.45-6.88). Women placed high importance on learning components of GPC. The majority would prefer to be with similar women, especially in age. About two-thirds would prefer to have support persons attend GPC and over half would be comfortable with male partners. CONCLUSION: Approximately half of women receiving traditional prenatal care were interested in participating in GPC. Our findings will hopefully assist providers interested in optimizing satisfaction with traditional prenatal care and GPC by identifying important elements of each, and thus help engage women to consider GPC.

What is the most bothersome lower urinary tract symptom? Individual- and population-level perspectives for both men and women.

BACKGROUND: No study has compared the bothersomeness of all lower urinary tract symptoms (LUTS) using a population-based sample of adults. Despite this lack of evidence, investigators have often cited their LUTS of interest as the "most bothersome" or "one of the most bothersome." OBJECTIVE: To compare the population- and individual-level burden of LUTS in men and women. DESIGN, SETTING, AND PARTICIPANTS: In this population-based cross-sectional study, questionnaires were mailed to 6000 individuals (18-79 yr of age) randomly identified from the Finnish Population Register. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The validated Danish Prostatic Symptom Score questionnaire was used for assessment of bother of 12 different LUTS. The age-standardized prevalence of at least moderate bother was calculated for each symptom (population-level burden). Among symptomatic individuals, the proportion of affected individuals with at least moderate bother was calculated for each symptom (individual-level bother). RESULTS AND LIMITATIONS: A total of 3727 individuals (62.4%) participated (53.7% female). The LUTS with the greatest population-level burden were urgency (7.9% with at least moderate bother), stress urinary incontinence (SUI) (6.5%), nocturia (6.0%), postmicturition dribble (5.8%), and urgency urinary incontinence (UUI) (5.0%). Burden from incontinence symptoms was higher in women than men, and the opposite was true for voiding and postmicturition symptoms. At the individual level, UUI was the most bothersome for both genders. Although the response proportion was high, approximately a third did not participate. CONCLUSIONS: Both men and women with UUI report moderate or major bother more frequently than individuals with other LUTS. At the population level, the most prevalent bothersome symptoms are urgency, SUI, and nocturia. PATIENT SUMMARY: Urinary urgency was the most common troubling symptom in a large population-based study; however, for individuals, urgency incontinence was the most likely to be rated as bothersome.